Before We Start…A Summary of

Urine Production
Don’t Sweat the Numbers Game –
Think Form and Function!
 Water Balance
& Kidney Disorders
 Importance of Water…
• Average adult loses 2 L of water per day

• 1% decrease in body water causes thirst

• 5% decrease causes extreme pain and collapse

• 10% decrease causes death

 Water Balance
Increased water in take = Increased urine
output
water intake or more exercise = more urine
output
 Antidiuretic Hormone (ADH)
• Antidiuretic: preventing the outpt of urine
• Antidiuretic hormone
– Produced in the hypothalmus
– Released from the posterior pituitary

• Osmoreceptor cells in the hypothalamus continually monitor the

osmolarity of the blood.
– They stimulate the release of ADH when the blood osmolarity
too high

– Sweating or diarrhea cause an increase in blood osmolarity

***ADH causes the epitilial cells lining the collecting ducts to become more
permeable to water

• Alcohol and coffee inhibit the release of ADH

– A hangover may partially be due to dehydration
 ADH & Low Body Water
• body water = blood solutes = osmotic pressure

• Water moves into the bloodstream, causing

hypothalamic osmoreceptors to shrink
– an impulse is sent to the posterior pitituary to
release ADH

– ADH travels gto the collecting ducts

• ↑ water reabsorption = concentrated urine

 ADH & Low Body Water
• Also initiates a sensation of thirst

• As water is consumed…
– ↓ blood’s osmotic pressure
– Water moves back into the body cells and the
hypothalamic osmoreceptors
– Osmoreceptors swell and “deactivate”
– Less ADH released and less water is reabsorbed
 Lose electrolytes after
you are exercising. If
serious blood loss the
blood pressure drops and
you lose Na.

What happens when you lose Na+ or

there is a drop in blood pressure?
Firstly – What activities would lead to
a decrease in blood Na+? A change in
blood pressure?
 A Different Pathway ensues…

• Renin-Angiotensin
aldosterone
system(RAAS)
(RAAS)
– This system is stimulated
by changes detected by a
specific region of the
nephron called the:

JUXTO GOMULAR APPARATUS

(JGA)
 RAAS Continued
Stimulus: Drop in FILTERATION PRESSURE at the
glomerulus (decrease blood volume in afferent
arterioles – contributing factors?)

Response: JGA releases Renin

Function of RENIN: Converts Angiotensinogen

(produced by liver) to Angiotensin I
 More RAAS…rah rah RAAS
What happens to Angiotensin 1?

At the Lungs:

Angiotensin I Angiotensin II
 Role of Angiotensin II
Angiotensin II

IF WE INCREASE
OUR BLOOD
VOLUME THEN IT
ALLOWS US TO
Adrenal Cortex
ABSORB MORE
Systemic Arterioles
WATER
CNS
Stimulation
of Thirst
Secrete Centres Vasoconstriction
ALDOSTERONE
 The RESULT…Increase Blood
Pressure
More water = more volume
ALDOSTERONE: secretion causes kidney tubules to
reabsorb Na+ = Water follows (OSMOSIS!) =
Increased blood volume and pressure

CNS activation of thirst centres: drink more = more

fluid to increase blood volume

Vasoconstriction: of efferent arterioles to increase

pressure at JGA ( shuts off renin receptors )
Kidney Conditions – Urinalysis
Look Fors….
 Glucose goes thru with
the filtrate but gets
absorbed , thus the
excreted urine should
not have glucose.

Protein ( big molecule) and RBC

shouldn't be passing thru the filtrate
.Can signal damage to kidney is high
blood pressure

Ketone bodies are used during diabetes when the

glucose in blood is not being used so the body
uses the lipids
 Kidney Stones
• Typically arise when the urine becomes saturated with a
salt that is capable of forming solid crystals

• They can lodge in the renal pelvis, or move into urethra

• 75% of stones are CALCIUM SALTS

• As sharp stones pass through excretory passage tissues

can be torn causing pain

• 80 - 85% pass spontaneously while large stones must be

either surgically removed or broken up using shockwave
treatment
http://www.umm.edu/patiented/articles/kidney_stones_animation_000475.htm
 Dialysis
• A dialysis machine is used to help restore the proper
solute balance in people with a malfunctioning
kidney
– Dialysis is the exchange of substances across a semi-
permeable membrane

• A dialysis machine can not perform active transport,

nor can it produce hormones

• Types:
1. Hemodialysis - Blood purified OUTSIDE body with
machine (81% of Canadian dialysis patients)
2. Peritodialysis - Blood purified INSIDE body in
peritoneum
Hemodialysis
This form of dialysis
removes waste
products from the
blood by passing it
out of the body,
through a filtering
system (dialyser)
and returning it,
cleaned, to the
body.
Peritoneal Dialysis
With this method, instead
of being cleaned by an
artificial membrane
outside the body, the
blood is cleaned inside the
body, through the
Peritoneum. This is the
thin membrane that
surrounds the outside of
the organs in the
abdomen.
 Kidney Transplants
• Kidney transplants take a person off
dialysis, and have a success rate around
85%
• Involves placing a new kidney and
ureter in the lower abdomen near the
groin
• They are surgically attached to the
blood vessels and bladder
• Sometimes, the kidney recipient’s
immune system sets out to destroy the
donated kidney
– Immunosuppressive drugs help stop
this