[医学]chapter 8 urine formation and excretion-2010-update.ppt

Regulation on ADH secretion An increase in extracellular fluid osmolarity → ADH release (the most important factor) - Osmoreceptor-ADH Set point: 280 mOSM/kg.H2O -Water diuresis: urine volume increases after drinking water; results from reduced secretion of the ADH of the in response to the lowered osmotic pressure of the blood.????? Cardiovascular Reflex Stimulation of ADH Release by Decreased Arterial Pressure and/or Decreased Blood Volume Renal Clearance Plasma clearance refers to the volume of plasma cleared of a particular substance per minute. Concept: Calculation of C: U – concentration of substance Y in urine, mg/100ml; V – volume of urine per minute, ml/min; P – concentration of substance Y in plasma, mg/100ml; C = U×V/ P. C is a good criterion to evaluate the function of kidneys. Solutes used to measure GFR Required properties are: Solute is freely-filtered (conc. in Bowman’s space = that in blood plasma). Tubules do not absorb, secrete or metabolize X. Thus, amount of X in urine per unit time = that which glomerulus filters per unit time WHAT GOES IN = WHAT COMES OUT! INULIN（菊粉） is such a substance that satisfies all of these criteria and is commonly used to measure GFR Inulin clearance for GFR estimation Creatinine clearance to estimate GFR Summary 1.The kidney is the most important excretory organ of the human body. 2.The functional unit of the kidney is the nephron 3.Formation of urine involves three basic processes: 4.Glomerular filtration depends on the permeability of the glomerular membrane and the effective filtration pressure. 5.The proximal tubule is the main site of reabsorption where glucose, amino acids and vitamin are completely reabsorbed. 6.The kidney provides a powerful function of urine concentration and dilution. 7.Antidiuretic hormone and aldosterone act on kidneys to regulate the volume and osmolarity of the urine. * Excretion of metabolic waste products and foreign chemicals Regulation of water and electrolyte balan