Excretory/Urinary System

As animals perform their various metabolic processes, protein and nucleic acid, both of which contain nitrogen, are
broken down. While some of the nitrogen is used to manufacture new nitrogen-containing molecules, much of it cannot
be used for this purpose and must be disposed of as waste. Typically, the first nitrogen-containing molecule that forms
is ammonia (NH3, which is very water-soluble, forming NH4OH, a strong base. In some way, this ammonia must be
gotten rid of before it raises the pH of the body fluids. Because ammonia is so water-soluble, aquatic animals often can
get rid of it just by diffusion into the surrounding water. That’s one reason why the water in your aquarium gets “bad”
and needs to be changed, and why not changing the water could kill the fish. However, ammonia doesn’t readily go
from body fluids into air, so terrestrial animals need other ways of getting rid of nitrogenous wastes.

The two most common substances used by terrestrial animals to get rid of excess nitrogen are urea and uric acid.
Many animal species that aren’t terribly concerned about water-loss, including humans, convert the ammonia to
urea, which is water-soluble and excreted in a water-based solution. Other organisms such as birds, insects, or
lizards, especially if they live in an arid area, must conserve water whenever possible, thus convert the NH3 to uric
acid. Uric acid is not water-soluble, thus can be excreted with little, if any, water with it. This is the white goo in
bird droppings. While the major portion of human nitrogenous waste is in the form of urea, humans typically
excrete some uric acid, too. Uric acid is another kind of purine like the adenine and guanine in our DNA
(structure to the right).

Gout is a disorder in which humans start to accumulate more than the usual amount of uric acid (caused by either the
body manufacturing excess uric acid or the kidneys not excreting enough of it) and since it’s not water-soluble, it gets
stored in the body, frequently in toe joints, causing pain and deformation of the joints involved as well as the formation
of kidney stones. Traditionally, people who had gout were put on diets low in purines to try to help alleviate the
condition, but according to the Merck Manual, now these people are doped up with drugs rather than given nutritional
counseling: [“Drugs are so effective in lowering the serum urate concentration that rigid restrictions of the purine
content of the diet usually is unnecessary.”]. Typically, gout is treated with colchicine, a deadly poison (see further
notes below)! Caffeine and its relatives, theobromine (in cocoa), and theophylline (in tea) are classified as xanthines
(a subgroup within the purines), thus it would make sense that people with gout should be counseled to avoid coffee,
tea, and chocolate.

Some insects, notably blowfly larvae (larvae of those shiny green or blue flies) excrete their nitrogenous wastes as
allantoin, another purine. Allantoin is known to be a “cell-proliferant,” thus is used to help wounds to heal. For
hundreds of years, people have recognized that the presence of blowfly larvae in a gangrenous wound actually helped it
to heal better. From about the turn of the century until the invention of a lot of synthetic drugs, blowfly larvae were
raised aseptically, and used to treat severe wounds. With the increase in availability of chemicals after World War II,
the use of blowfly larvae declined, but I’ve heard of several cases lately where, for some reason, this treatment was
necessary and/or preferred over synthetic drugs. It has been found that the fly larvae only eat dead, gangrenous tissue,
leaving the live, healthy tissue, and since their nitrogenous waste is allantoin, that stimulates the wound to heal, usually
with less scaring. In this procedure, small, sterile larvae are introduced into the wound and, if needed, traded for other
small ones when they get big.

We excrete nitrogenous wastes via our kidneys. Our kidneys are located on either side of the spine, just up under the
bottom ribs. They are well supplied with blood via the renal artery and renal vein. Urine made in the kidney collects
in the renal pelvis within the kidney, then flows down the ureter to the bladder where it is stored until voided. From
the bladder, the urine flows to the outside via the urethra, (which in the male also serves as part of the reproductory
tract).

The kidney is composed of an outer layer, the cortex, and an inner core, the medulla. The kidney consists of repeating
units (tubules) called nephrons. The “tops” of the nephrons make up or are in the cortex, while their long tubule
portions make up the medulla. To the right is a diagram
of an individual nephron. Each nephron has a closely
associated blood supply. Blood comes in at the
glomerulus and transfers water and solutes to the
nephron at Bowman’s capsule. In the proximal tubule,
water and some “good” molecules are absorbed back
into the body, while a few other, unwanted
molecules/ions are added to the urine. Then, the filtrate
goes down the loop of Henle (in the medulla) where more water is removed (back into the bloodstream) on the way
“down”, but the “up” side is impervious to water. Some NaCl (salt) is removed from the filtrate at this point to adjust
the amount in the fluid which surrounds the tubule. Capillaries wind around and exchange materials with the tubule. In
the distal tubule, more water and some “good” solutes are removed from the urine, while some more unwanted
molecules are put in. From there, the urine flows down a collecting duct which gathers urine from several nephrons. As
the collecting duct goes back through the medulla, more water is removed from the urine. The collecting ducts
eventually end up at the renal pelvis which collects the urine from all of them. The area where the collecting ducts
enter the renal pelvis is a common area for formation of kidney stones, often giving them a “staghorn” shape.
(clipart edited from Corel Presentations 8)

Antidiuretic hormone (ADH) from the pituitary is one factor influencing urine production. ADH promotes water
retention by the kidneys, and its secretion is regulated by a negative feedback loop involving blood water and salt
balances. ADH helps the kidney tubules reabsorb water to concentrate the urine. When the blood water level is too high
(when you’ve been drinking a lot of liquids), this acts as a negative feedback to inhibit the secretion of ADH so more
water is released. Ethanol also inhibits secretion of ADH, so a person who consumes a lot of alcoholic beverages could
excrete too much water (and maybe even become dehydrated). Many diuretics work by interfering with ADH
production, thus increasing the volume of urine produced. These diuretic effects are one reason why a person drinking
beer (alcohol) or coffee (caffeine) needs to urinate more frequently.

When a person’s kidneys cease functioning, due to illness or other causes, renal dialysis can be used on a short-term
basis to filter the person’s blood. This is not a perfect process; it can’t do everything a person’s kidneys can. Typically a
person is put on renal dialysis as a temporary measure to extend the person’s life until a kidney transplant can be found.
While life-saving, this procedure is often very inconvenient and stressful for the person. It requires spending long
periods of time, several days a week, hooked up to the dialysis machine: the person’s blood must actually pass into the
dialysis machine so the wastes can be filtered out, and then the blood is returned to the person’s body. This, combined
with symptoms caused by the renal failure (the inability of the person’s kidneys to function) often preclude working at
a job to earn the money to pay for the treatment. People can get by with one kidney, and the closest tissue match for a
kidney transplant is often a sibling. However, as one former student who was a kidney-transplant recipient pointed out,
even kidney transplants don’t last “forever”. Besides the constant workings of the person’s immune system to reject this
foreign tissue, whatever disease caused the problem in the first place will probably eventually also affect the
transplanted kidney. Since the same donor can’t provide another new kidney, this may mean going back on dialysis and
hoping a matching donor (accident victim) can be found before it’s too late.

Some diseases and disorders of the excretory system include:

• Nephritis is an inflammation of the glomeruli, due to a number of possible causes, including things like strep
throat. Symptoms include bloody urine, scant urine output, and edema (swelling/puffliness). Another, more
severe form, is due to an autoimmune attack on the glomeruli. Other types of nephritis affect the tubules.
• Nephrosis also affects the glomeruli, and is characterized by excretion of abnormally large amounts of
protein (often causing “foamy” urine) and generalized edema (water retension/swelling) throughout the
whole body, especially noted as “puffy” eyelids. Because these people’s kidneys often do not handle sodium
properly, a low-salt diet is usually prescribed. My younger brother developed nephrosis at age 4, and to
control it, had to stay on a no-added-salt diet and take prednisone on a regular basis from then until age 16, at
which point, his body finally responded positively to being weaned off the drug.
• Most urinary tract infections (UTIs) are caused by Gram negative bacteria such as E. coli. If there is an
obstruction of the urethra, catheterization may be needed, but as a general rule, catheterization in cases of
UTI is contraindicated because it can actually introduce pathogens and make the infection worse. Women
tend to acquire more urethral and bladder infections than men, perhaps because the opening of the urethra is
closer to the anus. The way a woman cleans the area after relieving herself can influence her chances of
contracting a UTI and/or vaginal infection. When parents are toilet-training toddlers, the common mistake is
to wipe young girls from back to front. The toddlers get used to this feeling, and when they start to wipe
themselves, they also go from back to front. This technique wipes bacteria from the anal area towards or into
the ends of the vagina and urethra. Rather, young girls should be trained to wipe from front to back, and
women who were not trained this way should make a conscious effort to change their habits.
• There are a variety of types of kidney stones depending on what conditions caused their formation.
According to the Merck Manual, in the United States, about 80% are calcium oxalate (and/or other calcium-
based stones), 5% are uric acid, 2% are cystine, and the other 13% due to magnesium ammonium phosphate
or other causes. Stones may be microscopic to large “staghorn” stones that fill the whole renal pelvis. Often,
as the stone is passed down the ureter, the person experiences much pain, and the affected kidney may even
temporarily become nonfunctional. Stones may be broken up by ultrasound so they can be passed more
easily, but large stones may have to be surgically removed. If possible, the underlying cause of the stone(s)
 should be identified and alleviated. For example, calcium stones might be caused by anything from a
parathyroid gland problem to too much vitamin D to some forms of cancer to a genetic predisposition.

Although the urinary system has a major role in excretion, other organs contribute to
the excretory function. The lungs in the respiratory system excrete some waste
products, such as carbon dioxide and water. The skin is another excretory organ that
rids the body of wastes through the sweat glands. The liver and intestines excrete
bile pigments that result from the destruction of hemoglobin. The major task of
excretion still belongs to the urinary system. If it fails the other organs cannot take
over and compensate adequately.

In addition to maintaining fluid homeostasis in the body, the urinary system controls red
blood cell production by secreting the hormone erythropoietin. The urinary system also
plays a role in maintaining normal blood pressure by secreting the enzyme renin.

Kidney

Sixty percent of the human body wight is water, over half of which is inside the
body cells and tissues. The rest of the water bathes all the body's cells. This water
contains salt. The amount of salt in the watery blood tissue, is very important. Too
much or too little salt can lead to servere problems, therefore, the salt in the
body's water has to be kept at exactly the same concentrations. That task is the job
of the Kidneys.
Each bean shaped kidney is divided into inner and an outer section. The outer
section contains millions of chemical filtering factors called nephrons.
Blood is carried by the arteries into the inner section of the kidneys. When the
blood gets into the kidneys, the blood travels into smaller and smaller arteries.
Eventually, it enters a cluster of capillaries. Various substance in the blood,
including water, salts, digested food particles, and other materials are filtered out
of the blood here. A nitrogen waste, known as urea, is also filtered out of the
blood. Then these substances pass into a cup-shaped part of the nephron called the
capsule. The capsule leads to a set of tiny tubes in the nephron.
As the filtered material moves through pipe like passages in the nephron, much of
the water and digested food that was filtered out of the blood is reabsorbed into
the blood stream. This liquid that is left after reabsorption is called urine.
In the inner section of the kidney the, the urine passes through a cone shaped area
into a funnel shaped area. This area is connected to a tube called the ureter, which
conducts the urine to the urinary bladder. The urinary bladder is a sac of tissue
that has the ability to expand as it fills with urine. Eventually, the urine passes out
of the body through a tube at the bottom of the bladder called the urethra.