Human Physiology 451/551Renal PhysiologyExample QuestionSlide 4Slide 5Renal FunctionsSlide 7Slide 8Slide 9Hypertension TreatmentBody Fluid CompartmentsDistribution of Body WaterFluid CompartmentsSpecific Fluid CompositionElectrolyte CompositionOrgan Systems Affecting Body Fluid CompositionReliance on Circulation and Driving ForcesRenal Daily Filtration Excretion and ResorptionAnatomy of the KidneyLocalization of NephronsLayout of Individual NephronsRenal FlowGFRSlide 24Filtration Across the Renal CorpusclePodocytes and Fenestrated EndotheliumOther Features at the Renal CorpuscleSelective FiltrationCharge and Size ExclusionForces Affecting Filtration- PressureForces Affecting FiltrationOSMOLARITYWhat is Osmolarity?Osmotic PressureOsmotic Regulation Between Fluid CompartmentsDiseases Affecting GFR and FiltrationHydrostatic Pressures Across the Renal VasculatureControl of GFRHydrostatic Regulation of GFRMechanical Forces Affecting FiltrationTGF/JGAPowerPoint PresentationTGF/JGA- AutoregulationSlide 44RAS- Hormonal RegulationOther Hormones (ANP)Diagram of the Actions of ANPAutonomic Regulation of GFRReabsorption & Secretion Along the NephronOnly Small Amounts are ExcretedRenal Oxygen ConsumptionMass ActionClearanceCalculating ClearanceMeasuring GFR Using ClearanceMeasuring RPF Using ClearanceFree Water ClearanceSlide 58Examples of Renal DiseaseVolume ExpansionVolume Contraction-ANGIIStages of Renal DysfunctionESRDAwayda, 2016- PGY451Human Physiology 451/551 Renal Physiology- Dr. Awayda ([email protected], 242 Cary Hall)Lecture Organization (participation encouraged)Ask questions anytimeTime at the beginning of lectures to deal with questionsBring your questions to classAwayda, 2016- PGY451Renal PhysiologyWHAT ARE THE FUNCTIONS OF THE KIDNEYSAwayda, 2016- PGY451Example QuestionTrue or False: The amount of water excreted by the kidneys is always more than the amount of sodium excreted by the kidneys.a. TrueConcentration Water? Conc. NaCl?b. FalseEat lots Na+ sometimes? not always true, so false?Awayda, 2016- PGY451Renal PhysiologySO…WHAT ARE THE FUNCTIONS OF THE KIDNEYSAwayda, 2016- PGY451Renal PhysiologyMAIN FUNCTION: FLUID HOMEOSTASISAwayda, 2016- PGY451Renal FunctionsTransport• Regulation of water and inorganic ion balance•e.g., Na+, K+, Cl-, Ca++, Mg++, H+, etc...• Removal of waste byproducts from the blood•e.g., urea, ammonia, creatinine, other non-nitrogenous waste Hormonal•Renin•1,25-dihydroxyvitamin D3•Gluconeogenesis•ErythropoietinAwayda, 2016- PGY451Renal FunctionsTransport• Regulation of water and inorganic ion balance•e.g., Na+, Cl-, etc...•Removal of waste byproducts from the bloode.g., Urea, ammonia, creatinine, other non-nitrogenous wasteUreaproteins amino acids NH2 removed ammonia, liver converts to urea Uric acidnucleic acid catabolismCreatininecreatine phosphate catabolism Hormonal•Renin•1,25-dihydroxyvitamin D3•GluconeogenesisAwayda, 2016- PGY451Renal FunctionsTransport• Regulation of water and inorganic ion balance•e.g., Na+, K+, Cl-, Ca++, Mg++, H+, etc...• Removal of waste byproducts from the blood•e.g., urea, ammonia, creatinine, other non-nitrogenous waste Hormonal•Renin•1,25-dihydroxyvitamin D3•Gluconeogenesis•ErythropoietinAwayda, 2016- PGY451Renal FunctionsTransport• Regulation of water and inorganic ion balance•e.g., Na+, Cl-, etc...FLUID HOMEOSTASISAwayda, 2016- PGY451Hypertension Treatment DiureticsACE/AngII inhibitorsARBAdrenergic BlockersVasodilatorsC.O.= S.V. x H.R. (FLUID HOMEOSTASIS)Increase: UNa.V, and/or UvAwayda, 2016- PGY451Body Fluid CompartmentsIntracellular•ICFExtracellular•ECF•Plasma•Interstitial•Other FluidsPAwayda, 2016- PGY451Distribution of Body WaterIn a typical 70 Kg (156 lbs) individual:Approximately 60% (40L) of body weight is water!1/3 of this is extracellular (ECF)2/3 of this is intracellular (ICF)Awayda, 2016- PGY451Fluid CompartmentsHuman Anatomy and Physiology 6th edition, E. Marieb VERY STABLEAwayda, 2016- PGY451Specific Fluid CompositionTotal Body Volumes (mEq) Plasma Interstitial IntracellularNa+ 135-145 135-145 10-30Cl- 95-105 95-105 10-20K+ 3-5 3-5 120-145Ca++ 1-2 1-2 0.0001Protein 10-20 <1 50 Osmolarity 295 295 295Awayda, 2016- PGY451Electrolyte CompositionModified from: Human Anatomy and Physiology 6th edition, E. Marieb ICF Vs. ECFReversed Na+/K+ ConcentrationsVery low ICF Ca++ISOTONICAwayda, 2016- PGY451Organ Systems Affecting Body Fluid Composition RespiratoryGI tractIntegumentRenalHuman Anatomy and Physiology 6th edition, E. MariebSKINAwayda, 2016- PGY451Reliance on Circulation and Driving ForcesAll are EpitheliaAll Limited by DiffusionDistance DiffusionTime Significance100Ang 0.0000001S Cellmembranethickness1micron 0.001secSizeofmostbacteriaormitochondria10microns 0.1secDiameterofsmalleukaryoticcells100microns 10secDiameteroflargeeukaryoticcells250microns 1min Radiusofgiantsquidaxon2millimeters 1hrThicknessoffrogsartoriusmuscle,halfthicknessoflensofeye5millimeters 7hrRadiusofmatureovarianfollicle2centimeters 5daysThicknessofventricularmyocardium10Cent 120daysDiameterofseaurchins&othersmallanimals1meter 32yrs HalfheightofhumanDatafromRobertMacey.Mathematicalmodelsofmembranetransportprocesses.In:MembranePhysiology,editedbyThomasAndreoli,JosephHoffman&DarrellFanestil.NY:Plenum,1980,p.125-146.Awayda, 2016- PGY451Renal Daily Filtration Excretion and ResorptionSubstance Filtered Excreted Resorbed (%Resorbed)Water(L) 180 1.5 178.5 99.2Na+(mEq) 25,200 150 25,050 99.4K+(mEq) 720 100 620 86.1Ca++(mEq) 540 10 530 98.2HCO3-(mEq) 4,320 2 4,318 >99.9Cl-(mEq) 18,000 150 17,850 99.2Glucose(mM) 800 0 800 ~100Urea(g) 56 28 28 50Osmolarity <295 50-1200Adapted from: Principals of Physiology, Berne and LevyAwayda, 2016- PGY451Anatomy of the KidneyAnatomical differences underlie physiological & functional differencesCortical, Medullary, & Pyramidal regionsBasic unit “Nephron”Varying depth of NephronsAwayda, 2016- PGY451Localization of NephronsFrom: