TOPIC-6

Part-2
Kidneys and Excretion
 Introduction
• A major part of homeostasis is maintaining the composition,
pH, and volume of body fluids within normal limits
• The urinary system removes metabolic wastes and
substances in excess, including foreign substances like drugs
and their metabolites that may be toxic
• It consists of a pair of kidneys, a pair of ureters, a urinary
bladder and a urethra

2
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Kidney

Renal
Renal artery
vein
Inferior
Hilum vena cava

Abdominal
aorta

Ureters

Urinary
bladder
Urethra

© CNRI/SPL/Photo Researchers, Inc.

3
 Kidneys
• A kidney is a reddish brown, bean-shaped organ with a
smooth surface
• In the adult it is about 12 centimeters long, 6 centimeters
wide, and 3 centimeters thick
• It is enclosed in a tough, fibrous capsule

4
Location of the Kidneys
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Kidney
Adipose tissue
Parietal
peritoneum Spleen

Inferior vena cava Aorta

Pancreas Small intestine
Large intestine

Stomach

(a)

Adrenal gland Liver

Twelfth rib

Kidney Parietal peritoneum

Renal fascia Renal fascia

Hip bone (cut) Large intestine

5
(b)
 Kidney Structure
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Renal capsule
Renal cortex
Renal corpuscle

Nephrons Renal
Renal medulla
cortex

Minor calyx

Major calyx
Renal sinus Renal
medulla Renal
Renal column
Collecting tubule
Fat duct
in renal sinus Papilla
Renal pelvis Minor calyx

Renal papilla
(b) (c)
Renal pyramid

Ureter

(a)

6
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Inferior vena cava Abdominal aorta

Suprarenal artery Suprarenal vein

Adrenal gland Renal artery

Renal column
Renal capsule

Renal pelvis

Renal papilla

Renal vein Renal medulla

Hilum
Renal pyramid

Renal cortex

Ureter
Minor calyx

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 Function of the Kidneys
• The main function of the kidneys is to regulate the volume,
composition, and pH of body fluids
• The kidneys remove metabolic wastes from the blood and
excrete them to the outside of the body, including nitrogenous
and sulfur-containing products of protein metabolism
• The kidneys also help control the rate of red blood cell
production, regulate blood pressure, and regulate calcium ion
absorption

8
 Renal Blood Vessels
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Cortical radiate
artery and vein
Proximal
Cortical radiate
Cortex convoluted
artery and vein
tubule
Afferent arteriole
Arcuate vein Medulla Efferent Distal convoluted
and artery arteriole tubule

Interlobar Peritubular
vein and artery capillary

Renal
artery
Renal
vein

Renal pelvis

Efferent Afferent Peritubular

arteriole arteriole capillary
Ureter
Glomerulus
(a)
(a)

Renal tubules

Glomerulus Glomerular
(b) capsule
(a) : Tissues and Organs: A Text-Atlas of Scanning Electron Microscopy, by R.G. Kessel and R.H. Kardon. © 1979 W.H. Freeman and Company
(b) : Courtesy of R.B. Wilson MD, Eppeley Institute for Research in Cancer, University of Nebraska Medical Center

(b) 9
b: © L.V. Bergman/The Bergman Collection
 Nephrons
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Slit pore Pedicel Primary process

Afferent Efferent of podocyte
arteriole arteriole
Blood
flow
Blood
flow

Glomerular
capsule

Parietal layer
of glomerular
capsule
Slit pore
Glomerulus

Visceral layer of
glomerular capsule
Proximal
convoluted
tubule Pedicel Primary process
of podocyte
© David M. Phillips/Visuals Unlimited

10
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Glomerular Cortical radiate

capsule artery
Cortical radiate
Proximal vein
convoluted
tubule Collecting ducts

Afferent Epithelial cell

Glomerulus arteriole

Distal Renal
Efferent convoluted Blood vessel
arteriole cortex
tubule (a) Renal Glomerular Glomerulus
tubules capsule
From renal Renal
Peritubular artery corpuscle (b)
capillary To renal
vein a: © Biophoto Associates/Photo Researchers, Inc., b: © Manfred Kage/Peter Arnold

Descending
limb Renal
Nephron medulla
loop Ascending
limb
Collecting duct

11
Juxtaglomerular Apparatus
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Glomerular Afferent
capsule arteriole
Glomerulus Juxtaglomerular
apparatus

Distal
convoluted
tubule

Efferent
arteriole

Proximal
convoluted Glomerulus
tubule
Podocyte

Afferent arteriole
Nephron loop

(a) Juxtaglomerular
cells
Juxtaglomerular
Macula densa apparatus

Ascending limb
of nephron loop
Glomerular capsule

Efferent arteriole

(b) 12
Cortical and Juxtamedullary Nephrons
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Cortical nephron

Renal
cortex

Juxtamedullary
nephron

Renal
medulla

Collecting
duct 13
 Blood Supply of a Nephron
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Glomerular Cortical radiate

Renal artery
capsule artery and vein

Interlobar artery
Proximal
convoluted
tubule Arcuate artery
Glomerulus
Afferent arteriole
Efferent Distal Cortical radiate artery
arteriole convoluted
tubule
Afferent arteriole

Peritubular
capillaries
Glomerular capillaries

Efferent arteriole

Vasa recta
Peritubular capillaries

Cortical radiate vein

Arcuate vein

Collecting duct Interlobar vein

Nephron loop 14
Renal vein
 Urine Formation
• The main function of the nephrons and collecting ducts is to
control the composition of body fluids and remove wastes
from the blood, the product being urine
• Urine contains wastes, excess water, and electrolytes
• Urine is the final product of the processes of:
• Glomerular filtration
• Tubular reabsorption
• Tubular secretion
 Urine Formation
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Arteriole Venule
Blood
Net reabsorption
flow

Net filtration
Interstitial fluid

(a) In most systemic capillaries, filtration predominates at the arteriolar end

and osmotic reabsorption predominates at the venular end.

Peritubular
capillaries
Afferent Glomerular Efferent
arteriole capillaries arteriole Venule
Blood
flow

Glomerular Tubular Tubular

filtration reabsorption secretion
Filtered
fluid
Tubular fluid Urine

Renal tubule

(b) In the kidneys, the glomerular capillaries are specialized for filtration. The renal tubule is 16
specialized to control movements of substances back into the blood of the peritubular
capillaries (tubular reabsorption) or from the blood into the renal tubule (tubular secretion).
 Glomerular Filtration
• Glomerular filtration
• Substances move from the blood to the glomerular capsule
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Glomerulus

Afferent
Proximal arteriole
convoluted
tubule
Capillary
endothelium
Podocyte

Glomerular Glomerular
capsule filtrate

Blood Fenestrae
flow

Podocyte
Efferent
arteriole

17
(a) (b)
Plasma, Glomerular Filtrate, and Urine Components

18
 Filtrate Pressure
• The main force that moves substances by filtration through
the glomerular capillary wall is hydrostatic pressure of the
blood inside
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Hydrostatic
pressure of
blood
Glomerular hydrostatic
pressure

Capsular
Plasma colloid
hydrostatic
osmotic pressure
pressure
Net Outward Pressure
Outward force, glomerular hydrostatic pressure = +60 mm
Inward force of plasma colloid osmotic pressure = –32 mm
Inward force of capsular hydrostatic pressure = –18 mm 19
Net filtration pressure = +10 mm
 Filtrate Rate
• Glomerular filtration rate (GFR) is directly proportional to
the net filtration pressure
Net filtration pressure = force favoring filtration – forces opposing filtration
(glomerular capillary (capsular hydrostatic pressure
hydrostatic pressure) and glomerular capillary osmotic pressure)
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180 Liters

• Normally the glomerular net 180

170

filtration pressure is positive 160

150

causing filtration 140

130

• The forces responsible include 120

110

hydrostatic pressure and osmotic 100

Liters
90

pressure of plasma and the 80

hydrostatic pressure of the fluid

70

60

in the glomerular capsule 50

40

30

20

10

0
0.6 – 2.5 Liters
20
Glomerular filtrate Urine
(a) (b)
 Control of Filtrate Rate
• GFR remains relatively constant through a process called
autoregulation
• Certain conditions override autoregulation, including when
GFR increases
• Primarily three mechanisms are responsible for keeping the
GFR constant:
• Autoregulation
• Increased sympathetic impulses that decrease GFR by
causing afferent arterioles to constrict
• The hormone-like renin-angiotensin system
• There also is the hormone atrial natriuretic peptide
(ANP) affects sodium causing an increase in GFR

21
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Lung capillaries

Kidney
Liver

Renin Angiotensin-
converting
enzyme

Angiotensinogen Angiotensin I Angiotensin II

Bloodstream

• Vasoconstriction
• Increased
Release into aldosterone
bloodstream secretion
• Increased
Stimulation ADH secretion
• Increased thirst 22
 Tubular Reabsorption
• Tubular reabsorption
• Substances move from the renal tubules into the
interstitial fluid where they then diffuse into the
peritubular capillaries
• The proximal convoluted tubule reabsorbs (70%):
• Glucose, water, urea, proteins, and creatine
• Amino, lactic, citric, and uric acids
• Phosphate, sulfate, calcium, potassium, and sodium
ions

23
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Blood Blood
flow flow
Afferent Afferent
arteriole arteriole
Glomerular Glomerular
capsule Efferent capsule Efferent
arteriole arteriole
Glomerulus Glomerulus

Glomerular Glomerular
filtrate filtrate

Peritubular
capillary
Tubular
Peritubular
reabsorption
capillary Tubular
secretion

Renal Renal
tubule tubule

Blood flow Blood flow

(a) (b)

24
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Blood
flow

Glomerulus

Glomerular
capsule

Blood
Glomerular flow
filtrate

Proximal
convoluted
tubule Na+ + 1 Sodium ions
Na+ are reabsorbed by
+
active transport
Cl– –
–
PO4–3 2 Negatively charged ions
–
are attracted to positively
HCO3– –
charged ions
N+ +
– +
Cl– – + 3 As concentration of ions
+–
– + (solute) increases in plasma,
Na+ osmotic pressure increases
H2O – +
– +
H2O ++
– + 4 Water moves from proximal
+– tubule to capillary by
– –
++ osmosis
– –

Isotonic Peritubular capillary

tubular fluid Blood 25
flow
26
 Tubular Secretion

• Tubular secretion
• Substances move from the plasma of the peritubular
capillaries into the fluid of the renal tubules
• Active transport mechanisms function here
• Secretion of substances such as drugs and ions
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Peritubular capillary
Blood flow
K+ or H+

Tubular reabsorption Tubular secretion

Na+ Na+ Na+ H+ Na+ K+

Na+
Na+ Na +
K+
K+
Na+ Na+

Na+ H+
Tubular fluid Distal convoluted tubule
Na+ K+
Na+ Na+

Ascending limb Collecting duct

of nephron loop

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 Regulation of Urine
Concentration and Volume
• Hormones such as aldosterone and ANP affect the solute concentration
of urine, particularly sodium
• The ability of the kidneys to maintain the internal environment rests in a
large part on their ability to concentrate urine by reabsorbing large
volumes of water
• The distal convoluted tubule and the collecting duct are impermeable to
water, so water may be excreted as dilute urine
• If ADH is present, these segments become permeable, and water is
reabsorbed by osmosis into the extremely hypertonic medullary interstitial
fluid
• A countercurrent mechanism in the nephron loops (the descending and
the ascending limbs) ensures that the medullary interstitial fluid becomes
hypertonic
• This mechanism is known as the countercurrent multiplier
• The vasa recta also contributes as a countercurrent mechanism
29
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Distal convoluted
tubule
Medullary Medullary
interstitial fluid H2O interstitial fluid

H2O H2O

H2O H2O

H2O
H2O

Collecting duct Collecting duct

Hypertonic Hypertonic
interstitial interstitial
fluid fluid
H2O

Dilute urine Concentrated urine

(a) low ADH levels (b) high ADH levels

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31
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1 Na+
H2O Cl–

Salty
Increasing
NaCl
concentration
2
Na+
Cl– H2O Cl–
Hypotonic fluid
Na+
Isotonic fluid
More
Cl – Thick ascending salty
H2O limb (impermeable
Na+
to water)

H2O Cl– 3 Na+

Na+ Cl–
Descending Medullary H2O
limb interstitial
H2O
(permeable fluid Even
to water) more
salty

Hypertonic
(a) fluid (b) 32
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Blood
flow Blood
flow

Increasing
NaCl
concentration

Medullary
interstitial
NaCl fluid

NaCl NaCl NaCl

NaCl
NaCl NaCl
NaCl

Vasa
recta
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34
 Urea and Uric Acid Excretion
• Urea:
• A by-product of amino acid catabolism
• The plasma concentration reflects the amount or protein
in diet
• It enters the renal tubules through glomerular filtration
• It contributes to the reabsorption of water from the
collecting duct
• About 80% is recycled
• Uric acid:
• Is a product of nucleic acid metabolism
• It enters the renal tubules through glomerular filtration
• Most reabsorption occurs by active transport
• About 10% is secreted and excreted
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 Urine Composition
• Urine composition reflects the volumes of water and solutes
that the kidneys must eliminate from the body or retain in the
internal environment to maintain homeostasis
• It varies from time to time due to dietary intake and physical
activity, but is:
• About 95% water
• Usually contains urea, uric acid, and creatinine
• May contain trace amounts of amino acids and varying
amounts of electrolytes
• Volume varies with fluid intake and environmental
factors

36
 Renal Clearance
• This is the rate at which a chemical is removed from the
plasma
• It indicates kidney efficiency
• Tests of renal clearance:
• Inulin clearance test
• Creatinine clearance test
• Para-aminohippuric acid (PAH) test
• These tests of renal clearance are used to calculate the GFR
(glomerular filtration rate)

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 Elimination of Urine
• After forming along the nephrons, urine:
• Passes the collecting ducts to:
• Openings of the renal papillae:
• Enters the minor and major calyces:
• Passes through the renal pelvis:
• Enters into the ureters:
• Enters into the urinary bladder:
•The urethra carries the urine out of the body

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 Ureters
• The ureters:
• Each is about 25 centimeters long
• Extends downward posterior to the parietal peritoneum
• Runs parallel to vertebral column
• Join the urinary bladder in the pelvic cavity
• The wall of ureter has three layers:
• The inner mucous coat
• The middle muscular coat
• The outer fibrous coat

39
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Mucous coat

Lumen
Muscular coat

Fibrous coat

Adipose tissue
© Per H. Kjeldsen

40
 Urinary Bladder
• The urinary bladder is a hollow, distensible, muscular organ
located within the pelvic cavity, posterior to the symphysis
pubis and inferior to the parietal peritoneum
• It contacts the anterior walls of the uterus and vagina in the
female, and lies posteriorly against the rectum in the male
• The openings for the ureters is the area of trigone
• It has four layers: inner mucous coat, a submucous coat, a
muscular coat, and an outer serous coat
• Smooth muscle fibers comprise the detrusor muscle which
is the muscle of the bladder wall

41
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Abdominal wall Ureter

Parietal peritoneum

Urinary bladder

Symphysis pubis

Prostate gland

Urethra
Rectum
Rectum

(a) (b)

42
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Serous coat
Ureter Urinary bladder

Ureter
Detrusor
muscle
Submucous
coat Ductus (vas)
deferens
Mucous coat
Openings of
the ureters
Seminal
Trigone
vesicle
Neck

Prostate gland
Internal urethral sphincter
Prostate gland
Urethra
Region of external Urethra
urethral sphincter
(a) (b)
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Submucous
Muscular coat Mucous coat coat

Lumen

© John D. Cunningham/Visuals Unlimited

44
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Ureter

Urinary
bladder

Trigone

Urethra

External
urethral orifice
(a)

Ureter

Urinary
bladder
Trigone

Prostatic Prostate
urethra gland
Bulbourethral
Membranous
gland
urethra

Penile
urethra Penis

External 45
urethral orifice
(b)
 Urethra
• The urethra is a tube that conveys urine from the urinary
bladder to the outside of the body
• Its wall is lined with a mucous membrane and it has a thick
layer of longitudinal smooth muscle fibers
• In a female:
• It is about 4 centimeters long
• It runs obliquely
• In a male:
• It is about 17.5 centimeters long
• It has a dual function for both urination and
reproduction
• It has three sections:
• Prostatic urethra
• Membranous urethra 46
• Penile urethra
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Urethral glands
Muscle layer

Lumen of urethra

Mucous membrane

© Ed Reschke
47
 Micturition
• Urine leaves the urinary bladder by micturition or urination
reflex

48
Micturition

49
 Lifespan Changes
• The urinary system is sufficiently redundant, in both structure and
function, to mask age-related changes
• The kidneys become slower to remove nitrogenous wastes and toxins
and to compensate for changes that maintain homeostasis
• Changes include:
• The kidneys appear scarred and grainy
• Kidney cells die
• By age 80 the kidneys have lost a third of their mass
• Kidney shrinkage is due to loss of glomeruli
• Proteinuria may develop
• The renal tubules thicken
• It is harder for the kidneys to clear certain substances
• The bladder, ureters, and urethra lose elasticity
• The bladder holds less urine
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 Important Points in this topic
Outcomes to be Assessed
20.1: Introduction
 Name the organs of the urinary system and list their general functions.
20.2: Kidneys
 Describe the location of the kidneys.
 Describe the structure of a kidney.
 List the functions of the kidneys.
 Trace the pathway of blood flow through the major vessels within a
kidney.
 Describe a nephron and explain the functions of its major parts.
20.3: Urine Formation
51
 Explain how glomerular filtrate is produced and describe its composition.
 Important Points in Chapter 20:
Outcomes to be Assessed

 Explain how various factors affect the rate of glomerular filtration

and identify ways that this rate is regulated.
 Define tubular reabsorption and explain its role in urine formation.
 Identify the changes in the osmotic concentration of the glomerular
filtrate as it passes through the renal tubule.
 Identify the characteristics of the countercurrent mechanism and
explain its role in concentrating the urine.
 Define tubular secretion and explain its role in urine formation.
20.4: Elimination of Urine
 Describe the structures of the ureters, urinary bladder, and urethra.
 Define micturition and explain how it occurs and how it is controlled.52
 Important Points in Chapter
Outcomes to be Assessed

20.5: Lifespan Changes

 Describe how the components of the urinary system change with age.

53