URINALYSIS AND RENAL
FUNCTION WEEK 1
HISTORY
Inorganic substance
Physicians lacked the sophisticated testing Chloride
mechanisms now available, they were able to diagnose Sodium
information from basic observations as color, turbidity, Potassium
odor, volume, viscosity and even sweetness.
Urine may also contain:
Modern urinalysis has expanded beyond the
Cells
physical examination of urine
Crystals
a. Chemical analysis
Cast
b. Miscroscopic.
Mucus
Hippocrates 5th century BCE Bacteria
-> Wrote a book on “Uroscopy”
Increased amount of these formed elements are often
Frederik Dekkers’s indicative of disease
Chemical testing progressed from Ant-testing and Creatinine, urea, sodium and chloride are significantly
Taste higher in urine than in other body fluids.
testing for glucose Frederik Dekkers’s discovery in
1694 of albuminuria by boiling urine Protein and glucose are not present in normal urine.
Indicative of: Proteinuria , Diabetes.
URINE
Liquid produced by the kidney to move waste from
Component Comment
the bloodstream.
Ultrafiltrate plasma.
Primary organic component. Product
Reabsorption of water and filtered substances Urea of metabolism of protein and amino
essential to body function converts approx. acids.
170,000 mL of filtered plasma.
Product of metabolism of creatine by
1200mL average daily urine output (depending on Creatinine
muscles.
fluid intake)
Composed of 5% solutes and 95% water. Uric acid breakdown of nucleic acid in food
and cells.
-> solutes can occur due to the dietary intake, physical
activity, body metabolism and endocrine functions. Chloride found in combination with sodium
and many other inorganic substances.
UREA
-A metabolic waste product produced in the liver from Sodium from salt
the breakdown of protein and amino acids.
Potassium combine with chloride and other salt
Organic substances of Urine
Uric Acid
Creatinine
URINALYSIS AND RENAL
FUNCTION WEEK 1
Component Comment
RENAL BLOOD FLOW
Combines with sodium to buffer the
Phosphate blood. Blood enters the capillaries Flows through the And into efferent
of the nephron through glomerulus arteriole
afferent arteriole.
Regulates blood and tissue fluid
Ammonium
acidity.
Before returning to renal vein:
Calcium Combines with chloride, sulfate and Blood from efferent arteriole enters he peritubular capillaries and
phosphate. vasa recta and flows slowly through the cortex and medulla of
the kidney close to the tubules.
1. Renal artery
RENAL PHYSIOLOGY
2. Afferent arteriole
3. Glomerulus
KIDNEY-> removes the unwanted waste of our body,
4. Bowman’s capsule
selectively from the blood and simultaneously to 5. Efferent Arteriole
maintain the body’s essential water and electrolyte 6. Peritubular capillaries
balances. 7. Vasa recta
8. Renal vein
Contains approximately 1 to 1.5 million functional unit
call nephron.
Urinary Filtrate Flow
2 types of nephron 1. Bowman capsule / Glomerulus
2. Renal Tubules
1. Cortical nephron - 85% Proximal convoluted tubule
Primarily in the cortex of the kidney. Loop of Henle
Descending loop of Henle
Responsible for removal of waste products and
Ascending loop of Henle
reabsorption of nutrients.
Distal convoluted tubule
Collecting duct
2. Juxtamedullary nephrons - 15% 3. Renal Calyses
have longer loops of Henle that extend deep into 4. Ureter
the medulla of kidney, 5. Urethra
Responsible for concentration of urine
Renal functions controlled by nephrons: The peritubular capillaries surround the proximal and distal
convoluted tubules providing for the immediate reabsorption of
1. Renal blood flow essential substances from the proximal convoluted tubules and
final adjustment of urinary composition in the distal convoluted
2. Glomerular filtration
tubule.
3. Tubular reabsorption
4. Tubular secretion
URINALYSIS AND RENAL
FUNCTION WEEK 1
Average body size of 1.73m^2 of surface total renal blood Aldosterone- Sodium retaining hormone
flow is 1200mL/min. ADH (Antidiuretic hormone) - controls water in
Total renal plasma flow ranges from 600 to 700 mL/min. the body.
GLOMERULAR FILTRATION
Analysis of body fluid as it leaves the glomerulus
Glomerular filtration barrier - glomerulus consist shows the filtrate to have a specific gravity of
1.010 and confirms that it is a ultrafiltrate of
of a coil of approximately eight capillary lobes, the
plasma.
walls.
Glomerulus- located within Bowman capsule, which ACTION OF RAAS
forms the beginning of renal tubules. 1. Dilates the afferent arteriole and constricts
serves as nonselective filter of plasma substances the efferent arteriole
with molecular weight of less than 70,000. 2. Stimulates sodium reabsorption in the
proximal convoluted tubule.
Factors influence the actual filtration: 3. Triggers the adrenal cortex to release
Cellular structure of the capillary walls and aldosterone to cause sodium reabsorption and
Bowman capsule potassium excretion in the distal convoluted
Hydrostatic pressure tubule and collecting duct,
Oncotic pressure 4. Triggers the hypothalamus to release ADH to
Feedback mechanism od RAAS (renin- stimulate water reabsorption in collecting
duct.
angiotensin-aldosterone system)
RAAS - regulates the flow of blood to and within
glomerulus.
Renin - an enzyme produced by juxtaglomerular cell, is
secreted and reacts with the bloodborne substrate
angiotensinogen to produce the inert hormone
angiotensin 1.
This passes through the alveoli of the lungs,
angiotensin-converting enzyme (ACE) changes it to
active form angiotensin II.
Angiotensin II corrects renal blood flow through:
1. Causing vasodilation of the afferent arterioles and
constriction of efferent art.
2. Stimulates reabsorption of NA and H2O in the
proximal convoluted tubules.
3. Triggering the release of the aldosterone by
adrenal cortex and ADH by the hypothalamus.
A systematic blood pressure and plasma sodium content
increase, the secretion of renin decrease.