GINJAL

FUNGSI
Pengaturan keseimbangan air &
elektrolit
Pengaturan konsentrasi osmolaritas
cairan tubuh & elektrolit
Pengaturan keseimbangan asam basa
Ekskresi hasil sisa metabolisme
Pengaturan tekanan arteri
Sekresi hormon
Glukoneogenesis

Functions of the urinary system

Excretion
The removal of organic waste products from body fluids

Elimination
The discharge of waste products into the environment

Homeostatic regulation of blood plasma

Regulating blood volume and pressure
Regulating plasma ion concentrations
Stabilizing blood pH
Conserving nutrients

ANATOMI FISIOLOGI GINJAL

ANJING

ANATOMI FISIOLOGI GINJAL

SAPI

Figure 26.3 The Urinary System in

Gross Dissection

Figure 26.3

ANATOMI & FISOLOGI

Two types of nephron

Cortical nephrons
~85% of all nephrons
Located in the cortex

Juxtamedullary nephrons
Closer to renal medulla
Loops of Henle extend deep into renal pyramids

Figure 26.7 Cortical and

Juxtamedullary Nephrons

Figure 26.7a

Figure 26.7 Cortical and Juxtamedullary

Nephrons

Figure 26.7b, c

Nephron functions include:

Production of filtrate
Reabsorption of organic nutrients
Reabsorption of water and ions
Secretion of waste products into tubular fluid

Urine production maintains

homeostasis
Regulating blood volume and composition
Excreting waste products
Urea
Creatinine
Uric acid

Basic processes of urine formation

Filtration
Blood pressure
Water and solutes across glomerular capillaries

Reabsorption
The removal of water and solutes from the filtrate

Secretion
Transport of solutes from the peritubular fluid into
the tubular fluid

Figure 26.9 An Overview of Urine

Formation

Figure 26.9

Carrier Mediated Transport

Filtration in the kidneys modified by carrier
mediated transport
Facilitated diffusion
Active transport
Cotransport
Countertransport

Carrier proteins have a transport maximum

(Tm)
Determines renal threshold

Reabsorption and secretion

Accomplished via diffusion, osmosis, and
carrier-mediated transport
Tm determines renal threshold for
reabsorption of substances in tubular fluid

Sectional anatomy of the kidneys

Superficial outer cortex and inner medulla
The medulla consists of 6-18 renal pyramids
The cortex is composed of roughly 1.25 million
nephrons

Major and minor calyces along with the pelvis

drain urine to the ureters

NEPHRON
Merupakan unit fungsionil terkecil
ginjal
1 Juta / Ginjal
Panjang seluruh nephron = 45 65
mm

GLOMERULUS
Kapsula Bowman : pars visceralis & pars
parietalis
Filter glomerulus : 3 lapis
1. Endhotelium kapiler :100nm
2. Lamina basalis :8 nm
3. Epithel Pars viceralis kapsula Bowman
( Podocyt) : 25 nm
Luas area filtrasi 0,8 m2
Ultra filtrat = plasma - protein

Figure 26.10 Glomerular Filtration

Figure 26.10

Figure 26.8 The Renal Corpuscle

Figure 26.8a, b

Figure 26.8 The Renal Corpuscle

Figure 26.8c, d

Figure 26.10 Glomerular Filtration

Figure 26.10a, b

Functional anatomy of the

nephron

Proximal convoluted tubule (PCT)

Actively reabsorbs nutrients, plasma proteins
and ions from filtrate
Released into peritubular fluid

Loop of Henle
Descending limb
Ascending limb
Each limb has a thick and thin section

PLAY

Animation: Urinary System Anatomy

Reabsorption and secretion at the

PCT

Glomerular filtration produces fluid similar to plasma without

proteins
The PCT reabsorbs 60-70% of the filtrate produced
Reabsorption of most organic nutrients
Active and passive reabsorption of sodium and other
ions
Reabsorption of water

Secretion also occurs in the PCT

PLAY

Animation: Early Filtrate Processing

PLAY

Animation: Glomerular filtration

TUBULUS PROKSIMALIS
P = 15 mm
Tight junction
Lateral intercellular space
Brush border
Reabsorbsi 65 %
Zat yg direabsorbsi tidak disekresi
kecuali K+
Sekresi zat diikat oleh protein plasma

Figure 26.12 Transport Activities at the PCT

PLAY

Animation: Proximal Convoluted Tubule

Figure 26.12

The loop of Henle and countercurrent

multiplication
Countercurrent multiplication
Between ascending and descending limbs of
loop
Creates osmotic gradient in medulla
Facilitates reabsorption of water and solutes
before the DCT
Permits passive reabsorption of water from
tubular fluid

ANSA HENLE
Pars decendent : 2- 14 mm
Pars Ascendent : mithokondria >>, Sel
Junxtaglomerular vas. Afferent
mensekresi RENIN
ANSA HENLE SEGMEN TIPIS :
permeabilitas besar, metabolisme
minimal
ANSA HENLE SEGMEN TEBAL : tidak
permeabel thd H2O & Ureum, reabsorbsi
aktif Cl- & Na+

Figure 26.13 Countercurrent Multiplication and Concentration

of Urine

Figure 26.13a

Figure 26.13 Countercurrent Multiplication and

Concentration of Urine

Figure 26.13b

Figure 26.13 Countercurrent Multiplication and

Concentration of Urine

Figure 26.13c

Functional anatomy of the

nephron
Distal convoluted tubule (DCT)
Actively secretes ions, toxins, drugs
Reabsorbs sodium ions from tubular fluid

PLAY

Animation: Urinary System Dissection and Flythrough

Reassertion and secretion at the

DCT
DCT performs final adjustment of urine
Active secretion or absorption

Absorption
Tubular cells actively resorb Na+ and ClIn exchange for potassium or hydrogen ions
(secreted)

TUBULUS DISTALIS
P = 5 mm
Ephitel lebih pipih dari ephitel tubulus
proksimalis
Brush border ()
Bagian proksimal = segmen tebal
ansa henle
Bagian distal terjadi ion exchange K+
dg Na+ : Hormon Aldosteron

Figure 26.14 Tubular Secretion and Solute Reabsorption at the

DCT

PLAY

Animation: Distal Convoluted Tubule

Figure 26.14

Figure 26.14 Tubular Secretion and Solute Reabsorption at the

DCT

Figure 26.14c

Reabsorption and secretion along the

collecting system
Water and solute loss is regulated by
aldosterone and ADH
Reabsorption
Sodium ion, bicarbonate, and urea are resorbed

Secretion
pH is controlled by secretion of hydrogen or
bicarbonate ions

DUKTUS COLLIGENTES
P = 20 mm
Menampung beberapa tubulus distalis
Ber muara di papilla renalis
Bagian Cortex : tidak permeabel thd
ureum
Bagian medulla ; permeabel thd ureum
ADH < : tidak permeabel thd H2O

Figure 26.6 A Representative Nephron

Figure 26.6

Figure 26.5 The Blood Supply to the Kidneys

Figure 26.5c, d

Figure 26.5 The Blood Supply to the Kidneys

Figure 26.5a, b

SUPLAI DARAH GINJAL

RENAL FRACTION
Vasa afferent glomerulus membentuk
vasa recta
Renal Blood Flow = 1200 ml/menit
Cardiac Out Put = 5000ml/ menit
Renal Fraction = 1200/5000 X 100% =
24%

KECEPATAN ALIRAN DARAH TIAP

100 g JARINGAN
ORGAN

BLOOD FLOW (ml /

min )

Otot Skelet
Otak
Hati
Otot Jantung
Ginjal

3
54
58
84
420

ALIRAN CAIRAN DLM TUBUH

JARINGAN

Kecepatan
(ml/min)

Reabsorp
si ( %)

Tubulus Proksimal
Ansa Henle
Tubulus Distalis
Duct. Colligentes
Urine

125
45
25
12
1

65
15
10
9,3
0,7

REABSORPSI ELEKTROLIT
( kation ) perlu dikendalikan, bila
berubah : kegagalan faal ginjal
K+ > : potensial membran < : paralisis
K+ < : potensial membran > : paralisis
Na+ << : Potensial aksi < : paralisis
Ca++ < : permeabilitas membran > :
tetani

Glomerular filtration rate (GFR)

Amount of filtrate produced in the kidneys
each minute
Factors that alter filtration pressure change
GFR

GLOMERULAR FILTRATION RATE

( GFR)
Jumlah filtrat yg disaring dr plasma
dalam satu menit
Normal : 125 ml / min
Lebih dr 99% direabsorpsi
Produk urine : 1 L / hari
Zat yg digunakan untuk mengukur :
Inulin, Manitol

Factors controlling the GFR

A drop in filtration pressure stimulates
Juxtaglomerular apparatus (JGA)
Releases renin and erythropoietin

FAKTOR YG MEMPENGARUHI
Perubahan Tek. Darah
1. Tek. Darah umum
2. Status vasa afferent / efferent
Contoh :
latihan jasmani : vasokontriksi vasa
afferent
Caffein : Vasodilatasi vasa afferent

Perubahan Tekanan Capsular :

Obstruksi, Edema jaringan
Perubahan Tek. Osmotik Koloid :
Dehidrasi, Hipoprotein
Perubahan Permeabilitas :
Peny. Ginjal, Keracunan Obat
Perubahan Luas Area Filtrasi :
Peny. Ginjal, Nephrotomy

FILTRASI GLOMELURUS
Effective Filtration Pressure (EFP)
Tek. Darah Tek Capsular Tek
Koloid Osmotik = 70 20 32 = 18
mmHg

DIURETIKA

1.
2.

1.
2.
3.

Zat yg dpt meningkatkan kec.pembentukan urine

Cara :
Meningkatkan GFR
Mengurangi reabsorpsi cairan dlm tubuh
Terapi : Edema , Hipertensi
Mekanisme kerja :
Meningkatkan GFR
Meningkatkan muatan osmotik koloid tubuh
Menghambat ADH

MENINGKATKAN GFR
1.
2.
3.
4.

Cara :
Tek darah >
Vasodilatasi vasa afferent
Vasokonstriksi vasa efferent
Tek. Osmotik Koloid <

BEBERAPA JENIS OBAT

EPINEPHRINE :
Tek darah Tek Caps Bowman
GFR Diuresis
DIGITALIS :
Decompensatio Cordis sirkulasi
diperbaiki P Bowman GFR
Diuresis
THEOPHYLIN & CAFFEIN :
Vasodilatasi Vasa Aff. P Bowman
GFR Diuresis

MENINGKATKAN MUATAN
OSMOTIK TUBULUS
1. Mempunyai efek terutama di tub. Proks:
Ureum, Sukrosa, Manitol, Glukosa
2. Menghambat Reabsopsi Na+
Di Ansa Henle : Furosemide, Ethacrynil
Acid
Di Tub. Distal bgn Proksimal : thiazide,
metalazone
Di tub. Distalis bgn Distal :
spironolactone, amiloride

Menghambat ADH
ADH reabsorpsi H2O di Ductus
colligentes diuresis
Alkohol, narkotika, anastesi

Figure 26.11 The Response to a Reduction in the

GFR

Figure 26.11a

Figure 26.11 The Response to a Reduction in the

GFR

Figure 26.11b

Figure 26.16 A Summary of Renal Function

Figure 26.16a

the DCT and Collecting Ducts

Figure 26.15

the DCT and Collecting Ducts

Figure 26.15a, b