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NUTRITION AND RENAL FUNCTION

DR.dr. Sri Lestari Sulistyo Rini, MSc


Multi cellular organisms

• In multi cellular organisms, a groups of cells


converted to a tissue , to perform specific function
• A number of systems are evolved in humans
• To provide nutrients to all the systems The Gastro
intestinal tract is accounted for extraction of
nutrients from the food
The Food

• The most of the food we eat are macromolecules ,


it can not cross the cell membrane easily
• so it must be converted to monomers
• Gastrointestinal tract is to make the food in
absorbable form by help of chewing and mixing
with various enzymes in mouth to small intestine
Functions of the Urinary System

• Regulate aspects of homeostasis • Elimination of waste products


• Conserve nutrient • Nitrogenous wastes
• Water and electrolytes balance • Toxins
• Acid-base balance • Drugs
• Blood pressure
• RBC production
• Activation of vit.D
• Gluconeogenesis
Major Parts of the Machine
food, water intake oxygen intake

elimination
Digestive System Respiratory System of carbon
dioxide
nutrients, oxygen
water, carbon
salts dioxide

Circulatory System
Urinary System
water
solutes

elimination rapid transport elimination of


of food to and from all excess water
residues living cells salts, wastes
Reabsorption
What substances are reabsorbed?
Where do they go?

If blood levels of certain substances are high, the


substances will not be reabsorbed.
How does this help maintain homeostasis?

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Reabsorption
 The peritubular capillaries reabsorb several
materials
 Some water
 Glucose
 Amino acids
 Ions
 Some reabsorption is passive, most is active
 Most reabsorption occurs in the proximal
convoluted tubule
Glucose and Amino Acid Reabsorption

• Filtered glucose and amino acids are normally


reabsorbed by the nephrons.
• Carrier mediated transport:
• Saturation.
• Exhibit Tm.
• Renal transport threshold:
• Minimum [plasma] of a substance that results in
excretion of that substance in the urine.
Electrolyte Balance

• Kidneys regulate Na+, K+, H+, Cl-, HC03-, PO4-2.


• Control of Na+ important in regulation of blood
volume and pressure.
• Control of plasma of K+ important in proper
function of cardiac and skeletal muscles.
• Match ingestion with urinary excretion.
The Link Between Water and Salt

 Changes in electrolyte balance causes water to


move from one compartment to another
 Alters blood volume and blood pressure
 Can impair the activity of cells
NaCl Transport along the Nephron
Percentage of
Percentage of Mechanism of Na++ Entry Major Regulatory
Segment Filtrate
Percentage of Mechanism of Na + Entry Major Regulatory
Segment Filtrate
Percentage of across the
Mechanism Apical Membrane
of Na
Na + Entry
Hormones
Major Regulatory
Segment Reabsorbed
Filtrate across the Apical
Mechanism of Membrane
Entry Hormones
Major Regulatory
Segment Reabsorbed
Filtrate across
across the Apical
the Apical Membrane
+ Membrane
Hormones
Hormones
Angiotensin II
Reabsorbed
Reabsorbed
+ +
Na -H antiporter, Na symporter with
Angiotensin II
Proximal + + + Norepinephrine
67% Na -Hacids
amino antiporter,
and Na symporter
organic solutes, with+-
1Na Angiotensin II
Proximal
tubule + +
Na+-2Cl
+ -
-Hacids
antiporter,
+
Na+ symporter
symporter with+- Norepinephrine
EpinephrineII
Angiotensin
67% 1H
amino
Na -H -anion
andantiporter,
antiporter,organic
Na paracellular
solutes, 1Na
with
tubule
Proximal + - +
+ Dopamine
Epinephrine
Norepinephrine
tubule
67% 1H -2Cl
amino acids-anion
andantiporter, paracellular
organic solutes, 1Na -
Epinephrine
Loop of + -
1H -2Cl -anion Dopamine
Aldosterone
1Na -1K antiporter, paracellular
+ + -
25% -2Cl symporter Dopamine
Henleof
Loop + + - Angiotensin
AldosteroneII
Loop of 25% 1Na+-1K+-2Cl- symporter AldosteroneII
Loop
Henleof 25% 1Na+-1K
NaCl +-2Cl- symporter
symporter (early) Aldosterone
Angiotensin
Aldosterone
Henle
Distal tubule 25%
≈5% 1Na -1K -2Cl symporter Angiotensin II
Henle +
Na symporter
NaCl channels (late)
(early) Angiotensin
AldosteroneII
Distal tubule ≈5% NaCl+ symporter (early) AldosteroneII
Na+ channels (late)
NaCl Angiotensin
Na+ symporter (early) Aldosterone
Distal tubule ≈5% Aldosterone, ANP,II BNP,
Distal tubule
Collecting ≈5% channels
+ (late) Angiotensin
duct
≈3% NaNa channels (late)
channels Angiotensin
urodilatin,
Aldosterone, ANP,II BNP,
uroguanylin,
Collecting + Aldosterone,
guanylin, ANP, BNP,
angiotensin II
Collecting ≈3% Na + channels urodilatin,
Aldosterone, uroguanylin,
ANP, BNP,
duct
Collecting ≈3% Na channels urodilatin, uroguanylin,
duct guanylin, angiotensin
uroguanylin,IIII
+
≈3% Na channels urodilatin,angiotensin
guanylin,
duct
guanylin, angiotensin II
Water Transport along the Nephron

Hormones That
Percentage of Mechanism of Water Hormones That
Segment Percentage of Mechanism of Water Regulate Water
Hormones
Hormones That
That
Segment Filtrate Reabsorbed
Percentage of
Percentage of Reabsorption
Mechanism of
Mechanism of Water
Water Regulate Water
Segment
Segment Filtrate
Filtrate Reabsorbed
Reabsorbed Reabsorption
Reabsorption
Permeability
Regulate
Regulate Water
Water
Filtrate Reabsorbed Reabsorption Permeability
Permeability
Proximal tubule 67% Passive None
Permeability
Proximal tubule 67% Passive None
Proximal tubule 67% Descending thin limb only;
Passive None
Loop of Henle 15% Descending thin
Descending thin limb
limb only;
only; None
Loop of Henle
Loop of Henle 15%
15% passive None
None
passive
Descending thin limb only;
Loop
Distaloftubule
Henle
tubule 15%
0%
passive
No water
water reabsorption None
None
Distal 0% No passive
reabsorption None
Distal
Late tubule
distal tubule 0% No water reabsorption None
Distal tubule 0%
≈8%-17% No water reabsorption
Passive None BNP*
ADH, ANP,
and
and collecting
Latecollecting duct
duct
distal tubule
Late distal tubule ≈8%-17% Passive ADH, ANP, BNP*
and collecting duct ≈8%-17% Passive ADH, ANP, BNP*
and collecting duct
Regulation of Water Balance

Brain monitors water content of blood

If low water content, pituitary releases ADH

ADH travels in blood to nephron

ADH causes more water to move from urine back


into blood
EXCRETION
Removal of wastes
• Respiratory system
• CO2, water
• Integumentary system
• Water, salts, lactic acid, urea
• Digestive system
• Water, salts, CO2, lipids, bile pigments, cholesterol, etc.
• Urinary system
• Metabolic wastes, toxins, drugs, hormones, salts, H+, water
The Urinary System
blood

filtration
General
Functioning of tubular
the Kidney reabsorption
and secretion

urine “refreshed” blood


When protein is broken down in the
body, it results in nitrogenous waste
that must be eliminated from the
body
Protein

Based on: Mader, S., Inquiry Into Life, McGraw-Hill


Disposed of in urine and sweat
Ammonia and Urea

• Ammonia is toxic
and highly water
soluble.
• The liver turns
ammonia into
urea, which is
less toxic and
less soluble.
Formation of Urine
Amino acids in protein are broken down,
resulting in production of ammonia

Ammonia is converted to urea in liver

Urea travels in blood to kidneys, where


removed from blood and incorporated into
urine
Color
Color- pigment is urochrome
Yellow color due to metabolic breakdown of hemoglobin (by
bile or bile pigments)

Beets or rhubarb- might give a urine pink or smoky color


Vitamins- vitamin C- bright yellow

Bile pigments-
Bilirubinuria (bile pigment in urine)- liver pathology such as
hepatitis or cirrhosis
Urinalysis

4.02 Understand the functions and disorders of the urinary system 39


Abnormal Constitutes of Urine

Glucose- when present in urine condition called


glycosuria (nonpathological) [glucose not normally
found in urine]

Albumin-abnormal in urine; it’s a very large molecule, too


large to pass through glomerular membrane >
abnormal increase in permeability of membrane
Ketone bodies- normal in urine but in small amounts
Ketonuria- find during starvation, using fat stores
References
• Ganong W.F, Review of Medical Physiology, The
McGraw-Hill Companies, 2010
• Guyton A.C, Hall E.J, Textbook of Medical Physiology,
Elsevier Saunders, Philadelphia, 2006
• Rhoades R, Tanner G, Medical Physiology, Lippincott
Williams & Wilkins, 2009
• Vander et al, Human Physiology: The Mechanism of
Body function, The McGraw Hill Companies, 2001
Thank You