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Blood supply of the kidney: 21% of the cardiac output = 1200 ml/mnt
Juxtaglomerular cell
Capsule space
Efferent arteriole
Proximal convoluted tubule Endothelium of glomerulus Pedicel
Podocyte
Stellate cells called mesangial cells are located between the basal lamina and the endothelium. They are similar to cells called pericytes, which are found in the walls of capillaries elsewhere in the body. Mesangial cells are especially common between two neighboring capillaries, and in these locations the basal membrane forms a sheath shared by both capillaries (Figure 382).
The mesangial cells are contractile and play a role in the regulation of glomerular filtration. Mesangial cells secrete the extracellular matrix, take up immune complexes, and are involved in the progression of glomerular disease.
Formation of Urine
Involves three main processes: 1.Filtration 2.Reabsorption 3.Secretion
Filtration membrane
Is composed of three layers: 1. fenestrated glomerular endothelium
2.basement membrane
3.filtration slits are formed by the pedicels of the podocytes
Substance are filtered are on the basis of size and/or electrical properties
Podocytes:
Foot pedicels form small filtration slits. Passageway through which filtered molecules must pass.
filtration slit
fenestrated endothelium
filtration slit
fenestrated endothelium podocyte primary cell body process
filtration slit
capillary
Kf, the glomerular ultrafiltration coefficient, is the product of the glomerular capillary wall hydraulic conductivity (ie, its permeability) and the effective filtration surface area.
PGC is the mean hydrostatic pressure in the glomerular capillaries, PT the mean hydrostatic pressure in the tubule (Bowmans space), GC the oncotic pressure of the plasma in the glomerular capillaries, and T the oncotic pressure of the filtrate in the tubule (Bowmans space).
Autoregulation Mechanism
To counteract changes in GFR Myogenic mechanism Increased systemic pressure: Autoregulation: afferent arteriole diameter decreased (constricted) to maintain the GFR Decreased systemic pressure: Autoregulation: afferent arteriole diameter increased (dilated) to maintain the GFR
Creatinine:
End product of muscle creatine metabolism Used in clinical setting to measure GFR but less accurate than inulin method Small amount secrete from the tubule
Para-aminohippurate (PAH):
An organic anion not present in body Freely filtered, secreted but not reabsorbed by nephron Non-toxic, neither synthesized nor metabolized in kidney
Low concentrations are enough (10 mg/100 ml plasma)
Concept of clearance
Qx extracted = Qx excreted Px . Cx = Ux . V Ux . V GFR = Cx = Px Where, Cx = Clearance of substance X (mg/min) Ux = Urine concentration of X (mg/ml) Px = Plasma concentration of X (mg/ml) V = Urine flow rate of X (ml/min)
ERBF = Cx =
ERPF 1 - Hct
Hct=hematocrit
RBF =
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