The Mechanism of Urine Production

1. Glomerular Filtration

Urinary formation begins with plasma filtration in the glomerulus, like other body capillaries,

glumerular capillaries are relatively impermeable to large plasma proteins and sufficiently

permable to water and smaller solutions such as electrolytes, amino acids, glucose, and

nitrogen residues. Renal blood flow (RBF = Renal Blood Flow) is about 25% of cardiac

output or about 1200 ml / min. About one fifth of plasma or about 125 ml / min is passed

through the glomerulus to the bowman's capsule. This is known as the glomerular filtration

rate (GFR). The movement into the bowman's capsule is called the filtrate. The filtration

pressure comes from the pressure difference between the glomerular capillaries and the

bowman's capsule, the blood hydrostatic pressure in the glomerular capillaries facilitates

filtration and this strength is countered by the hydrostatic pressure of the filtrate in the

bowman's capsule and the osmotic pressure of the blood colloids. Glomerular filtration is not

only influenced by the above colloidal pressures but also by capillary wall permeability.
2. Reabsorption

Reabsorption is the second process after glomerular filtration. Reabsorption is the process of

transferring fluid from the renal tubules to the surrounding blood vessels, namely the

capitular capillaries. Renal tubule cells selectively reabsorb the substances present in the

primary urine where reabsorption occurs depending on needs. Food substances contained in

primary urine will be reabsorbed as a whole, while reabsorption of inorganic salts is

reabsorbed depending on the amount of inorganic salts in blood plasma. The reabsorption

process occurs in the proximal tubule portion of the tubule which will be produced secondary

urine after the reabsorption process is complete. The process of water reabsorption in the

proximal tubule and the the distal tubule. The reabsorption process will occur filtering of

amino acids, glucose, acetic acid, vitamins, inorganic salts and water. After the formation of

secondary urine in the secondary urine does not already contain the substances needed by the

body anymore so that later urine that is removed really has substances that are not needed by

the human body

3. Secretion

Tubular secretion involves the active transfer of molecules from the bloodstream through the

tubules into the filtrate. Many substances that are secreted do not occur naturally in the body

(for example penicillin). Substances that naturally occur in the body include uric acid and

potassium and hydrogen ions. In the distal tubules, active transfor- mation of the sodium

carrier system is also involved in the secretion of hydrogen and tubular potassium ions. In

this connection, each time the carrier carries sodium out of the tubular fluid, the carrier can

be hydrogen or potassium ions into the tubular fluid "on its way back" so, for every sodium

ion absorbed, hydrogen or potassium must be secreted and vice versa. The choice of cations

to be secreted depends on the concentration of extratubular fluid (CES) from these ions

(hydrogen and potassium). Knowledge of cation exchange in the distal tubule helps us

understand some of the relationships that electrolytes have with others. For example, we can

understand why aldosterone blockers can cause hyperkalemia or why initially there is a

decrease in plasma potassium when severe acidosis is corrected therapeutically. About one

third of the total body fluid volume is in the extracellular space. Approximately 25% of this

amount is plasma, and the remainder is interstitial fluid.

Ref:

1. Silbernagl, Stefan. Teks & Atlas Berwarna Patofisiologi . Dalam : Lang F,editor. Jakarta :

EGC ; 2007.