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RENAL PHYSIOLOGY
       (III)
        m
 RENAL TUBULAR
  PROCESSING


     Mohammed Abdel Gawad
OBJECTIVES
2


       Formation of urine
       Forms of membrane Transport
       PCT Function
       Loop of Henle Function
       DCT Function
       Urea, Na & Water Tubular Handling
       Hormones & Kidney Tubules
       Tubular Transport Maxima
OBJECTIVES
3


       Formation of urine
       Forms of membrane Transport
       PCT Function
       Loop of Henle Function
       DCT Function
       Urea, Na & Water Tubular Handling
       Hormones & Kidney Tubules
       Tubular Transport Maxima
Formation of URINE in 3 steps
4




                Tubular         Tubular
              Reabsorption      Secretion


Glomerular                      Excretion
 Filtration
RENAL CIRCULATION
5
Formation of URINE in 3 steps
6
Formation of URINE in 3 steps
7
OBJECTIVES
8


       Formation of urine
       Forms of membrane Transport
       PCT Function
       Loop of Henle Function
       DCT Function
       Urea, Na & Water Tubular Handling
       Hormones & Kidney Tubules
       Tubular Transport Maxima
Cell Membrane
9



                    Polar heads
                    love water
                    & dissolve.


                    Non-polar
                    tails hide
                    from water.
Forms of Membrane Transport
10
Forms of Membrane Transport
11
PASSIVE TRANSPORT
12


         With concentration gradient (downhill)




                    No need for energy
Diffusion through phospholipid bilayer
13
Diffusion through phospholipid bilayer
14




      inside cell
                                    lipid
                     K                      O2




                     Na   glucose   a.a.    CO2
      outside cell
Leak Channels
15
Leak Channels
16



                     high




                     low
Facilitated Diffusion
17
Facilitated Diffusion
18




                             high




                             low
ACTIVE TRANSPORT
19

     • Against concentration gradient (UPhill)




             • need energy (ATP, CP)
Primary Active Transport
20
Primary Active Transport
21
Secondary Active Transport
22
Secondary Active Transport
23
Secondary Active Transport
24
Secondary Active Transport
25

                                               Tubular                           Interstitial
Tubular Tubular Cell            Interstitial                 Tubular Cell
                                               lumen                             Fluid
lumen       co-transport        Fluid                    counter-transport
             (symport)                                        (antiport)


            out            in                            out                in


        Na+                                            Na+



  glucose                                                                        H+


Co-transporters will move one moiety,           Counter-transporters will move one
e.g. glucose, in the same direction as          moiety, e.g. H+, in the opposite direction
the Na+.                                        to the Na+.
Pinocytosis
26

        Some parts of the tubule, especially the proximal
         tubule, reabsorb large molecules such as
         proteins by pinocytosis.
OBJECTIVES
27


        Formation of urine
        Forms of membrane Transport
        PCT Function
        Loop of Henle Function
        DCT Function
        Urea, Na & Water Tubular Handling
        Hormones & Kidney Tubules
        Tubular Transport Maxima
Proximal Convoluted Tubule
28
Proximal Convoluted Tubule
     Reabsorption
29




                  phosphate   phosphate
Proximal Convoluted Tubule
         Reabsorption
30

        Some parts of the tubule, especially the proximal
         tubule, reabsorb large molecules such as
         proteins by pinocytosis.
Proximal Convoluted Tubule
     Secretion
31
Proximal Convoluted Tubule
     Secretion
32


        The proximal tubule is also an important
         site for secretion of:
          organic acids and bases such as bile
           salts,oxalate, urate, and catecholamines.
          drugs penicillin and salicylates

          toxins

          PAH
OBJECTIVES
33


        Formation of urine
        Forms of membrane Transport
        PCT Function
        Loop of Henle Function
        DCT Function
        Urea, Na & Water Tubular Handling
        Hormones & Kidney Tubules
        Tubular Transport Maxima
Loop of Henle
34
     (Descending Limb)
Loop of Henle
35
     (Ascending Limb)
Loop of Henle
36
     (Ascending Limb)
OBJECTIVES
37


        Formation of urine
        Forms of membrane Transport
        PCT Function
        Loop of Henle Function
        DCT Function
        Urea, Na & Water Tubular Handling
        Hormones & Kidney Tubules
        Tubular Transport Maxima
Early Distal Convoluted Tubule
38
Early Distal Convoluted Tubule
39
Late Distal Convoluted Tubule
     Collecting Duct
40
Late Distal Convoluted Tubule
     Collecting Duct
41
Late Distal Convoluted Tubule
     Collecting Duct
42
OBJECTIVES
43


        Formation of urine
        Forms of membrane Transport
        PCT Function
        Loop of Henle Function
        DCT Function
        Urea, Na & Water Tubular Handling
        Hormones & Kidney Tubules
        Tubular Transport Maxima
Urea Tubular Handling
44
Sodium Tubular Handling
45




             65%

                               8-10%



                        25%
Water Tubular Handling
46

             65% by osmosis
                                  15%
                (obligatory
                              Under effect of
              reabsorption)
                                  ADH
                               (Facultative
                              reabsorption)



                 15-20%
               by osmosis
                (obligatory
              reabsorption)
OBJECTIVES
47


        Formation of urine
        Forms of membrane Transport
        PCT Function
        Loop of Henle Function
        DCT Function
        Urea, Na & Water Tubular Handling
        Hormones & Kidney Tubules
        Tubular Transport Maxima
Hormones & Kidney Tubules
48
OBJECTIVES
49


        Formation of urine
        Forms of membrane Transport
        PCT Function
        Loop of Henle Function
        DCT Function
        Urea, Na & Water Tubular Handling
        Tubular Transport Maxima
Tubular transport maxima (Tm)
50

        It is the maximum amount of a substance in mg, which can be
         reabsorbed or secreted per minute.
        TmG with normal blood glucose level = 375 mg/min for men, 300
         mg/min for women
51




            Follow On
     www.nephrotube.blogspot.com
                 &
           Facebook Group
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52




     Gawad

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Renal Physiology (III) - Renal Tubular Processing - Dr. Gawad