Endocrine function of the kidney

By
Dr. Isam Eldin Mohamed abd Alla
 Renin–Angiotensin system:
• Renin is a polypeptide hormone secreted by
the Juxtaglomerular cells in the wall of
afferent arteriole of kidneys, in response to:
↓ in systemic or renal blood pressure due to
hypovolaemia & hyponatraemia.
Sympathetic stimulation.
Catecholamines (Adrenaline & Nor
adrenaline).
↓ in flow rate of Na+ across macula densa at
the end of Loop of Henle.
• Angiotensinogen is a large protein
synthesized by the liver.
Renin acts on circulating angiotensinogen
to produce Angiotensin1 which is then
converted to Angiotensin11 by the action
of angiotensin converting enzyme (ACE)
secreted by the endothelial cells mainly In
lungs.
• AngiotensinII maintains BPr by:
Causing vasoconstriction.
 Stimulating contraction of the heart.
Stimulation of thirst centre,
Decreasing filtration in the kidneys.
Stimulation of Sodium & bicarbonate
reabsorption from renal PCT
 Stimulates Aldosterone secretion from
adrenal cortex. Aldosterone Stimulates
Sodium reabsorption from renal DCT, CD
Stimulation of Vasopressin secretion
from posterior pituitary gland.
Vasopressin is antidiuretic hormone ADH
that stimulates water reabsorption from
renal Collecting duct CD.
1.25 Dihydroxycholecalciferol (Calcitriol):
• Is the active metabolite of vitamin D
(Cholecalciferol).
• Vitamin D is found in animal diets & can
be synthesized in the skin from 7-
Dehydrocholesterol by the action of
ultraviolet (UV) rays in the sun light.
• Calcitriol is synthesized by hydroxylation
of vitamin D by 25Hydroxylase in the liver
& renal 1-α Hydroxylase in the kidneys.
• Vitamin D (Cholecalciferol) 25Hydroxylase→ 25
Hydroxy cholecalciferol (Calcidiol) 1-α
hydroxylase
→1.25 Dihydroxy cholecalciferol
(Calcitriol).
• The activity of renal 1-α Hydroxylase is
stimulated by the parathyroid hormone
(PTH).
Physiologic effects of Calcitriol:
1. Stimulates intestinal absorption of
Calcium & phosphates.
2. Facilitates renal reabsorption of Calcium
& phosphates.
3. Stimulates osteoblasts activity for bones
&teeth formation & mineralization.
Erythropoietin:
• Is a glycoprotein hormone that stimulates
erythropoiesis.
• 85—90% of erythropoietin is secreted by the
kidneys, 10—15% secreted by the liver.
• Half life is 5—7 hours
• Stimuli for secretion are:
↓O2 at tissue level (hypoxia): main stimulus
 Catecholamines.T3, T4.& Glucocorticoids
Prostaglandins.
Androgens.
Cobalt salts.
• Erythropoietin deficiency in chronic renal failure
leads to anaemia
 Micturition (urination)
• the process of bladder emptying in,
• is governed by two mechanisms:
The micturition reflex.
 voluntary control.
• Urine is collected by the collecting ducts
into the renal pelvis.
• Peristaltic contractions of ureteric
smooth muscles move the urine from the
renal pelvis to the bladder.
Urine collection
• The ureters pass obliquely through the
bladder wall, thus are kept closed,
preventing urine reflux from the bladder..
• The bladder wall contains spiral,
longitudinal, and circular bundles of
smooth muscle .
• The urethra is controlled by internal
urethral sphincter of smooth muscles &
external urethral sphincter of skeletal
muscle
 Urinary Bladder:
Has a property
of plasticity,
thus has a
capacity
of 400 ml.
• The micturition reflex:
Stimulus: urine volume 300- 400 ml
(stretch)
Receptors: Stretch receptors in the
bladder wall.
Afferent (Sensory): Sacral fibers.
Centre: Sacral segments of spinal cord.
 Efferent: Parasympathetic sacral fibers in
the pelvic nerves, & somatic sacral fibers
in the pudendal nerve.
Response: Contraction of the circular
(Detrusor) muscle, with relaxation of
urethral sphincters empties the bladder.
NOTE:
Part of the urethra pass through the
prostate gland, thus enlargement of the
prostate can obstruct the urine flow (Urine
retention)
Female male