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Mohammad Rudiansyah
Inter-lobar artery
2
Arcuate artery
3 Renal
artery
1
Inter-lobular artery
4
KIDNEY: Blood flow 2
Inter-lobular artery
4
Cortico-medullary
6 junction is the site
Glomerulus of both arcuate
arteries & veins
Afferent arteriole
5 7 8
Efferent arteriole feeding tortuous capillaries
(cortex) or straight capillaries (medulla)
KIDNEY: Blood flow 3
Efferent arteriole
5 7
Afferent arteriole
Parietal layer of
Afferent
glomerular capsule
arteriole
Juxtaglomerular
cell
Capsule
space
Efferent
Proximal arteriole
convoluted
tubule
Endothelium
Podocyte of glomerulus
Pedicel
Glomerulus and Bowmans capsule
Glomerular filtrate drains into
Bowmans space, and then into
proximal convoluted tubule.
Endothelium has pores to allow
small molecules through.
Podocytes have negative charge.
This and the basement membrane
stops proteins getting through into
tubular fluid.
Macula densa senses GFR by
[Na+]
Juxtaglomerular (JG) apparatus
includes JG cells that secrete
renin.
JGA helps regulate renal blood
flow, GFR and also indirectly,
modulates Na+ balance and
systemic BP
RENAL CORPUSCLE
Afferent Efferent arteriole
arteriole
Mesangial cells & matrix
between roots of
capillaries
Visceral epithelium
Glomerular of podocytes
capillary tuft
Glomerular capillary
Slit diaphragm
Filtration barrier
GBM
Fenestrated endothelium
Glomerular Filtration
Depends on:
Pressure gradient across the filtration slit
(endothelium, basal membrane, epithelium =
podocytes)
Blood circulation throughout the kidneys
Permeability of the filtration barrier
Filtration surface
Glomerular Capillaries
Higher filtration rate
hydrostatic pressure and large Kf
Renal Hemodynamics
GFR is 20 % of RPF
tubule vein
~149 ml/min
Urine ~1 ml/min
FILTRATION FRACTION
an example
Glomerular
membrane is
similar to other
capillary
membranes except
for the presence of
the Podocytes
Effect of charge on filtration
Albumin = 6 nanometers vs glomerular membrane = 8 nanometers
In some kidney disease negative charges are lost from membrane and
albumin appears in urine Proteinuria or Albuminuria
The glomerular filtration surface showing the inner layer of fenestrated
endothelium, the GBM, and the outer layer of podocyte foot processes
between which he filtrate passes.
Filtration Process
Bowmans
space pedicel Capillary
endothelium has
fenestra which
pass plasma
filtration proteins easily.
slit Barrier is
associated with
(-) charged
proteoglycans in
capillary the basement
membrane.
Filterability of the Membrane
Determined by:
Arterial Pressure
Afferent Arteriolar Resistance
Efferent Arteriolar Resistance
Note:
Autoregulation
is important to
prevent large
changes in GFR
that would
greatly affect
urinary output.
Impact of autoregulation
Autoregulation:
GFR=180L/day and tubular
reabsorption=178.5L/day
Results in 1.5L/day in urine
Without autoregulation:
Small in BP 100 to 125mm Hg, GFR by 25% (180
to 225L/day)
If tubular reabsorption constant, urine flow of 46.5
L/day
Increase of Flow
arterial pressure increases
Vascular smooth muscle responds by contracting
thus increasing resistance
Flow
Increase of
returns to
vascular tone
normal
Renal Blood Flow - Autoregulation
2. Tubuloglomerular
feedback 4. Ra
3.signal from
JGA
GFR
Alteration of tubular flow
(NaCl ) is sensed by the
GFR
macula densa of the
juxtaglomerular
apparatus (JGA) and
produces a signal (renin)
that alters GFR 2. filtrate
The juxtaglomerular apparatus
Including macula densa, extraglumerular mesangial cells, and
juxtaglomerular (granular cells) cells
Feedback mechanism for GFR
Decreased NaCl in
macula densa is
due to increased
reabsorption
resulting from the
slower tubular flow
Regulation of GFR