FISIOLOGI TERAPI LATIHAN

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INTRODUCTION
Exercise induces profound changes in the renal haemodynamics
Effective renal plasma flow is reduced during exercise.
The reduction is related to the intensity of exercise and renal blood flow
may fall to 25% of the resting value when strenuous work is performed.
The combination of sympathetic nervous activity and the release of
catecholamine substances is involved in this process.
Plasma volume decreased  activate the Renin-Angiotensin-
Aldosterone System (RAAS)  Water and salt conservation mechanism
~ RENAL RESPONSE TO EXERCISE

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RENAL RESPONSE TO
EXERCISE
Reduced arterial pressure and blood volume (~ plasma
volume)  release of renin from the kidneys.
Renin release is mediated by the sympathetic nervous system
 direct effect of arterial pressure on the kidneys  renal
blood flow  decrease of GFR  Retention of water and
salt

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 RAAS
Renin + angiotensinogen  Angiotensin I
Angiotensin I + angiotensin-converting enzyme (ACE) 
Angiotensin II
Angiotensin II :
• Powerful arteriolar vasoconstrictor  increase systemic
vascular resistance (SVR)
• Reduces sodium excretion by increasing sodium reabsorption
by proximal tubules of the kidney.
• Causes the release of aldosterone from the adrenal cortex.
• Causes the release of ADH from the posterior pituitary gland.

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 PRODUCTS OF RAAS
Aldosterone  reduce renal excretion of sodium  Retention of
sodium
• Retention of sodium paves the way increasing blood volume
Antidiuretic hormone (ADH) , also known as Arginine
vasopressin (AVP)
• ADH  decrease renal excretion of water  concentrated urine.
• ADH release stimulates the thirst centre  encourage water intake
 Correct the water deficit

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Thank You

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KIDNEY DISEASE

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SPECIAL CONSIDERATIONS

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SPECIAL CONSIDERATIONS…

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