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Renal Function
1. Elimination of Waste Products
2. Regulation of Fluid Balance
3. Regulation of Acid-Base Balance
4. Nutrient Balance : - electrolytes : Na +, K+,
Cl-,
Ca++,Mg++
- amino acids, glucose, proteins
vitamin
5. Elimination, Detoxification of Drug and Toxins
6. Endocrine Function : - erytropoietin
- vitamin D metabolism
- renin
Struktur Nefron
The NEPHRON:
The Functional
Renal Unit
Afferent
Arteriole
Efferent
Arteriole
Urine formation
Eliminasi produk sisa metabolik
Urea, Kreatinin, Asam urat, Sulfat,
Nitrat, Phosphat, dll.
Proses :
1. Filtrasi glomerulus
2. Reabsorpsi tubulus
3. Sekresi tubulus
4. Ekskresi
Ekskresi = Filtrat reabsorpsi + sekresi
p 904
Filtrasi Glomerulus
Pgc
gc
Pt
Filtrasi glomerulus
Filtration Membrane
Fenestrated endothelium
70-90nm pores exclude blood
cells
Basement membrane
proteoglycan gel, negative
charge excludes molecules >
8nm
blood plasma 7% protein,
glomerular filtrate 0.03%
Filtration slits
podocyte arms have pedicels
with negatively charged
filtration slits, allow particles
< 3nm to pass
Filtrasi Glomerulus
Loop of Henle
Descending limb permeabel terhadap air
Ascending limb impermeabel terhadap air
reabsorpsi Na dan Cl
Tubulus Distal
Reabsorpsi Na, Cl dan air
ADH mempengaruhi permeabilitas terhadap air
Reabsorpsi dan sekresi Kalium
Aldosteron mempengaruhi reabsorpsi Natrium
dan sekresi Kalium
Mekanisme Countercurrent
Renal Regulation
Renal autoregulation
Regulation of NFP
Macula densa
Cells of DCT
Slow filtrate flow, low
osmolality (low Na,
Cl) causes dilation of
afferent arterioles
High flow, high
osmolality causes
contraction of JGA
cells, vasoconstriction
Duktus kolegentes
Reabsorpsi Na
dan Cl
dipengaruhi ADH
Hormones
Aldosterone
Acts on distal convoluted tubule
cells to stimulate active transport
of 3 molecules of Na+ out of
tubule (reabsorption) for every 2
molecules of K + brought into
tubule (secretion)
Water from tubule lumen follows
Na+ by osmosis into blood
Homeostatic
Control
involving
Aldosterone
Urine Composition
about 95% water
usually contains urea, uric acid, and creatinine
(break down product from creatine phosphate used
up in muscles)
may contain trace amounts of amino acids and
varying amounts of electrolytes
volume varies with fluid intake, diuretics (caffeine &
alcohol) and environmental factors (heat, humidity)
Inulin
Clearance
Micturition Reflex
p 923
Thirst
Osmoreceptors detect changes decreases in
blood volume and increases in blood solute levels
They activate the thirst center in hypothalamus and
ADH-secreting cells
Angiotensin II
formed from the interaction of renin (produced by
the kidneys) with circulating angiotensinogen in the
plasma
also acts on brain to promote thirst and ADH
secretion
Acid-base
balance
All of these are
constantly changing,
trying to maintain
HOMEOSTASIS!
CARDIOVASCULAR
SYSTEM
RESPIRATORY
SYSTEM
TERIMA KASIH