Urinary System Functions

• Filtering of blood via filtration, reabsorption,

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• Location • External Anatomy
– Lie behind peritoneum – Renal capsule: fibrous connective
(retroperitoneal) on tissue. Surrounds each kidney
posterior abdominal wall – Perirenal fat
on either side of vertebral • Engulfs renal capsule and acts as
column cushioning
– Lumbar vertebrae and rib – Renal fascia: thin layer loose
cage partially protect connective tissue
• Anchors kidneys and surrounding
– Right kidney slightly lower adipose to abdominal wall
than left
– Hilum
• Renal artery and nerves enter and
renal vein and ureter exit kidneys
• Opens into renal sinus (cavity filled
with fat and loose connective tissue)

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Internal Anatomy of Kidneys
• Cortex: outer area
– Renal columns: part of cortical
tissue that extends into medulla
• Medulla: inner area; surrounds
renal sinus
– Renal pyramids: cone-shaped.
Base is boundary between
cortex and medulla. Apex of
pyramid is renal papilla,
points toward sinus.
• Calyces
– Minor: papillae extend into
funnel of minor calyx
– Major: converge to form pelvis
• Pelvis: enlarged chamber
formed by major calyces
• Ureter: exits at the hilum;
connects to urinary bladder

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 The Nephron
• Functional and histological unit
of the kidney
• Parts of the nephron:
Bowman’s capsule, proximal
tubule, loop of Henle
(nephronic loop), distal
tubule
• Urine continues from the
nephron to collecting ducts,
papillary ducts, minor
calyses, major calyses, and
the renal pelvis
• Collecting ducts, parts of the
loops of Henle, and papillary
ducts are in the renal medulla

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 Types of Nephrons
• Juxtamedullary nephrons.
Renal corpuscle near the
cortical medullary border.
Loops of Henle extend deep
into the medulla.
• Cortical nephrons. Renal
corpuscle nearer to the
periphery of the cortex. Loops
of Henle do not extend deep
into the medulla.
• Renal corpuscle. Bowman’s
capsule plus a capillary bed
called the glomerulus.

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 Renal Corpuscle
• Bowman’s capsule:
outer parietal (simple
squamous epithelium)
and visceral (cells
called podocytes)
layers.
• Glomerulus: network
of capillaries. Blood
enters through afferent
arteriole, exits through
efferent arteriole.
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Bowman’s Capsule
• Parietal layer: outer.
Simple squamous
epithelium that becomes
cube-shaped where
Bowman’s capsule ends
and proximal tubule
begins
• Visceral layer: inner.
Specialized podocytes that
wrap around the
glomerular capillaries

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 Filtration Membrane
• Fenestrae: window-like openings in
the endothelial cells of the
glomerular capillaries.
• Filtrations slits: gaps between the
cell processes of the podocytes.
Basement membrane sandwiched
between the endothelial cells of the
glomerular capillaries and the
podocytes.
• Filtration membrane: capillary
endothelium, basement membrane
and podocytes. First stage of urine
formation occurs here when fluid
from blood in capillaries moves
across filtration membrane into the
lumen inside Bowman’s capsule.
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 Circulation in the Glomerulus
• Afferent arteriole: supplies blood to glomerulus
• Efferent arteriole: drains glomerulus
• Both vessels have a layer of smooth muscle
• Juxtaglomerular apparatus: sight of renin production
– Juxtaglomerular cells- ring of smooth muscle in the afferent arteriole where the latter
enters Bowman’s capsule
– Macula densa- Specialized tubule cells of the distal tubule. The distal tubule lies between
the afferent and efferent arterioles.

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Histology of the Nephron
• Proximal tubule: simple cuboidal
epithelium with many microvilli
• Loops of Henle
– Descending limb: first part
similar to proximal tubule.
Latter part simple squamous
epithelium and thinner
– Ascending limb: first part
simple squamous epithelium
and thin, distal part thicker and
simple cuboidal
• Distal tubule: shorter than
proximal tubule. Simple cuboidal,
but smaller cells and very few
microvilli
• Collecting ducts: form where
many distal tubules come together.
Larger in diameter, simple cuboidal
epithelium. Form medullary rays
and lead to papillary ducts

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 Circulation Through the Kidney
Arterial supply:
1. Renal arteries branch
from abdominal aorta
2. Segmental arteries
branch from renal
3. Interlobar arteries
ascend within renal
columns toward cortex
4. Arcuate arteries
branch and arch over
the base of the pyramids
5. Interlobular arteries
project into cortex and
give rise to afferent
arterioles

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 Circulation Through the Kidney
• The part of the circulation
involved with urine formation
6. Afferent arterioles supply
blood to glomerulus
7. Glomerulus
8. Efferent arterioles exit the
renal corpuscle
9. Peritubular capillaries form a
plexus around the proximal and
distal tubules
10. Vasa recta: specialized parts of
peritubular capillaries that course
into medulla along with loops of
Henle, then back toward cortex
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 Circulation Through the Kidney
• Venous drainage
11. Peritubular
capillaries drain into
interlobular veins
and lead to
12. Arcuate veins
13. Interlobar veins
14. Renal veins

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 Urine Formation
Nephrons considered functional units of the kidney: smallest
structural component capable of producing urine

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 Filtration
• Movement of fluid, derived from blood flowing through the
glomerulus, across filtration membrane
• Filtrate: water, small molecules, ions that can pass through
membrane
• Pressure difference forces filtrate across filtration membrane
• Renal fraction: part of total cardiac output that passes through the
kidneys. Varies from 12-30%; averages 21%
• Renal blood flow rate: 1176 mL/min
• Renal plasma flow rate: renal blood flow rate X fraction of blood
that is plasma: 650 mL/min
• Filtration fraction: part of plasma that is filtered into lumen of
Bowman’s capsules; average 19%
• Glomerular filtration rate (GFR): amount of filtrate produced
each minute. 180 L/day
• Average urine production/day: 1-2 L. Most of filtrate must be
reabsorbed 26-15
26-16
 Filtration
• Filtration membrane: filtration barrier. It prevents blood cells and proteins
from entering lumen of Bowman’s capsule, but is many times more permeable
than a typical capillary
– Fenestrated endothelium, basement membrane and pores formed by
podocytes
– Some albumin and small hormonal proteins enter the filtrate, but these are
reabsorbed and metabolized by the cells of the proximal tubule. Very little
protein normally found in urine
• Filtration pressure: pressure gradient responsible for filtration; forces fluid from
glomerular capillary across membrane into lumen of Bowman’s capsules
• Forces that affect movement of fluid into or out of the lumen of Bowman’s
capsule
– Glomerular capillary pressure (GCP): blood pressure inside capillary
tends to move fluid out of capillary into Bowman’s capsule
– Capsule pressure (CP): pressure of filtrate already in the lumen
– Blood colloid osmotic pressure (BCOP): osmotic pressure caused by
proteins in blood. Favors fluid movement into the capillary from the lumen.
BCOP greater at end of glomerular capillary than at beginning because of
fluid leaving capillary and entering lumen
– Filtration pressure (10 mm Hg) = GCP (50 mm Hg) – CP (10 mm Hg) –
BCOP (30 mm Hg) 26-17
Filtration Pressure

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 Filtration
• Colloid osmotic pressure in Bowman’s capsule normally close to zero.
During diseases like glomerular nephritis, proteins enter the filtrate and
filtrate exerts an osmotic pressure, increasing volume of filtrate
• High glomerular capillary pressure results from
– Low resistance to blood flow in afferent arterioles
– Low resistance to blood flow in glomerular capillaries
– High resistance to blood flow in efferent arterioles: small diameter vessels
• Pressure lower in peritubular capillaries downstream from efferent
arterioles
• Filtrate is forced across filtration membrane; fluid moves into peritubular
capillaries from interstitial fluid
• Changes in afferent and efferent arteriole diameter alter filtration
pressure
– Dilation of afferent arterioles/constriction efferent arterioles increases glomerular
capillary pressure, increasing filtration pressure and thus glomerular filtration

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 Autoregulation and
Sympathetic Stimulation
• Autoregulation
– Involves changes in degree of constriction in afferent
arterioles
– As systemic BP increases, afferent arterioles constrict
and prevent increase in renal blood flow
– Increased rate of blood flow of filtrate past cells of
macula densa: signal sent to juxtaglomerular apparatus,
afferent arteriole constricts
• Sympathetic stimulation: norepinephrine
– Constricts small arteries and afferent arterioles
– Decreases renal blood flow and thus filtrate formation
– During shock or intense exercise: intense sympathetic
stimulation, rate of filtrate formation drops to a few mm
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 Tubular Reabsorption: Overview
• Tubular reabsorption: occurs as filtrate flows through the
lumens of proximal tubule, loop of Henle, distal tubule, and
collecting ducts
• Results because of
– Diffusion
– Facilitated diffusion
– Active transport
– Symport
– Osmosis
• Substances transported to interstitial fluid and reabsorbed
into peritubular capillaries: inorganic salts, organic
molecules, 99% of filtrate volume. These substances return
to general circulation through venous system
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 Reabsorption in Proximal
Convoluted Tubule
• Substances pass through cells of tubule
wall. Each cell has
– Apical surface: surface that faces
filtrate. Apical membrane
– Basal surface: faces interstitial fluid.
Basal membrane
– Lateral surfaces: surfaces between
cells
• Active transport of Na+ across the basal
membrane from cytoplasm to interstitial
fluid linked to reabsorption of most
solutes
•Because of active transport, the concentration of Na+ is low inside the cell and
Na+ moves into nephron cell from filtrate through the apical membrane. Other
substances moved by symport from the filtrate into the nephron cell are substances
that should be retained by the body
•Substances transported
–Through apical membrane: Na+, Cl-, glucose, amino acids, and water.
–Through basal membrane: Na+, K+,
Cl-, glucose, amino acids, water
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 Reabsorption in Proximal
Convoluted Tubule
• Number of carrier molecules
limits rate of transport
• In diabetes mellitus
– Concentration of glucose in filtrate
exceeds rate of transport
– High concentration of glucose in
plasma (and thus in filtrate) reflected
in glucose in the urine
• Diffusion between cells: from
lumen of nephron into interstitial
fluid
– Depends on rate of transport of same
solutes through the cells of the tubule
– K+, Ca2+, and Mg2+
• Filtrate volume reduced by 65%
due to osmosis of water 26-23
 Changes in Concentration of
Solutes in the Nephron
• Urea: enters glomerular filtrate.
– As volume of filtrate decreases, concentration of urea
increases
– Walls of nephron not very permeable to urea: only
40-60% passively reabsorbed
• Urate ions, creatinine, sulfates, phosphates,
nitrates partially reabsorbed
– Concentration is high in urine
– Toxic substances and are eliminated

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 Tubular Secretion
• Moves metabolic by-products, drugs, molecules not
normally produced by the body into tubule of
nephron
• Active or passive
• Ammonia: produced by epithelial cells of nephron
from deamination of amino acids. Diffuses into
lumen
• H+, K+, penicillin, and substances such as para-
aminohippuric acid (PAH): actively secreted
into nephron
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 Urine Production
• In ascending limb of loop of
• In Proximal convoluted Henle
tubules – Na+, Cl-, K+ transported out of
filtrate
– Na+ and other substances
– Water remains
removed
– Water follows passively • In distal convoluted tubules
– Filtrate volume reduced and collecting ducts
– Water movement out regulated
• In descending limb of loop by ADH
of Henle • If absent, water not reabsorbed
– Water exits passively, solute and dilute urine produced
• If ADH present, water moves
enters
out, concentrated urine
– Filtrate volume reduced 15% produced

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Urine Concentrating Mechanisms

26-27
 Other Hormones
• Atrial natriuretic hormone
– Produced by right atrium of heart when blood volume
increases stretching cells
– Inhibits Na+ reabsorption
– Inhibits ADH production
– Increases volume of urine produced
– Venous return is lowered, volume in right atrium
decreases
• Prostaglandins and kinins: produced in kidney.
Role unclear
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Clearance and Tubular Maximum
• Plasma clearance: calculated using substances
like inulin
– Volume of plasma cleared of a specific substance each
minute
– Used to estimate GFR
– Used to calculate renal plasma flow. Calculated using
substances like PAH
– Used to determine which drugs or other substances
excreted by kidney
• Tubular load
– Total amount of substance that passes through filtration
membrane into nephrons each minute

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 • Maximum rate at which a
Tubular substance can be actively
absorbed
– Each substance has its own
Maximum tubular maximum
– Normally, glucose
concentration in the plasma
(and thus filtrate) is lower
than the tubular maximum
and all of it is reabsorbed;
none of it is found in the urine
– In diabetes mellitus tubular
load exceeds tubular
maximum and glucose
appears in urine. Urine
volume increases because
glucose in filtrate increases
osmolality of filtrate reducing
the effectiveness of water
reabsorption

26-30
 Urine Movement
• Hydrostatic pressure forces urine through
nephron
• Peristalsis moves urine through ureters from
region of renal pelvis to urinary bladder.
Occur from once every few seconds to once
every 2-3 minutes
– Parasympathetic stimulation: increase
frequency
– Sympathetic stimulation: decrease frequency
• Ureters enter bladder obliquely through
trigone. Pressure in bladder compresses
ureter and prevents backflow
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Anatomy and Histology of Ureters and Bladder
• Ureters: bring urine from
renal pelvis to urinary
bladder. Lined by transitional
epithelium
• Urinary bladder: hollow
muscular container. In pelvic
cavity posterior to symphysis
pubis. Lined with transitional
epithelium; muscle part of
wall is detrusor
•Trigone: interior of urinary bladder. Triangular area between the
entry of the two ureters and the exit of the urethra. Area expands
less than rest of bladder during filling

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 Anatomy and Histology of Urethra
• Male: extends from the inferior
part of the urinary bladder through
the penis
• Female: shorter; opens into
vestibule anterior to vaginal
opening
• Internal urinary sphincter: in
males, elastic connective tissue and
smooth muscle keep semen from
entering urinary bladder during
ejaculation
• External urinary sphincter:
skeletal muscle surrounds urethra
as it extends through pelvic floor.
Acts as a valve
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Micturition Reflex

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 Effects of Aging
• Gradual decrease in size of kidneys, but only one-
third of one kidney necessary for homeostasis
• Amount of blood flowing through gradually
decreases
• Number of glomeruli decrease and ability to
secrete and reabsorb decreases
• Ability to concentrate urine declines and kidney
becomes less responsive to ADH and aldosterone
• Reduced ability to participate in vitamin D
synthesis contributing to Ca2+ deficiency,
osteoporosis, and bone fractures
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