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INDARGAIRI
UNIVERSITAS MEGA REZKY
SISTEM PERKEMIHAN
• Anatomi ginjal
• Fungsi ginjal (ren)
• Proses produksi urine
– Filtrasi oleh glomerulus
– Reabsorbsi oleh tubulus
– Sekresi oleh tubulus
• Evaluasi fungsi ginjal
• Transportasi, penyimpanan, dan ekskresi urine
Fungsi ginjal:
1.Regulasi komposisi ion darah
2.Regulasi pH darah
3.Regulasi volume darah
4.Regulasi tekanan darah
5.Pemeliharaan osmolaritas darah (300
mOsm/l)
6.Produksi hormon (calcitriol &
erythropoetin)
7.Regulasi tingkat glukosa darah
8.Ekskresi sampah
ANATOMI GINJAL
Struktur Ginjal
http://images.google.co.id/imgres?imgurl=http://academic.kellogg.cc.mi.us/herbrandsonc/bio201_McKinley/f27-9a_urinary_bladder_c.jpg&imgrefurl=http://academic.kellogg.cc.mi.us/herbrandsonc/bio201_McKinley/Urinary
%2520System.htm&h=490&w=800&sz=135&hl=id&start=3&tbnid=PjiUmIL-b7BE7M:&tbnh=88&tbnw=143&prev=/images%3Fq%3Dmicturition%2Breflex%26svnum%3D10%26hl%3Did%26lr%3D%26sa%3DG
Nephron:
1. Kapsul:
a. Glomerulus
b. Bowman’s capsule
2. Tubulus:
a. Proximal convoluted tubule
b. Loop of Henle
c. Distal convoluted tubule
Collecting duct
Papillary duct
http://www.farmakologija.com/materia/images/nephron.gif
http://coe.fgcu.edu/faculty/greenep/kidney/glomer3.jpg
Vaskularisasi Ginjal
• Aorta
Peritubular venules
• Afferent arterioles
Peritubular capillaries
http://www.colorado.edu/eeb/web_resources/cartoons/nephr.gif
Filtrasi oleh Glomerulus
• Filtrat glomerular = 150 l (F)/ 180 l (M); Fraksi filtrasi (16-
20%); 99% filtrat direabsorbsi (ekskresi 1-2 l)
• Net filtration pressure (NFP)
1. Glomerular blood hydrostatic pressure (GBHP) = 55 mmHg
2. Capsular hydrostatic pressure (CHP) = 15 mmHg
3. Blood colloid osmotic pressure (BCOP) = 30 mmHg
NFP = GBHP – CHP – BCOP = 10 mmHg
• Glomerular Filtration Rate (GFR): jumlah filtrat
terbentuk di dalam corpusculi renalis per menit =
125 ml/min (M) atau 105 ml/min (F)
• Regulasi GFR
1. Autoregulasi renal
1. Mekanisme myogenik
2. Umpan balik tubuloglomerular
2. Regulasi saraf simpatis
3. Regulasi hormonal
1. Angiotensin II
2. Atrial natriuretic peptide (ANP)
1. Autoregulasi renal
1. Mekanisme myogenik:
BP RBF GFR regangan arteriola afferent
kontraksi otot arteriola afferent lumen menyempit
GFR ke tingkat semula
http://people.eku.edu/ritchisong/554images/proximal_tubule.jpg
• Osmosis air (tub. prox. & descending limb of Henle -> permeable)
• Difusi pasif: Cl- (50%), K+ (65%), Ca2+, Mg2+, HPO42+
• Hepatosit: Ammonia (NH3) urea filtrasi & sekresi
• Deaminasi asam amino ammonia
Reabsorbsi di Loop of Henle
• Akhir tubulus proximalis: osmolaritas = darah
• Loop of Henle:
– Descending limb reabsorbsi 15% air
– Thick ascending limb impermeable thd. air
– Reabsorbsi HCO3- (10-20%)
• Sistem Na+ -K+ -2Cl- symport:
– Reabsorbsi Na+ & Cl- (35%)
– K+ kembali ke tubulus
• Reabsorbsi kation: Na+, K+,Ca2+ (20-30%), Mg2+
• Akhir loop of Henle: osmolaritas
http://www.mscd.edu/~biology/2320course/2320images/nephron.jpg
Reabsorbsi di Tubulus Distalis
• Sistem Na+ -Cl- symport
• Hormon parathyroid reabsorbsi Ca2+
• Reabsorbsi air 10-15%
• Akhir tubulus distalis: 90-95% ion & air terserap
http://www.varimed.hu/hypertension/pha/img/pha_577.gif
Reabsorbsi & Sekresi di Ductus Collectivus
Principal cells: reabsorbsi Na+ & sekresi K+
• Intercalated cells: reabsorbsi K+ & HCO3- ;
sekresi H+
http://users.rcn.com/jkimball.ma.ultranet/BiologyPages/N/nephron.gif
Regulasi Reabsorbsi & Sekresi oleh Hormon
• Sistem Renin – Angiotensin – Aldosteron
• Vol darah sel juxtaglomerular
renin angiotensin
converting enzyme
2. Countercurrent flow
• Proses Produksi Urine Pekat
1. Symporters di thick ascending limb (Na+, K+, Cl-)
gradien osmotik di medula renalis. Air tak direabsorbsi