Early Filtrate Processing

Gambaran seluler dari

tubulus renalis
Tubulus proximal: simple cuboidal cells
(brush border cells ok terdapat microvilli)
Thin loop of henle: simple squamous cell,
highly permeable to water not to solute
Thick ascending loop of henle & early
distal tubule: cuboidal cells, highly
permeable to solutes, particularly NaCl
but not to water

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

There are two reabsorption

pathways:

1. the transcellular pathway (>>)

2. the paracellular pathway

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

Sodium Reabsorption
PUMP: Na/K ATPase
Sodium

Lumen
Cells
Potassium

Plasma
Chloride
Water

Keluar

dari sel ke
interstiital

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

 Transport

Maximum (Tm)

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.

Reabsorption: Receptors can Limit

Figure 19-15: Glucose handling by the nephron

 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.

Distal Tubule & Collecting

Duct
The

Late Distal Tubule & CCT are

composed of principal cells &
intercalated cells
Intercalated cells secrete hydrogen
ions into filtrate
Principals cells perform hormonally
regulated water & sodium
reabsorption & potassium secretion

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
Principals

cells are more permeable

to water on the presence of ADH

Reabsorption in Proximal
Tubule
Glucose

and Amino Acids

67% of Filtered Sodium
Other Electrolytes
65% of Filtered Water
50% of Filtered Urea
All Filtered Potassium

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

Figure 19-9: The juxtaglomerular apparatus

Glomerulotubular
Balance
is

the intrinsic ability of the tubules

to increase their reabsorption rate in
response to increased tubular load
(increased tubular inflow).
occurs in other tubular segments,
especially the loop of Henle.

TUBULOGLOMERULAR
FEEDBACK
a

feedback mechanism that links

changes in sodium chloride
concentration at the macula densa with
the control of renal arteriolar resistance.
helps ensure a relatively constant
delivery of sodium chloride to the distal
tubule and helps preventspurious
fluctuations in renal excretion that
would otherwise occur.

 The

tubuloglomerular feedback
mechanism has two components that
act together to control GFR:
(1) an afferent arteriolar feedback
mechanism and
(2) an efferent arteriolar feedback
mechanism.
depend on the juxtaglomerular complex

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

Sympathetic Regulation of GFR

Insert fig. 17.11