Urinary System and Fluid Balance
Urinary system – major excretory
system of the body; consists of 2
kidneys, 2 ureters, urinary bladder,
and the urethra.
Urine – consists of (1) excess water,
(2) excess ions, (3) metabolic wastes,
including the protein by-product rea,
and (4) toxic substances.
Excretion – major function of the
urinary system.
Functions of the Urinary System
1. Excretion
2. Regulation of blood volume and
pressure
3. Regulation of the concentration
of solutes in the blood
4. Regulation of extracellular fluid
pH
5. Regulation of red blood cell
synthesis
6. Regulation of vitamin D
synthesis
Anatomy of the Kidneys
Kidneys – behind the peritoneum, or
retroperitoneal; located each side of
the vertebral column; bean-shaped
organs.
Retroperitoneal – structures that are
behind the peritoneum.
Protects the kidneys:
(1) Rib cage, (2) renal capsule, (3)
adipose tissue and (4) renal fascia
Renal capsule – layer of connective
tissue that surrounds the kidney.
Thick layer of adipose tissue –
protects the kidney from mechanical
shock.
Hilum – medial side of each kidney;
where the renal artery and nerves
enter and where the renal vein,
ureter, and lymphatic vessels exit the
kidney.
Renal sinus – a cavity where hilum
opens; contains blood vessels, part of
the system for collecting urine, and
adipose tissue.
Internal Anatomy and Histology of
the Kidneys
Kidneys – divided into two major
regions: outer cortex and inner
medulla, which surrounds the renal
sinus.
Renal pyramids – cone-shaped
located at the boundary between the
cortex and the medulla.
Calyx – funnel-shaped structure that
surrounds the tip of each renal
pyramid.
Renal pelvis – large funnel.
Ureter – a small tube which exits the
kidney and connects to the urinary
bladder.
Flow of urine:
From the tips of the renal pyramids
 calyces  renal pelvis  ureter 
bladder
The Nephron
Nephron – functional unit of the
kidney; does not regenerate.
 Renal corpuscle
 Proximal convoluted tubule
 Loop of Henle
 Distal convoluted tubule
*Each kidney has approximately 1.3
million nephrons.
Blood is filtered in the renal corpuscle
 proximal convoluted tubule 
loop of Henle  distal convoluted
tubule  collecting duct
Collecting duct – carries the fluid
from the cortex through the medulla.
Papillary duct – empty their contents
into a calyx.
Two types of nephrons:
 Juxtamedullary nephrons (15%) –
have loops of Henle that extend
deep into the medulla.
 Cortical nephrons (85%) – have
loops of Henle that do not extend
deep into the medulla.
Renal corpuscle consists of:
 Bowman’s capsule (BC) – enlarged
end of the nephron intended to
form a double-walled chamber.
 Glomerulus – tuft of capillaries
that resembles a ball of yarn; lies
within the indentation of
Bowman’s capsule.
Podocytes – inner layer of Bowman’s
capsule that consists of specialized
cells.
Fenestra – openings of the
glomerulus.
Filtration slits – gaps of the
Bowman’s capsule.
Filtration membrane (FM) – formed
by endothelium of the glomerular
capillaries, basement membrane, and
podocytes of BC.
GBM (Glomerular Basement
Membrane) – between the
endothelial cells and podocytes of
the Bowman’s capsule.
Filtrate – the fluid that passes across
the filtration membrane.
Afferent Arteriole – supplies blood to
the glomerulus filtration.
Efferent arteriole – transports the
filtered blood away from the
glomerulus.
Juxtaglomerular apparatus –
important regulatory structure;
consists of unique set of afferent
arteriole cells and specialized cells:
 Juxtaglomerular cells – secretes
renin; smooth muscle cells found
where the afferent arteriole
enters the renal corpuscle.
 Macula densa – group of
specialized cells the distal
convoluted tubule.
Arteries and Veins
Renal arteries – branch off the
abdominal aorta and enter the
kidneys.
Interlobar arteries – pass between
the renal pyramids.
Arcuate arteries – arch between the
cortex and the medulla.
Interlobular arteries – branch off the
arcuate arteries and project into the
cortex.
Afferent arterioles – arise form
branches of the interlobular arteries
and extend to the glomerular
capillaries.
Efferent arterioles – extend from the
glomerular capillaries.
Peritubular capillaries – surround the
proximal convoluted and distal
convoluted tubules and the loops of
Henle.
Vasa recta – specialized portions of
the peritubular capillaries that extend
deep into the medulla.
Blood flow through the kidney:
1. Renal artery
2. Interlobar artery
3. Arcuate artery
4. Interlobular artery
5. Afferent arteriole
6. Glomerulus
7. Efferent arteriole
8. Peritubular capillaries
9. Vasa recta
10. Interlobular vein
11. Arcuate vein
12. Interlobar vein
13. Renal vein
Urine Formation
1. FILTRATION
 Movement of water, ions, and
small molecules through the FM
into the BC.
Filtration – nonspecific process
whereby materials are separated
based on size or charge.
*Average of 21% of the blood
pumped by the heart each minute
flows through the kidneys.
*19% passes through the FM into the
BC to become filtrate.
*About 180 L of filtrate are produced
each day but only about 1% or less of
the filtrate becomes urine because
most of the filtrate is reabsorbed.
Filtration pressure (FP) – forces fluid
from the glomerular capillary across
the FM into the BC.
Glomerular capillary pressure (GCP) –
BP in the glomerular capillary.
Capsular pressure (CP) – pressure of
filtrate already inside the BC.
Colloid osmotic pressure (COP) –
pressure of filtrate within the
glomerular capillary.
Filtration pressure is calculated as
follows: GCP – CP – COP = FP
Regulation of Filtration
Cardiovascular shock – the filtration
pressure and filtrate formation fall
dramatically
2. TUBULAR REABSORPTION
 Movement of substances from the
filtrate across the wall of the
nephrons back into the blood of
the peritubular capillaries.
3. TUBULAR SECRETION
 Active transport of solutes across
the nephron walls into the filtrate.
Regulation of Urine
Concentration and Volume
Hormonal Mechanisms
Renin-Angiotensin-Aldosterone-
Mechanism (RAAS)
 Renin is secreted from the kidney
when blood pressure decreases.
 Renin converts angiotensinogen to
angiotensin I; then converted to
angiotensinogen II by angiotensin-
converting enzyme; which
stimulates aldosterone,
vasoconstriction, salt and water.
 Aldosterone increases Na+ and Cl+
reabsorption from the nephron.
Antidiuretic Hormone Mechanism
 Secreted from the posterior
pituitary when blood
concentration increases / blood
pressure decreases.
 Increases the permeability to
water of the distal convoluted
tubules and collecting ducts.
 Increases water reabsorption by
the kidney.
 Promotes aquaporin molecule
insertion.
Atrial Natriuretic Hormone (ANH)
 Secreted from cardiac muscle cells
in the right atrium in response to
increased blood pressure.
 Acts on the kidney to increase Na+
& water loss in the urine.
Urine Movement
Anatomy and Histology of the
Ureters, Urinary Bladder, and Urethra
Ureters – small tubes that carry
urine.
Urinary bladder – hollow, muscular
container that stores urine; can hold
about 1000 mL.
Cystitis – inflammation of the urinary
bladder results from bacterial
infection.
Bacterium E. coli – most common
cause of cystitis.
Urethra – tube that carries urine form
the urinary bladder to the outside of
the body.
Trigone – triangle-shaped portion of
UB between the opening of the
ureters and the opening of the
urethra.
Vit. D & The Kidneys – essential for
homeostasis of Ca and K.
Internal urinary sphincter (males) –
smooth muscle at the junction of the
urinary bladder and urethra.
External urinary sphincter (males +
females) – skeletal muscle that
surrounds the urethra.
Micturition Reflex – activated by
stretch of the urinary bladder wall.
BODY FLUID COMPARTMENTS
Intracellular fluid compartment –
fluid inside all the cells in the body.
Extracellular fluid compartment –
fluid outside all the cells in the body;
includes interstitial fluid, plasma and
fluid in the lymphatic vessels.
Composition of the Fluid in the BFC
 Intracellular fluid – contains more
K, Mg, PO4, SO4, and protein.
 Extracellular fluid – contains more
Na, Ca, Cl, and HCO3.
Exchange bet. BFC
 Water moves continually between
compartments I response to
hydrostatic pressure differences
and osmotic differences between
the compartments.
REGULATION OF EXTRACELLULAR
FLUID COMPOSITION
Thirst Regulation
 Blood concentration increases =
thirst center initiates sensation of
thirst
 When water is consumed, blood
concentration increases = thirst
sensation decreases
 Blood pressure decreases = thirst
sensation is triggered
 Consumption of water = increases
blood volume + allows blood
pressure to increase
Thirst center – neurons in the
hypothalamus that control water
intake.
Thirst – one of the important means
of regulating ECF volume and
concentration.
Ion Concentration Regulation
 Sodium ions are dominant
extracellular ions.
o Aldosterone increases Na+
reabsorption from filtrate.
o ADH increases water
reabsorption from the nephron.
o ANH increases Na+ loss in urine.
 Aldosterone increases K+
secretion in urine.
o Increased blood levels of K+
stimulate.
o Decreased blood levels of K+
inhibit.
 PTH increases extracellular Ca2 +
levels.
o Causes bone reabsorption.
o Increases Ca2 + uptake in the
kidney.
 PTH increases vit. D synthesis.
 Calcitonin (thyroid gland)
o Inhibits bone reabsorption.
o Lowers blood Ca2 + levels.
 Phosphate + Sulfate Ions
o When levels are low in the
filtrate = ions are reabsorbed.
o When levels are high = excess is
lost in the urine.
REGULATION OF ACID-BASE
BALANCE
Normal pH – between 7.35 -7.45.
Factors controlling pH of body fluids:
 Buffers
o Resist changes in the pH;
Proteins, phosphate buffer
system, bicarbonate buffer
system.
 Respiratory System
o Increase respiratory rate
raises pH = rate of CO2
elimination is increased.
o Reduced respiratory rate =  Hypochloremia: < 97 mEq/L
reduces pH (CO2 elimination (hyperexcited)
is reduced).  Hyperchloremia: > 107 mEq/L
 Kidneys (lethargy)
o Excrete H+ in response to
POTASSIUM REGULATION
decreasing blood pH.
o Reabsorb H+ in response to Potassium – major cation inside the
an increasing blood pH. cell (98% ICF).
Acidosis and Alkalosis  K NV: 3.5 – 5.0 mEq/L
 Hypokalemia: < 3.5 mEq/L
Failure of the buffer systems, the
 Hyperkalemia: > 5.0 mEq/L
respiratory system, or the urinary
CALCIUM REGULATION
system to maintain normal pH levels
can result in acidosis or alkalosis. Calcium – most abundant clotting
Acidosis – occurs when blood pH falls factor.
below 7.35.  Ca NV: 8.6 – 10.2 mg/dL
Respiratory acidosis – respiratory is  Hypocalcemia: < 8.6 mg/dL
unable to eliminate adequate  Hypercalcemia: > 10.2 mg/dL
amounts of CO2. MAGNESIUM REGULATION
Metabolic acidosis – excess  Mg NV: 1.5 – 2.5 mEq/L
production of acidic substances  Hypomagnesemia: < 1.5 mEq/L
(lactic acid + ketone bodies).
 Hypermagnesemia: > 2.5 mEq/L
Alkalosis – occurs when blood pH BODY FLUID COMPARTMENTS
increases above 7.45.
INFANT
Respiratory alkalosis – results from
 Total Body Water %: 75
hyperventilation in response to
stress.  ICF %: 45
 ECF %: 30
Metabolic alkalosis – results from
rapid elimination of H+ from body. ADULT MALE
ADDITIONAL INFOS:  TBW %: 60
 ICF %: 40
SODIUM REGULATION
 ECF %: 20
 Na Normal Volume: 135 – 145
ADULT FEMALE
mEq/L
 TBW %: 50
 Hyponatremia: < 135 mg/Dl
 Hypernatremia: > 145 mg/dL  ICF %: 35
 ECF %: 15
CHLORIDE REGULATION
 Cl NV: 96 – 106 mEq/L