ANATOMY AND PHYSIOLOGY
SCHOOL OF NURSING
THE PHYSIOLOGY OF URINE
FORMATION
PARTICIPANTS
1. GRACE CHAMDIMBA
2. AFRANSIA MBOYA
3. LUCAS KINYUNYU
Learning objectives
At the and of this presentation, each participant
will be able to;
1. Define urine and its composition
2. Explain the stages of urine formation
Glomerular filtration
Selective reabsorption
Tubular secretion
3. explain the process of micturation
What is Urine?
• Urine is liquid waste material produced by
metabolic processes and excreted by the body.
• Normal urine is a clear amber to yellow
coloured liquid that contains 95% water and 5%
solutes. These solutes include:
• ElectrolyteS such as sodium, potassium,
calcium, magnesium and chrolide
• Nitrogenous chemicals such as urea and
creatinine
Urine composition
• Urine composition varies from time to time
and reflects the amounts of water and solutes
that the kidneys eliminate to maintain
homeostasis
• Urine is 95% water
• Urea- 2%
• Uric acids, creatinine, pigment’s- 0.3%
• Inorganic salts-2%
Cont….
• Vitamins
• Organic acids such as uric acids
• Other organic compounds
Physical characteristics of Urine
• The following physical characteristics of urine are
of importance as they would help identifying
renal system pathologies
• Urine has a pH of around 6.2 with a range of 5.5-
7.0
• Urine has a specific gravity of 1.002 to 1.037
URINE FORMATION
Urine formation follows a complex process that
takes place in the nephrons of the kidneys. Urine
formation takes place in three stages which are:
Glomerular filtration
Selective reabsorption
Tubular secretion.
Cont…..
• Glomerular Filtration- this is the renal process where by
fluid in the blood is filtered across a permeable
membrane in the renal corpuscle
• The renal corpuscle is a structure at the beginning of the
nephron that consist of:
• Glomerulus- is the filtering unit of the kidney made up
of a bundle of capillaries lined by fenestrated endothelia.
This unit is contained within the glomerular capsule/
bowman’s capsule. These are the only capillaries in the
body that are not surrounded by interstitial tissue. They
are the only capillaries that are drained by an arteriole.
Cont…
• The glomerular capsule/ bowman’s capsule- a cup
like sack at the beginning of the nephron surrounding
the glomerulus. The bowman’s capsule encloses a
space called bowman’s space which is continuous with
the proximal tubule and the rest of the renal tubule.
• When fluid leaves the capillaries into the GBM, it
enters the glomerular space, all the way through the
tubules where reabsorption and secretion takes place.
Diagram of the kidney and nephron
Glomerular filtration
• Glomerular filtration is the renal process
whereby fluid in the blood is filtered across
the capillaries of the glomerulus.
• This takes place through the semipermeable
walls of the glomerular capillaries and
Bowman’s capsule.
• The volume of filtrate formed by both kidneys
each minute is called Glomerular Filtration
Rate (GFR)
• Glomerular filtration rate in healthy adult is
125ml/min or 180L/day (by both kidneys).
• The blood enters the glomerulus through
afferent arteriole and leaves through efferent
arteriole.
• The blood enters through afferent arteriole
contains urea, glucose, various salts, proteins
and water.
Auto-regulation of Glomerular Filtration
1. Myogenic mechanism- when GFR increases,
there is increased loads of (sodium chloride)
NaCl- which initiates signal causing the
constriction of afferent arteriole hence
decreasing ultrafiltration and vice-versa.
2. Juxtaglomerular mechanism- the cells of JGA
secrets an enzyme called Renin, which
regulates the blood pressure, renal blood
flow and rate of ultrafiltration
Auto-regulation of Glomerular Filtration
• 3. Neural control- sympathetic nerve fibres of
ANS stimulates the vasoconstriction of renal
arterioles which decreases renal blood flow
and GFR
Glomerular Filtration Regulation
Selective reabsorption
• As the filtrate passes to the renal tubules,
useful substances including some water,
electrolytes and organic nutrients such as
glucose, amino acids, vitamins hormones etc
are selectively reabsorbed from the filtrate
back into the blood in the proximal convoluted
tubule.
• Reabsorption of some substance is passive,
while some substances are actively
transported. Major portion of water is
reabsorbed by Osmosis.
Selective reabsorption
• Only 60–70% of filtrate reaches the Henle
loop. Much of this, especially water, sodium
and chloride, is reabsorbed in the loop, so that
only 15–20% of the original filtrate reaches
the distal convoluted tubule, More
electrolytes are reabsorbed here, especially
sodium, so the filtrate entering the collecting
ducts is actually quite dilute.
Selective reabsorption
• The main function of the collecting ducts is to
reabsorb as much water as the body needs.
• Nutrients such as glucose, amino acids, and
vitamins are reabsorbed by active transport.
• Positive charged ions are also reabsorbed by
active transport while negative charged ions
are reabsorbed most often by passive
transport. Water is reabsorbed by osmosis,
and small proteins are reabsorbed by
pinocytosis
Sites of reabsorption
• In PCT- glucose, amino acid, vitamins,
hormones, Na, K, Cl, phosphate, bicarbonates
ions, water and urea.
• In Descending Loop of Henle- water and urea.
• In Ascending Loop of Henle- K, Cl-, Na+
• In DCT- Na, Cl, bicarbonates ions and water
• In collecting duct- water and urea
Tubular Secretion
• Tubular secretion takes place from blood in
the peritubular capillaries to filtrate in the
renal tubules.
• This process ensure that wastes such as
creatinine, excess H+ and K+ ions are actively
secreted into the filtrate to be excreted.
• Tubular secretion of H+ ions is very important
in maintaining normal blood pH.
Tubular Secretion
• Excess K+ ion is secreted in the tubules in
exchange of Na+ ion reabsorption ( to prevent
hyperkalemia).
• Secretion of drugs including penicillin and
aspirin.
• The final tubular filtrate is known as urine.
• Human urine is usually hypertonic.
Urine Elimination
• Urine passes from the collecting ducts to the
renal papillae, then to the minor and major
calyces, and out the renal pelvis to the ureters,
urinary bladder, and finally to the urethra,
which conveys urine to the outside.
• The process of time to time collection and
removal of urine from urinary bladder is
known as Micturition.
Urine elimination
• Collection of more than 300ml of urine in
urinary bladder creates pressure on the wall.
• The pressure stimulates the desire for
urination.
• Normal urine output= 1.5ml/kg/hr.
• Normal amount urine for adult per day is 1.5
to 2L.
Aorta
Renal vein
Kidney
Renal artery
Vena cava
Ureter
Bladder
Urethra
REFERENCES
• Kardasz, S., 2015. The function of the nephron and
the formation of urine. Anaesthesia & Intensive
Care Medicine, 16(6), pp.286-291.
• Atherton, J.C., 2006. Function of the nephron and
the formation of urine. Anaesthesia & Intensive
Care Medicine, 7(7), pp.221-226.
• Lawrence, E.A., Doherty, D. and Dhanda, R., 2018.
Function of the nephron and the formation of
urine. Anaesthesia & Intensive Care Medicine,
19(5), pp.249-253.
