Early Filtrate Processing

Gambaran seluler dari tubulus

renalis
 Tubulus proximal: simple cuboidal cells
(brush border cells ok terdapat microvilli)
 Thin loop of henle: simple squamous cell,
highly permeable to water not to solute
 Thick ascending loop of henle & early
distal tubule: cuboidal cells, highly
permeable to solutes, particularly NaCl but
not to water
 Late distal tubule and cortical collecting
duct: cuboidal cells has two distinct
function:
 1. principal cells; permeability to water
and solutes are regulated by hormones
and,
 2. intercalated cells; secretion of hydrogen
ion for acid/base balancing
 Medullary collecting duct; principal cells;
hormonally regulated permeability to
water and urea
 Tubular Reabsorption
 By passive diffusion
 By primary active transport: Sodium
 By secondary active transport: Sugars and
Amino Acids
 Endositosis ; small proteins and peptide
hormones
 Reabsorption Pathways
 There are two reabsorption pathways:

1. the transcellular pathway (>>)

2. the paracellular pathway

Reabsorpsi Filtrat
 Trancellular pathway : Through luminal
and basolateral membranes of the tubular
cells into the interstitial space and then
into the peritubular capillaries.
 Paracellular pathway : through the tight
junctions into the lateral intercellular
space.
 Water and certain ions use both
pathways, especially in the proximal
convoluted tubule.
 Diffusion of Water

 Water diffuses from the lumen through the

tight junctions into the interstitial space:
 1. Water will move from its higher
concentration in the tubule through the
tight junctions to its lower concentration in
the interstitium.
 2. Water will also move through the
plasma membranes of the cells that are
permeable to water
 Sodium Reabsorption
PUMP: Na/K ATPase

Sodium
Lumen
Cells
Potassium

Plasma
Chloride

Water

 Keluar dari sel ke

interstiital
 Tubular Secretion
 Protons (acid/base balance)
 Potassium
 Organic ions
 Zat-zat lain yg tidak normal ada dalam
darah spt obat-obatan dan bahan-bahan
toksik
 Transport Maximum (Tm)

For most actively reabsorbed solutes, the

amount reabsorbed in the PCT is limited only by
the number of available transport carriers for
that specific substance.
This limit is called the transport maximum, or Tm.
If the volume of a specific solute in the filtrate
exceeds the transport maximum, the excess
solute continues to pass unreabsorbed through
the tubules and is excreted in the urine.
Reabsorption: Receptors can Limit

Figure 19-15: Glucose handling by the nephron

 The final processing of filtrate in the
late distal convoluted tubule and
collecting ducts comes under direct
physiological control in response to
changing physiological conditions and
hormone levels.
 Membrane permeabilities and cellular
activities are altered in response to the
body's need to retain or excrete specific
substances.
 Distal Tubule & Collecting Duct
 The Late Distal Tubule & CCT are
composed of principal cells & intercalated
cells
 Intercalated cells secrete hydrogen ions
into filtrate
 Principals cells perform hormonally
regulated water & sodium reabsorption &
potassium secretion
 Role of Aldosteron
 Principal cells are more permeable to
sodium ions and water in the presence of
Aldosterone & ADH
 Low level of Aldosterone result in little
basolateral sodium/potassium ATPase ion
pump activity & few luminal sodium &
potassium channel
 Aldosteron increases the number of
basolateral Na/K pump and luminal Na
& K channels
 Since there are no basolateral K
channel, K ion are secreted into the
instead of returning to the interstitium
 Without an increase in water
permeability, the interstitial osmolarity
increases
 Role of ADH
 Principals cells are more permeable to
water on the presence of ADH
Reabsorption in Proximal Tubule
 Glucose and Amino Acids
 67% of Filtered Sodium
 Other Electrolytes
 65% of Filtered Water
 50% of Filtered Urea
 All Filtered Potassium
 Juxtaglomerular apparatus

 As the thick ascending loop of henle

transition into early distal tubule, the
tubule runs adjacent to the afferent and
efferent arteriole.
 Where these structure are contact they
form the monitoring structure called the
juxtaglomerular apparatus (JGA), which is
composed macula densa and JG cells
Figure 19-9: The juxtaglomerular apparatus
 Glomerulotubular Balance
 is the intrinsic ability of the tubules to
increase their reabsorption rate in
response to increased tubular load
(increased tubular inflow).
 occurs in other tubular segments,
especially the loop of Henle.
 TUBULOGLOMERULAR
FEEDBACK
 a feedback mechanism that links changes
in sodium chloride concentration at the
macula densa with the control of renal
arteriolar resistance.
 helps ensure a relatively constant delivery
of sodium chloride to the distal tubule and
helps preventspurious fluctuations in renal
excretion that would otherwise occur.
 The tubuloglomerular feedback
mechanism has two components that act
together to control GFR:
 (1) an afferent arteriolar feedback
mechanism and
 (2) an efferent arteriolar feedback
mechanism.
 depend on the juxtaglomerular complex
 Sympathetic control

In extreme stress or blood loss,

sympathetic stimulation overrides the
autoregulation

 Increased sympathetic discharge cause

intense constriction of renal blood vessel
 Blood is shunted to other vital organs
 GFR reduction causes minimal fluid loss
from blood
 Reduction filtration can not go indefinitely,
a waste product build up & metabolic
imbalances increase in blood
 IV fluid increases blood volume  restores
blood pressure to resting levels  reduced
sympathetic stimulation allows for normal
arteriole diameter  GFR & filtrate flow is
normalized
Sympathetic Regulation of GFR

Insert fig. 17.11