Renal system

Renal system composition

• complex fxn of maintaining fluid homeostasis.

comprises of:
• Kidney- urine formation
• ureters
• urinary bladder
• urethra • Urine excretion
 Functions
 Main fxn: Excretion of waste substances to maintain
homeostasis.

 Other important functions:

 Blood volume regulation by excretion or conservation
of water
 Blood electrolyte content by the excretion or
conservation of minerals
 Regulation of the acid–base balance of the blood by
excretion or conservation of ions such as H ions or HCO
ions
 Regulation of all of the above in tissue fluid.
.
 Other functions
Endocrine function:
Haemopoetic fxn
– Erythropoietin
– Thrombopoietin
BP regulation via:
– Renin
blood calcium level regulation:
– 1,25-dihydroxycholecalciferol (calcitriol) activation
under the parathyroid hormone.
 Anatomical location
• Primarily
retroperitoneal
• Extend from T12 - L3
spine
 Variations In Position
Positional variation:
Embryological or surgically
- respiration & posture (2cm)
• Abdomino-pelvic
-Horseshoe-shaped kidney (note
relation with inferior mesenteric
artery)
• Pelvic kidneys
Radiological location
-Ultra-sonography
-Contrast media studies (CT)
-MRI Dr. J. AHENKORAH
 Fascia coverings
• Embedded in adipose
tissue.
• Perirenal fat
• cushioning
• Pararenal body/fat
• Renal fascia: fibrous
CT: holds it in place
• Floating kidneys:
different position
 STRUCTURE OF THE KIDNEYS
• Oval (bean-shaped), reddish-brown
(fresh)
• Dimensions
– Length: 10-11cm
– Breadth: 5-6cm
– Thickness (AP): 2.5-3cm;
– Weight: 135- 150g
• Poles, surfaces & borders
– Superior & inferior poles
– Anterior & posterior surfaces
– Medial border
• Concave between poles & convex
adjacent to them
• Renal hilum (hilus); renal sinus
• Renal pelvis & renal vessels
– Lateral border
• Convex Dr. J. AHENKORAH
Internal structure
 Lobes (5-11)
 renal cortex-renal corpuscles
and convoluted tubules
 renal medulla –
• pyramids-loops of Henle and
collecting tubules
 Renal columns-part of cortex
that project b/n pyramids--
renal vessels enter & exit
kidney
 Renal pelvis
– Major and minor calyces

• Urine flows from the renal

pyramids into the calyces, then
to the renal pelvis and out into
the ureter.
 structural and functional unit of
the kidney.
• nephrons: approx 1
mil

• Two(2) major
portions:
– renal corpuscle
– renal tubules.
The Nephrons
 Renal corpuscle
 A Glomerulus surrounded by a
Bowman’s capsule.
 Glomerulus = capillary network
formed from an afferent +
efferent arteriole.
 Unequal arteriole diameter, thus
high BP.

 Bowman’s capsule
 expanded end of a renal tubule
enclosing glomerulus.
 Inner layer; podocyte creates
pores thus permeable.
• Juxtaglomerullar cells
 Outer layer
 In btn layers is space to contains
Renal filtrate
• The Renal corpuscle
 The Juxtaglomerulus Appaaratus

 The Juxtaglomerulus Appaaratus

• Macula densa
• Extraglomerular mesangial cells
• Juxtaglomerullar cell
 Renal tubules
 Proximal convoluted
tubule + loop of Henle &
distal convoluted tubule.

• Collecting
tubules→papillary
ducts→calyx of pelvis

• Microvilli in PCT

• NB: peritubular
capillaries- reabsorption
of materials
• Macula densa -sensors
 • Gross Blood supply

Renal artery major branches (L1-L2 IV DISC)-

20% cardiac output
FURTHER BLOOD FLOW
• afferent arterioles, blood flow→
glomeruli (capillaries) →efferent
arterioles →peritubular capillaries
→venules →renal vein → inferior
vena cava.

• NB: Two(2) sets of capillaries; 2

sites of exchanges
• The Glomerulus & the
Peritubular capillaries
 Urine formation
 3 major process:
 glomerular filtration
(renal corpuscles).

 tubular reabsorption

 tubular secretion
(renal tubules)
 Glomerular filtration
 BP forces plasma, dissolved substances, and small
proteins out of the glomeruli and into Bowman’s capsules.

 renal filtrate results: approx 20—25% of glomerular blood

 Content = plasma without proteins & blood cells
• NB: Filtration is not based on usefulness but size.
 Glomerular filtration rate (GFR) = amount of renal filtrate
formed by the kidneys in minute;
• average 100 - 125 mL/min.

• GFR is affected by rate of kidney blood flow

• ↑flow → ↑GFR →↑ filtrate & vice versa;eg. Hemorrhage
 Tubular reabsorption
 Occurs btn renal tubules (65% PCT) & the peritubular capillaries

 150 to 180 liters of filtrate in a 24hr period but 1-2litrs of urine

output.

 99% of the filtrate is reabsorbed into peritubular capillaries with only

about 1% of the filtrate enters renal pelvis as urine.

 Mechanism for reabsorption

 Active transport: use of ATP by cell for molecule transportation from
filtrate into blood. Eg glucose, calcium (PTH), & Na/K (aldostorone)
base on threshold levels.
 Passive transport: esp for negative ions follows when the positive
ions are being reabsorbed.
 Osmosis: water following mineral reabsorption eg. Na
 Pinocytosis. Eg protein carriage in vessicles
 Tubular secretion
• Active secretion of sub.
from blood in peritubular
capillaries into the filtrate
in the renal tubules.

• Waste products.
– ammonia, creatinine,
Hydrogen ions and the
metabolic products of
medications.
 Hormones that influence the
reabsorption of water
• Aldostorne(adrenal cortex)- in response to low
BP; ↑Na uptake into blood & ↑ K excretion.

• Antinatriuretic peptide: ↓Na uptake

• Antidiuretic hormone(ADH)-in response to low

BP
 THE URETERS
• Length: 25-30cm
• Retroperitoneal

• Constrictions
-ureteropelvic junction
-Bifurcation of common
iliac
-Opening into bladder

Blood supply
Peristaltic contractions
Innermost- Tunica Mucosa
- middle- Tunica Muscularis
(made of smooth muscle) Dr. J. AHENKORAH
- outer-Tunica Adventitia
 Urinary Bladder
 A musculo-membranous sac behind pubic symphysis
which acts as a reservoir for the urine.

 Its size, shape, position and relations all vary according

to content and the state of neighbouring viscera.

 500ml max capacity

 Transitional epithelium- inner lining
 Rugae-fold when empty
 Trigone -∆area at ureter & urethra opening
 Detrusor muscle-spherical, contracts to empty
 Internal urethral sphincter

Dr. J. AHENKORAH
 Urethra
Carries urine to exterior
• Female = 1-1.5inch, male
=7-8inches

• External urethral
sphincter- pelvic floor
skeletal mscl(voluntory)

• Parts(males):
 Prostatic urethra
 Membranous urethra
 Carvenous/spongy
urethra
 Urinary reflex
• reflex is a spinal cord reflex over which voluntary
control may be exerted.

• Stimulus - detrusor muscle stretching-

 Reflex activated around 200-400mls urine
 sensory impulses →the sacral spinal cord.
 Motor impulses →parasymp nerves →detrusor
muscle→contraction (int. urethral sphincter
relaxes).
 voluntary contraction of the external urethral sphincter
--prevents urine.
 Enuresis/ Bedwetting????
 Characteristics of urine
• Amount: 1-2litres. Oligourea -Diarhoea, sweat; Polyuria-
excess fluid intake, alcohol.

• Color- yellow(straw/amber)-urochrome. cloudy, coca-cola).

• Specific gravity—normal range =1.010 to 1.025 (measure of

dissolved sub); low in diabetes insipidus and high in diabetes
mellitus, acute renal failure and excess medications.

• pH— range (4.6-8);diet influenced;vegetarian &high protein.

• Nitrogenous wastes: nitrogen content; urea-protein

metabolisn, creatinine- creatinine phosphate metabolism in
muscle cells, Uric acid- nucleic acids(DNA/RNA) metabolism.
• Non-nitrogenous waste -urobilin from hemoglobin; drugs
 Ageing & urinary system
• Reductions of nephrons occurs with ageing
• ½ by age 70-80

• GFR reduces partly due to artherosclerosis.

• urinary bladder & detrusor muscle decreases

• Urinary incontinence.

• UTI- common
 Acid – base balance
• Maintenance of acid–base homeostasis is accomplished
by the :

 kidneys.

 buffer systems in body fluids

 Rate and depth of respiration