Question

Describe the kidney's respond to reduce filtration pressure?

Answer 1

Ans:- Process of kidney respond to reduce filtration pressure:-

Filtrate is produced by the glomerulus when the hydrostatic pressure produced by the heart pushes water and solutes through the filtration membrane. Glomerular filtration is a passive process as cellular energy is not used at the filtration membrane to produce filtrate. Recall that the filtration membrane lies between the blood in the glomerulus and the filtrate in the Bowman’s (glomerular) capsule and this filtration membrane is highly fenestrated allowing the passage of small molecules such as water, sodium, glucose, etc.

The volume of filtrate formed by both kidneys per minute is termed glomerular filtration rate (GFR). Approximately 20% of your cardiac output is filtered by your kidneys per minute under resting conditions. The work of the kidneys produces about 125 mL/min filtrate in men (range of 90 to 140 mL/min) and 105 mL/min filtrate in women (range of 80 to 125 mL/min). This amount equates to a volume of about 180 L/day in men and 150 L/day in women. However, 99% of this filtrate is returned to the circulation through reabsorption resulting in only about 1–2 liters of urine per day.

GFR is influenced by multiple factors, like those seen at tissue capillary beds (see chapter 19). Recall that filtration occurs as pressure forces fluid and solutes through a semipermeable barrier with the solute movement constrained by particle size. Hydrostatic pressure is the pressure produced by a fluid against a surface. The blood inside the glomerulus creates glomerular hydrostatic pressure which forces fluid out of the glomerulus into the glomerular capsule. The fluid in the glomerular capsule creates pressure pushing fluid out of the glomerular capsule back into the glomerulus, opposing the glomerular hydrostatic pressure. This is the capsular hydrostatic pressure. These fluids exert pressures in opposing directions. Net fluid movement will be in the direction of the lower pressure. However, the concentration of the solutes in the fluids affects net movement of fluid as well.

Water moves across a membrane from areas of high water concentration (low dissolved solute concentration) to areas of low water concentration (high dissolved solute concentration) through the process of osmosis. The concentration of plasma solutes in the glomerulus is greater than the concentration of the filtrate in the glomerular capsule since the filtration membrane limits the size of particles crossing the membrane. Most proteins cannot pass into the filtrate resulting in water’s movement out of the capsule towards the glomerulus. This pressure acting to draw water into the glomerulus is called blood colloid osmotic pressure. The absence of proteins in the glomerular space (the lumen within the glomerular capsule) results in a capsular osmotic pressure near zero.

Glomerular filtration occurs when glomerular (blood) hydrostatic pressure exceeds the hydrostatic pressure of the glomerular capsule and the blood colloid osmotic pressure. The sum of all of the influences, both osmotic and hydrostatic, results in a net filtration pressure (NFP). Glomerular hydrostatic pressure is typically about 55 mmHg pushing fluid into the glomerular capsule. This outward pressure is countered by a typical capsular hydrostatic pressure of about 15 mmHg and a blood colloid osmotic pressure of 30 mmHg. To calculate the value of NFP:

NFP = Glomerular blood hydrostatic pressure (GBHP) – [capsular hydrostatic pressure (CHP) + blood colloid osmotic pressure (BCOP)] = 10 mm Hg

That is: NFP = GBHP – [CHP + BCOP] = 10 mm Hg

Or: NFP = 55 – [15 + 30] = 10 mm Hg (Figure 25.4.1).

Figure 1:-  Net Filtration Pressure: The NFP is the sum of osmotic and hydrostatic pressures.

A proper concentration of solutes in the blood is important in maintaining osmotic pressure both in the glomerulus and systemically. There are disorders in which too much protein passes through the filtration slits into the kidney filtrate. This excess protein in the filtrate leads to a deficiency of circulating plasma proteins. Together, blood colloid osmotic pressure decreases, resulting in an increase in urine volume potentially causing dehydration.

As you can see, there is a low net pressure across the filtration membrane. Intuitively, you should realize that minor changes in osmolarity of the blood or changes in capillary blood pressure result in major changes in the amount of filtrate formed at any given point in time. The kidney is able to cope with a wide range of blood pressures. In large part, this is due to the autoregulatory nature of smooth muscle. When you stretch it, it contracts. Thus, when blood pressure goes up, smooth muscle in the afferent arterioles contracts to limit any increase in blood flow and filtration rate. When blood pressure drops, the same capillaries relax to maintain blood flow and filtration rate. The net result is a relatively steady flow of blood into the glomerulus and a relatively steady filtration rate in spite of significant systemic blood pressure changes. Mean arterial blood pressure is calculated by adding 1/3 of the difference between the systolic and diastolic pressures to the diastolic pressure. Therefore, if the blood pressure is 110/80, the difference between systolic and diastolic pressure is 30. One third of this is 10, and when you add this to the diastolic pressure of 80, you arrive at a calculated mean arterial pressure of 90 mm Hg. Therefore, if you use mean arterial pressure for the GBHP in the formula for calculating NFP, you can determine that as long as mean arterial pressure is above approximately 60 mm Hg, the pressure will be adequate to maintain glomerular filtration. Blood pressures below this level will impair renal function and cause systemic disorders that are severe enough to threaten survival. This condition is called shock.

It is vital that the flow of blood through the kidney be at a suitable rate to allow for filtration and yet not too fast to overwhelm the reabsorbing potential of the nephron tubule. This rate determines how much solute is retained or discarded, how much water is retained or discarded, and ultimately, the osmolarity of blood and the blood pressure of the body.

Regulation of GFR

Glomerular filtration has to be carefully and thoroughly controlled because the simple act of filtrate production can have huge impacts on body fluid homeostasis and systemic blood pressure. Due to these two very distinct physiological needs, the body employs two very different mechanisms to regulate GFR. The kidney can control itself locally through intrinsic controls, also called renal autoregulation. These intrinsic control mechanisms maintain filtrate production so that the body can maintain fluid, electrolyte, and acid-base balance and also remove wastes and toxins from the body. There are also control mechanisms that originate outside of the kidney, the nervous and endocrine systems, and are called extrinsic controls. The nervous system and hormones released by the endocrine systems function to control systemic blood pressure by increasing or decreasing GFR to change systemic blood pressure by changing the fluid lost from the body.

Intrinsic Controls: Renal Autoregulation

The kidneys are very effective at regulating the rate of blood flow over a wide range of blood pressures. Your blood pressure will decrease when you are relaxed or sleeping. It will increase when exercising. Yet, despite these changes, the filtration rate through the kidney will change very little. The kidney’s ability to autoregulate can maintain GFR with a MAP of as low as 80 mm Hg to as high as 180 mm Hg. This is due to two internal autoregulatory mechanisms that operate without outside influence: the myogenic mechanism and the tubuloglomerular feedback mechanism.

Arteriole Myogenic Mechanism

The myogenic mechanism regulating blood flow within the kidney depends upon a characteristic shared by most smooth muscle cells of the body. When you stretch a smooth muscle cell, it contracts; when you stop, it relaxes, restoring its resting length. This mechanism works in the afferent arteriole that supplies the glomerulus and can regulate the blood flow into the glomerulus. When blood pressure increases, smooth muscle cells in the wall of the arteriole are stretched and respond by contracting to resist the pressure, resulting in little change in flow. This vasoconstriction of the afferent arteriole acts to reduce excess filtrate formation, maintaining normal NFP and GFR. Reducing the glomerular pressure also functions to protect the fragile capillaries of the glomerulus. When blood pressure drops, the same smooth muscle cells relax to lower resistance, increasing blood flow. The vasodilation of the afferent arteriole acts to increase the declining filtrate formation, bringing NFP and GFR back up to normal levels.