Regulation of Extracellular Fluid

Osmolarity and Sodium Concentration

Concept of
Osmolarity/Osmolality
Osmole: Number of osmotically active
particles in a solution
Osmolarity/osmolality: Osmolal concentration
of a solution (in oSm/L and oSm/kg)
In the body, 80% of total osmolarity of
plasma and intersitial fluid is due to sodium
and chloride
Osmolarity of plasma: 282 mOsm/L
Osmolarity of Interstitial fluid: 281 mOsm/L
Osmolarity of Intracellular fluid: 281 mOsm/L

Role of Kidneys
Kidneys excrete excess water by
forming dilute urine
Excess water when plasma osmolarity <
282 mOsm/L

Kidneys conserve water by excreting

concentrated urine
Too little water when plasma osmolarity
> 282 mOsm/L

Excretion of Concentrated Urine

Requires:
High Levels of ADH
High osmolarity of renal medullary
interstitial fluid

If above two conditions are present:

Water will flow out of the permeable
tubular membrane via osmosis (due to
osmole gradient between tubules and
renal medulla)
Water will be carried by blood vessels
back into the blood

Formation of concentrated
urine

Anti-Diuretic Hormone
Diuresis = urine production
Anti-diuretic hormone = decreased
urine production
Action of ADH: Increased
permeability to water molecules at
the
Distal collecting tubule
Cortical collecting tubule
Inter medulary collecting duct

Hyperosmotic Renal Medulla

Due to pumping of ions (sodium,
chloride, potassium) and urea into
interstitium (remember the
ascending loop of henle!)
Enhanced by countercurrent
mechanism
Maintained by countercurrent
exchange in the surrounding blood
vessles

Excreting Dilute Urine

No ADH
Water does not flow out of distal
tubules Resulting urine is dilute

Renal regulation of
Potassium

Potassium Homeostasis
Extracellular potassium = 4.2 mEq/L
Hyperkalaemia = Too much
potassium
Can result in cardiac arrest or fibrillation

Hypokalaemia = Too little potassium

Can result in cardiac arrhythmias

Role of kidneys
Potassium will always be filtered
through glomerular membranes
Hyperkalaemia Secrete extra
potassium
Hypokalaemia Absorb potassium
back

Renal Potassium Excretion

Determined by:
Potassium filtration
Potassium reabsorption
Potassium secretion

65% of filtered potassium will be reabsorbed in the

proximal tubule
25% to 30% of filtered potassium will be
reabsorbed in the loop of Henle
Only site at which potassium secretion/reabsorption
can be regulated is at the principal cells of the
distal and cortical collecting tubules

Renal Potassium Excretion

On normal
days,
potassium
is secreted

Potassium is lost because

you consume potassium
through food

What happens at the

principal cells

Secretion of potassium
Uptake into principal cells from renal
intersitium by active transport
Secretion into tubules from principal
cells by passive diffusion

Factors stimulating potassium

secretion
Increased extracellular potassium
Aldosterone
Increased tubular flow rate

Acid Base Regulation

Acid-Base Balance
Extracellular fluid contains H+ ions
Concentration of H+ ions determine
pH of extracellular fluid
Normal pH of extracellular fluid = 7.4
(range from 7.35 to 7.45)
Acidosis = pH < 7.35
Alkolosis = pH > 7.45

Acid Base equations of body

fluids
Acid

Base

When an acid is added, carbon dioxide is produced

When a base is added, bicarbonate salts are used to produced weak bases
Carbon dioxide in the blood is used to replace bicarbonate salts

3 systems of regulating H+
Chemical Acid-base buffers of body
fluids
Body stores of Bicarbonate
Phosphate
Proteins (intracellular)

Lungs
Kidneys

Lungs
Increase in breathing (ventilation)
eliminates carbon dioxide (acid)
Decrease in breathing (ventilation)
decreases elimination of carbon
dioxide
Works fast Can respond to
changes in minutes

Renal Control of Acid-Base

Excreting acidic or basic urine
Acidic urine: Large quantities of H+
In acidosis, kidneys reabsorb filtered HCO3- and
produce more HCO3-

Basic urine: Large quantities of HCO3 In alkalosis, kidneys do not reabsorb any filtered
HCO3-

3 methods:
Secretion of H+
Reabsorption of filtered HCO3 Production of HCO3-

Secretion and reabsorption of

HCO3 80 90% of HCO3- reabsorption and
secretion occurs in proximal tubule
10% of HCO3- is reabsorp in thick
ascending loop of henle
Remainder takes place in distal
tubule and collecting duct
Important concept: HCO3reabsorption and H+ secretion
always occurs simultaneously

Secretion and reabsorption of

HCO3-

Creation of new bicarbonate

Phosphate buffer

Ammonia buffer