Learning Objectives
By the end of this section, you will be able to:
- Describe glomerular filtration, including the hydrostatic and colloid osmotic forces that favor and oppose filtration
- Describe glomerular filtration rate (GFR) and net filtration pressure (NFP)
- Predict specific factors that will increase or decrease GFR
- Explain the mechanisms that control renal blood flow to the glomerulus.
- Explain how the kidney filters the blood to produce urine.
- Describe the myogenic and tubuloglomerular feedback mechanisms and explain how they affect urine volume and composition
- Describe the extrinsic mechanisms for controlling GFR
Glomerular Filtration
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 glomer