THIRD EDITION

HUMAN PHYSIOLOGY
AN INTEGRATED APPROACH
Dee Unglaub Silverthorn, Ph.D.

Chapter 19
The Kidneys

PowerPoint® Lecture Slide Presentation by

Dr. Howard D. Booth, Professor of Biology, Eastern Michigan University
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
About this Chapter

• Anatomy of the excretory system

• How the kidney is organized
• How the nephron works to filter blood, recycle,
secrete, and excrete
• How filtration is regulated
• Urination reflex

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Kidney Functions

• Filter 200 liters of blood daily, allowing toxins,

metabolic wastes, and excess ions to leave the
body in urine
• Regulate volume and chemical makeup of the
blood
• Maintain the proper balance between water and
salts, and acids and bases

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Other Renal Functions

• Gluconeogenesis during prolonged fasting

• Production of renin to help regulate blood
pressure and erythropoietin to stimulate RBC
production and activation of Vitamin D
• Homeostatic regulation: ECF volume, osmolarity,
ion & pH balance
• Excretion: Metabolic wastes & foreign molecules

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Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Excretory System: Anatomy Review

• Kidney
• Cortex
• Medulla
• Pelvis
• Nephrons
• Ureter
• Bladder
• Urethra

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Urinary System Organs

Figure 25.1a
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Kidney Location and External Anatomy

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Kidney Location and External Anatomy

• The bean-shaped kidneys lie in a retroperitoneal

position in the superior lumbar region and extend
from the twelfth thoracic to the third lumbar
vertebrae
• The right kidney is lower than the left because it is
crowded by the liver
• The lateral surface is convex and the medial
surface is concave, with a vertical cleft called the
renal hilus leading to the renal sinus
• Ureters, renal blood vessels, lymphatics, and
nerves enter and exit at the hilus
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Internal Anatomy

Figure 25.3b
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Other Urinary System Organs

• Urinary bladder – provides a temporary storage

reservoir for urine
• Paired ureters – transport urine from the kidneys
to the bladder
• Urethra – transports urine from the bladder out of
the body

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The Nephron

• Nephrons are the structural and functional units

that form urine, consisting of:
• Glomerulus – a tuft of capillaries associated
with a renal tubule
• Glomerular (Bowman’s) capsule – blind, cup-
shaped end of a renal tubule that completely
surrounds the glomerulus

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Kidney Functions: Overview

Figure 19-3: The excretion of a substance depends on the amount that was filtered, reabsorbed, and secreted

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Nephron Functions: Overview

Figure 19-2: Filtration, reabsorption, secretion, and excretion

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Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings
Glomerulus & Bowman's Capsule: Blood Filtration

• Capillaries
• Podocytes
• Mesanglial cells
• Bulk flow
• Solutes
• Water
• (Few proteins)
• (Not cells)

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Glomerulus & Bowman's Capsule: Blood Filtration

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Glomerular Flow Rate (GFR)
• Capillary
• Hydrostatic
pressure
• Colloidal
• Capsule pressure
• Back pressure
• Net Filtration p
• GFR  180L/day
(about 1% is
excreted)
Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19-6: Filtration pressure in the renal corpuscle
Glomerular Flow Rate (GFR)

Figure 19-5: The filtration fraction

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Regulation of GFR
• Autoregulation
• Myogenic stretch
• Tubuloglomerular feedback
• Macula densa
• J G cells
• ANS-Sympathetic
• Arteriole vasoconstriction
• Hormones/paracrines
• Angiotensin II
• Prostaglandins
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Regulation of GFR

Figure 19-9: The juxtaglomerular apparatus

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Reabsorption: 10 Active Transport
• (Passive diffusion in)
• Active Transport
• Na+ to ECF
• K+ into cell
• ATP-ase
• Uses energy
• Na+ ECF peritubular
capillaries
• Reabsorption  blood

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Reabsorption: 10 Active Transport

Figure 19-11: Sodium reabsorption in the proximal tubule

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Reabsorption: Secondary Active Transport

• Na+ linked 20 transport

• Symport
• Glucose
• Ions
• Amino acids
• Proximal tubule, key site

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19-12: Sodium-linked glucose reabsorption in the proximal tubule
Reabsorption: Passive Transport & Trancytosis

• Passive Transport of urea

• Na+ pumped out
• H2O follows
• Passive
•  [urea]
• [urea] higher than ECF
• passive diffusion to ECF
• Trancytosis of proteins

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Reabsorption: Passive Transport & Trancytosis

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19-13: Passive reabsorption of urea in the proximal tubule
Reabsorption: Receptors can Limit

• Transport maximum
• Saturation (# of receptors)
• Competition
• Specificity
• Renal Threshold
• Example: glucosuria

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Reabsorption: Receptors can Limit

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19-15: Glucose handling by the nephron
Secretion: From Peritubular Blood vessels & ECF

Figure 19-2 : Filtration, reabsorption, secretion, and excretion

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Solute Clearance: Rate of removal from the Blood

• Information on
Kidney Function
• GFR
• Reabsorption
rates
• Secretion rates

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Excretion:
All Filtration Products that are not reabsorbed

• Excess ions, H2O, molecules, toxins, "foreign

molecules"
• "nitrogenous waste": NH4+ and excess urea
• Kidney Ureter  bladder urethra
out of body

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Excretion:
All Filtration Products that are not reabsorbed

Figure 19-5: The filtration fraction

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Urination: Micturation reflex

• Bladder:
• smooth muscles
• internal sphincter
• external sphincter
• Regulation

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Urination: Micturation reflex

Copyright © 2004 Pearson Education, Inc., publishing as Benjamin Cummings Figure 19-18: The micturition reflex
Summary

• Kidney produces urine, ureter bladder

urethra
• Nephron filters, reabsorbs, secretes and excretes
• Arteriole pressure dictates GFR through
autoregulation, ANS and hormonal influences
• Most filtrate is reabsorbed & returned via
peritubular blood vessels; excess & toxic remains
are excreted
• Urination reflex uses involuntary and voluntary
paths

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