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In the early tubular segment of the nephron reabsorb solutes and water of the filtrate back into the blood to restore its volume and composition. They also remove some solutes from the blood and secrete them into the filtrate to fine tune the bloods composition
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
To be reabsorbed into the blood, substances in the filtrate must cross the barrier formed by the tubular cells.
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 Air dapat berdifusi di seluruh bagian tubulus kecuali di thick segment of the ascending limb loop of Henle
Sodium Reabsorption
Dapat mengalami reabsorpsi di seluruh tubulus kecuali thin segmeny of the limb Loop of Henle
PUMP: Na/K ATPase Lumen Sodium
Cells
Potassium Plasma Chloride Water
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
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.
Renal threshold of the plasma- past this point the kidney cannot reabsorb any longer and substance will be secreted (ie: too much glucose). Minimal 225 mg/min glucose Tm pada beberapa nefron Renal treshold; ambang maks konsentrasi zat dalam darah yg tidak dijumpai dalam urin
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.
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
80% of the blood goes back, only 20% of the volume is filtered. Of this 20%, only 19% will be reabsorbed. -total volume that is filtered is only about 180L/day, and 1% of this will excreted.
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
The amount of fluid entering the distal tubule at the end of the thick ascending limb of the loop of Henle depends on the amount of Na+ and Cl in it. The Na+ and Cl enter the macula densa cells via the NaK2Cl cotransporter in their apical membranes. The increased Na+ causes increased Na, K ATPase activity and the resultant increased ATP hydrolysis causes more adenosine to be formed.
Presumably, adenosine is secreted from the basal membrane of the cells. It acts via adenosine A1 receptors on the macula densa cells to increase their release of Ca2+ to the vascular smooth muscle in the afferent arterioles. This causes afferent vasoconstriction and a resultant decrease in GFR. Presumably, a similar mechanism generates a signal that decreases renin secretion by the adjacent juxtaglomerular cells in the afferent arteriole but this remains unsettled
Conversely, an increase in GFR causes an increase in the reabsorption of solutes, and consequently of water, primarily in the proximal tubule, so that in general the percentage of the solute reabsorbed is held constant. This process is called glomerulotubular balance, and it is particularly prominent for Na+.
The change in Na+ reabsorption occurs within seconds after a change in filtration, so it seems unlikely that an extrarenal humoral factor is involved. One factor is the oncotic pressure in the peritubular capillaries. When the GFR is high, there is a relatively large increase in the oncotic pressure of the plasma leaving the glomeruli via the efferent arterioles and hence in their capillary branches. This increases the reabsorption of Na+ from the tubule. However, other as yet unidentified intrarenal mechanisms are also involved.
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