Urinary System

Urinary System
• Consists of the kidneys,
ureters, urinary bladder,
and urethra

• Three functions:
1) excretion, the removal of organic waste products from body fluids;
2) elimination, the discharge of these waste products into the
environment; and
3) homeostatic regulation of the volume and solute concentration of
blood plasma.
 Kidney Functions:
• Regulate water homeostasis, electrolyte composition, extracellular
volume, and acid–base.
• Filter plasma of the blood and produce urine.
• Responsible for reabsorption of glucose and amino acids, in
addition to regulated calcium and phosphate uptake (high in
children).
• Play a role in gluconeogenesis and during fasting can synthesize
and release glucose into the blood, producing almost 20% of the
liver’s glucose capacity.
• As endocrine organs, making kinins, 1,25-dihydroxycholecalciferol,
erythropoietin and making and secreting renin.
 1,25-Dihydroxycholecalciferol
• Is a steroid hormone formed from vitamin D by successive
hydroxylations in the liver and kidneys.
• In the liver, vitamin D3 is converted to 25-
hydroxycholecalciferol (calcidiol, 25-OHD3 ).
• The 25-hydroxycholecalciferol is converted in the cells of
the proximal tubules of the kidneys to the more active
metabolite 1,25-dihydroxycholecalciferol , which is also
called calcitriol or 1,25-(OH)2D3 .
• 1,25-dihydroxycholecalciferol is also made in the placenta,
in keratinocytes in the skin, and in macrophages.
Effects of PTH and 1,25-
dihydroxycholecalciferol on
whole body calcium
homeostasis
 Erythropoietin
• A peptide hormone that is involved in the control of
erythrocyte (red blood cell) production by the bone
marrow.
• Its major source is the kidneys, although the liver also
secretes small amounts.
• The stimulus for its secretion is a reduction in the partial
pressure of oxygen in the kidneys, for example, in anemia,
arterial hypoxia, and inadequate renal blood flow.
• Renal disease may result in diminished erythropoietin
secretion, and the ensuing decrease in bone marrow
activity is one important causal factor of the anemia of
chronic renal disease.
 Renal Medullary Interstitial Cells (RMICs)

• Are specialized fibroblast-like cells .

• Contain lipid droplets and are a major site of
cyclooxygenase 2 (COX-2) and prostaglandin synthase
(PGES) expression.
• PGE 2 is the major prostanoid synthesized in the kidney
and is an important paracrine regulator of salt and water
homeostasis.
• PGE 2 is secreted by the RMICs, by the macula densa, and
by cells in the collecting ducts; prostacyclin (PGI 2 ) and
other prostaglandins are secreted by the arterioles and
glomeruli.
 Renin
• Renin in kidney extracts and
bloodstream is produced by
the juxtaglomerular cells
(JG cells).

• JG cells are located in the media of the afferent arterioles

as they enter the glomeruli.
• Renin is also found in agranular lacis cells that are
located in the junction between the afferent and efferent
arterioles, but its significance in this location is unknown.
• Increased tissue bradykinin produced when ACE is inhibited
acts on B 2 receptors to produce the cough that is an annoying
side effect in up to 20% of patients treated with ACE inhibitors.
 Kidney Nephron
• The kidneys, have a tremendous
reserve capacity, you must lose
nearly three-fourths of your
kidney function before
homeostasis begins to be
affected.
• At any given time, the kidneys
receive 20–25% of the cardiac
output.
• Nephron, is the functional unit
of the kidney and each human
kidney has approximately 1
million nephrons.
Nephron Function
 Kidney processes in
regulating body fluid
1) Glomerular filtration: the
movement of fluid from
blood into the lumen of the
nephron.
2) Tubular reabsorption is the
process of moving substances
in the filtrate from the lumen
of the tubule back into the
blood flowing through
peritubular capillaries
3) Tubular secretion removes
selected molecules from the
blood and adds them to the
filtrate in the tubule lumen.
THANK YOU
 References
• Silverthorn DE, Human Physiology an
integrated approach, 6th edition, Pearson,
2013.
• Barret KE, Barman SM, Boitano S & Brooks HL,
Ganong’s Review of Medical Physiology, 24th
edition, McGraw Hill Companies, 2012.