Renal | Glomerular Filtration
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- เผยแพร่เมื่อ 11 พ.ค. 2017
- Official Ninja Nerd Website: ninjanerd.org
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In this lecture Professor Zach Murphy will be teaching you about glomerular filtration. We talk about the many wastes and excess fluids that occurs here as well as the glomerular filtration rate. We hope you enjoy this lecture and be sure to support us below!
References:
● Sabatine MS. Pocket Medicine: the Massachusetts General Hospital Handbook of Internal Medicine. Philadelphia: Wolters Kluwer; 2020.
● Le T. First Aid for the USMLE Step 1 2020. 30th anniversary edition: McGraw Hill; 2020.
● Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2). McGraw-Hill Education / Medical; 2018
● Marieb EN, Hoehn K. Anatomy & Physiology. Hoboken, NJ: Pearson; 2020.
● Boron WF, Boulpaep EL. Medical Physiology.; 2017. Guyton and Hall Textbook of Medical Physiology. Philadelphia, PA: Elsevier; 2021.
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#ninjanerd #GlomerularFiltration #Renal
Blood supply of the Glomerulus: 1:28
Fenestrated capillaries: 2:03
Basement membrane structure: 05:40
Negatively charged basement membrane as a filter: 9:55
Conclusion of Glomerulus structure: 12:18
Podocytes: 13:40
Nephrin: 14:43
Filtration Slit (the slit diaphragm): 15:15
Parietal of the Bowman's capsule: 16:45
Conclusion of molecules that can be filtrated into the Bowman's space: 17:40
Mesangial cells: 21:55
J.G Cells (Jextra Glomerulus cell): 23:05
-------------------------------------------------------------------------------------------------------------------------------
Glomerulus filtration rate: 25:26
Factors affecting the filtration rate:
Net filtration rate (In: Colloid osmotic pressure / Capsular hydrostatic pressure, Out: Glomerulus hydrostatic pressure / Capsular osmotic pressure = 0 in healthy animals, no plasma protein should pass): 27:05
KF (Filtration coefficient - Surface area and permeability of the glomerulus capillaries): 34:45
What could affect GHP/COP/CHP: 39:20
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Summary:
Renal corpuscle: Glomerulus + Bowman's capsule
Glomerlus: endothelial lining + glomerular basement membrane
1. Tuft of capillaries that is fed by afferent arteriole.
2. Type of capillaries: fenestrated- pores in endothelial cells
No formed elements (RBCs, WBCs, platelets) (can go through fenestrated pores)
Can pass thru: H20, waste products, small proteins, electrolytes, nutrients)
3. Efferent arteriole drains glomerulus (NOT a venule- rare in body)
[Blue membrane] Glomerular basement membrane
1. Three sublayers (endothelial side to podocytes side)
a. Lamina rara interna- Heparin sulfate (very negatively charged)- thinner layer
Negative charge of heparin sulfate is important because proteins inside blood is negatively charged, eg, albumins, IgG. Positively charged electrolyes can easily pass through.
b. Lamina densa- type IV collagen and laminins
c. Lamina rara externa- Heparin sulfate
Bowman's capsule: Parietal + visceral layer
a. Visceral layer
1. Podocytes
2. Nephrin- proteins inbetween podocytes, interconnecting them
makes up the slit diaphragm
3. Filtration slit- space between podocytes
b. parietal layer
Freely Filterable stuff:
HCO3-, Na+, K+, Cl-, Ca2+, Mg 2+, H2O, Glucose, amino acids, lipids, Urea, creatinine
Mesangial cells [piranha looking]
> important to glomerular structure- phagocytose molecules that get hung up in slit diaphragm
> Contractile activity: control the amount of blood flow that comes to the glomerulus
> gap junctions connect to juxtaglomerular cells (stimulates release of renin from JG cells)
Net Filtration Pressure
Glomerular Filtration rate (GFR):
> DEF: plasma volume that is being filtered out from the glomerulus and into the Bowman's capsule for 1 min- 125 ml/min
> Every min, 1200 ml passes through arteriole. Only 625 ml/min out of this is used in filtration process. 575 ml leaves out.
> 20% of 635 filtered only = 125 ml
Factors that affect GFR:
1. NFP: pressures forcing out - pressures pulling things in
> Forcing out: Glomerular hydrostatic pressure (GHP), Colloidal Osmotic Pressure (CoOP)- the pressure created by albumin and such to keep all the things in the blood, in the blood and not anywhere else
> Forcing in: Capsular Hydrostatic Pressure (CHP), Capsular Osmotic Pressure (CaOP)- 0 mm Hg in normal humans since plasma proteins are not meant to pass.
> GHP + CaOP - (CHP + CoOP) = NFP
> 55 + 0 - ( 30 + 15 ) = 10 mm Hg
> NFP directly proportional to GFR
2. KF (Filtration Coeffient)
2a. Surface area of glomerulus
> directly proportional to GFR
> diabetic nephropathy: protein deposits in glomerulus that makes it thicker and reduces surface area
2b. Permeability of glomerulus
> directly proportional to GFR
> Glomerulonephritis: damage to glomerulus makes basement membrane very porous. Higher GFR causes lots of proteins to be lost.
GFR = NFP x KF
Clinical Correlations:
GHP- directly dependent on systemic BP (directly proportional)
CoOP-
> multiple myeloma (too many diff types of proteins in the blood) you end up taking a lot of water
> hypoproteinemia: can't hold on to proteins
CHP
> renal calculi (kidney stone >5mm diameter) stuck in nephron loop
> increase in CHP
> hydronephrosis due to renal ptosis- in individuals that are very emaciated (thin/weak) because of rapid weight loss, the kidneys can drop and kink up. Fluids flow back to the kidney causing hydronephrosis.
> increase in CHP
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25:38
The 600ml of the 1200 ml of the blood coming into glomerulus per minute is the plasma part of the blood ,the part of the blood filtred in the glomerulus .and as you know the plama constitutes 55% of the blood , hence we have 600 ml of plasma in the kidney the remaining 45% are the blood cells .
Renal blood flow per minute =1100 ml .
Renal plasma follow per minute = 600ml , and out of this we filter 125 ml which is about 20 % of renal plasma follow (filtration fraction )
So incredibly helpful!! I do have two questions if someone could please enlighten me!
1. Why do anions pass the glomerular basement membrane but proteins do not? If they are both negatively charged and of the appropriate size.
2. It was implied a few times that the increase/decrease in osmotic pressure was proportional to the concentration of proteins in the plasma and capsule. Why does changes in electrolytes not result in the same changes of osmotic pressure?
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Great lecture but I have a question
How negatvly charged ions like chlorde and bicrbonate pass through the GBM?
it can pass through the GBM, but it's more harder than the positive charge
same question here🤔🤔
they are negative but small, proteins are negative and large. so its harder for cl- and hco3- to filtrate but it can
I too have the same questions,,, how negative charge can pass through GBM ? In any condition dnt matter they r small why the GBM doesnt repell cl- and hco3- ?
Thanks a lot
You said that negatively charged particles can not pass through glomerular basement membrane. But cl and bicarbonat are negatively charged particles.
Can you explain about this?
Thank you 😊
They normally can't, but when there's too much of them and they're small enough to fit the fenestrations, then some may actually pass through
Yeah i have the same question!!
well there are sialoproteins (negatively charged proteins in the wall of the glomerular basement membrane. Due to these, the filtration of negatively charged proteins is slightly slower than the cationic substances of the same size. So HCO3- and cl- do pass through albeit in lesser quantities. In some diseases the negative charges in the glomerular basement membrane disappear leading to filtration of large amounts of albumin and other negatively charged molecules
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Hi, thanks for all!! Just a tiny correction: the fenestrations are not holes IN the endothelial cell, they are spaces BETWEEN the cells. 😉
nah theyre pores, aka holes. spaces would be more so discontinuous capillaries.
No, what you are talking about is known as inter-cellular clefts. Fenestrations are indeed the holes in the endothelial cells.
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20:18
Sir if bicarbonates and chloride are negatively charged how do they make out of the glomerular membrane? Please help.
Yes..same question sir
Our professor told us that because the molecular weight of Cl or HCO3 is really small (unlike big plasma proteins), the effects of the negative charge can be negligible.
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