第八章 肾脏的排泄功能excretive function of kidney 学习要求1．了解 .pptVIP

Kidney Physiology YU Yanqin, PhD Zhejiang University, School of Medicine Overview – Functions of the Kidney Regulation of body fluid osmolality (渗透压) Production of hormones: Erythropoietin（促红细胞生成素）, Kinins（激肽） and Renin（肾素）, Prostaglandins（前列腺素），1,25-dihydroxycholecalciferol（1,25-羟基维生素D3） Regulation of electrolyte and water Excretion of waste products Regulation of acid and base Structure of the Kidney Nephron（肾单位） Renal corpuscle（肾小体） - Glomerulus （肾小球） - Bowman’s capsule（肾小囊） Renal tubular system（肾小管） Proximal convoluted tubule Loop of Henle（髓袢） - Descending thick limb - Descending thin limb - Ascending thin limb - Ascending thick limb Distal convoluted tubule Collecting duct system Types of the Nephron Cortical nephron（皮质肾单位） Juxtamedullary nephron （近髓肾单位） Differences between the Nephrons Juxtaglomerular Apparatus（球旁复合体） Juxtaglomerular cells球旁细胞 Renin-producing granular cells Macula densa致密斑 Extraglomerular mesangial cells球外系膜细胞 Blood Supply of the Kidney ?1200 ml/min, 20 % of the cardiac output ? Cortex: 94 % Outer medulla: 5-6 % Inner medulla: 1 % ? two capillary networks Autoregulation of Renal Blood Flow Range of regulation BP: 80 ~ 170 mmHg Mechanisms Myogenic mechanism 肌源学说 Flow dependent mechanism (Tubuloglomerular feedback管球反馈) 1. Myogenic mechanism肌源学说 Arterial blood pressure ? → contraction of the vascular smooth muscle → constriction of the blood vessel → the blood flow relatively constant 2. Tubuloglomerular feedback管球反馈 Renal blood flow ? → glomerular filtration ? → Na+ content in the renal filtrate ? → detection by the macula densa → a signal sent to the renal arterial system → restoration of the renal blood flow and glomerular filtration rate to normal Neural Regulation of Renal Blood Flow Activation of the renal sympathetic nerves → constriction of the renal arterioles → renal blood flow an