Renal | Glomerular Filtration

all right ninja nerds in this video we're going to specifically start talking about glomerular filtration all right before we do that before we even get into glomerular filtration we have to look at the structure of something specific what is that structure that we have to talk about we have to talk about what's called a renal corpuscle okay so first off what is the renal corpuscle let's actually define what a renal corpuscle is so renal corpuscle is two things okay the first thing is actually the glomerulus okay which is capillaries which is a tuft of capillaries the other thing is the bowman's capsule or sometimes they even call it the glomerular capsule we're just going to call it the bowman's capsule okay so two components of the renal corpuscle again what are those two components of the renal corpuscle the two components of the renal corpuscle is specifically the glomerulus which is the tuft of capillaries and the bowman's capsule let's first talk about the glomerulus and the filtration membrane which is a part of it and then we'll talk about the bowman's capsule okay so let's first focus on the glomerulus so if you notice here this right here is the glomerulus because this is the tuft of capillaries right here so a glomerulus is like a tuft of capillaries and here's what's interesting if you notice let's say that this is the vessel coming into the glomerulus so this is feeding into the glomerulus when it goes into the glomerulus it's actually called afferent arterial okay so if there's a vessel that's feeding the glomerulus it's called the afferent arterial and again this is the glomerulus right here right here is the glomerulus okay so we'll put that right above it this is our glomerulus which is our tuft of capillaries oh what type of capillaries is within the glomerulus that's really really important you know what type of capillaries are here in the glomerulus they're actually called fenestrated capillaries you know what fenestrated capillaries means okay so let's say i take one of these endothelial cells and i zoom in on them so let's say here's an endothelial cell okay here's the nucleus of the endothelial cell in this endothelial cell it has little holes look at this you see this little hole right there little channel basically that's a fenestration there's another one over here too they have them all around these things there's hundreds upon hundreds maybe even thousands of these little fenestration pores on this endothelial cell now these fenestration pores what are they for let me explain to you what they're for well first off how big are these little things you know these little things right here these fenestrations are approximately about 50 to 100 nanometers in diameter that's really freaking small so about how much 50 to 100 nanometers in diameter so really what can actually filter through this okay you know within the blood you have your plasma which is consisting of a lot of water and different types of solute molecules kills right and then also you have formed elements like your white blood cells your red blood cells your platelets any type of formed elements cannot fit through these fenestrations okay so any type of formed elements cannot fit through these actual fenestration pores so formed elements are again what what are those components of formed elements red blood cells white blood cells platelets none of those can get in okay what can pass through the different components of the plasma so you know like small proteins small proteins can pass through this what else can pass through this water what else can pass through this electrolytes like sodium and potassium and calcium and chloride and a whole bunch of other different types of molecules a lot of different things okay and even nutrients waste products all different types of molecules can pass through these actual fenestration pores okay so these fenestration pores are basically riddled against all these little endothelial cells within the glomerulus that's one important point okay what is this structure draining the glomerulus here's a really really interesting watch this usually it's a vein right or a venule this is actually called the efferent arterial this is one of the only examples in the body in which a capillary bed is being fed by an arteriole and then drained by an arterial okay so we have a fat arterial feeding the glomerulus we have an efferent arterial draining the glomerulus and the glomerulus is again finest rated capillaries what does it mean to be fenestrated it's these little pores in the endothelial cell right that are about 50 to 100 nanometers in diameter and what do they allow for things for it to pass through electrolytes nutrients small proteins water molecules and even maybe some large molecular weight proteins that are less than 100 nanometers in diameter because if they're less than 100 nanometers in diameter they can pass through the actual fenestration pores so let's even say not only small proteins but like we'll say moderate size proteins and again any proteins or any molecules that are about less than 100 nanometers in diameter can fit through these fenestration force now look at this little nice blue baby blue thing that we have right here you see this blue membrane right here this is one of the most critical parts of the actual glomerulus okay one of the most important points of the glomerulus you know what this thing is actually called this blue membrane structure let's actually show it over here this blue membrane structure right here that we that i'm kind of showing here that i'm zooming in on right here this is actually called the glomerular basement membrane so again what is it called the glomerular basement membrane now some of you might be thinking okay it's just the basement membrane what what significance does that have oh my goodness so much significance okay this glomerular basement membrane is extremely interesting because if i were to let's say i actually zoomed in on even more let's say i even zoomed in this layer even more you know the glomerular basement memory is actually three sub layers look at this let's say i zoom in on it for a second so here's the glomerular basement membrane in the glomerular basement membrane there's three layers let's say here and i make a black layer right there a real real thick black layer this thick black layer is actually going to be specifically consisting of type 4 collagen so what is this layer right here consisting of it's specifically consisting of type 4 collagen and laminins these different types of proteins okay so one is actually going to be type 4 collagen and if you notice it's really dense you know what they call this actual layer they call this the lamina densa okay so one layer right smack dab in the middle which is consisting of type 4 collagen and laminans is called the lamina densa then let's say that this is the endothelial side and what do i mean by endothelial side i mean that here's your endothelial cells this part of the membrane closest to the endothelial cells is this side then you have these black cells which i'm going to talk about called the podocytes that's going to be on this side so the podocyte i'm going to put podocyte layer okay on this side here towards the endothelial cells it's a thinner like tissue okay it's a thinner layer this layer right here is actually made up of specific types of molecules like proteoglycans okay are glycosaminoglycans particularly heparin sulfate and guess what else you're going to find on the other side the same thing heparin sulfate these are different types of glycosaminoglycans now here's the next part that's really interesting heparin sulfate is extremely negatively charged okay so it's very very negatively charged so if i were to show that here let's say i show it here in orange on this side what are you going to have a lot of negative charges what would you have on this side a lot of negative charges that's important i'm going to talk about that why that is now if i were to be particular this side is closest to the endothelial cell we call this side lamina rara interna and then we call this site so that's laminar anterna the one towards the endothelial lining the one on the opposite side towards the podocyte lining is actually called the lamina rara externa okay so the glomerular base membrane is actually three different sub layers one in the middle is actually the lamina denzel with type 4 collagen laminans laminara interna and laminar rare externa are consisting of heparin sulfate okay so a different type of glycosaminoglycan which has a lot of negative charges on it why is this important okay you know inside of our blood we have these things called plasma proteins let's say i represent a plasma protein here as like albumin you know what albumin's charge is inside of the blood generally or most plasma proteins it's negatively charged let's say i draw another plasma protein just for the heck of it i put in here let's say i put in here specifically different types of immunoglobulin so i'm going to put i g and we'll just be for the heck of a igg immunoglobulins these are also negatively charged i could even put fibrinogen or different types of trans other type of transport proteins the whole point is proteins inside of our actual plasma are negatively charged what's the charge on this glomerular basement membrane negative charge so it's very very negatively charged now if you know a little bit about biology you know that same charges repel one another so for example if i have albumin i represent albumin here as this circle and then all around him i have negative charges if he tries to come through this membrane or any type of molecule that's negatively charged tries to come through that membrane what's going to happen to it it's going to repel it so can i get through this actual glomerular basement membrane no that's good at helping to actually act as a good filter so now it's acting as a very good filter so any type of negatively charged particles that actually try to move through the glomerular basement membrane is repelled but if you know again about biology what actually is going to want to come to the negative charge positively charged particles right so anything that's positively charged is going to want to come to the negative charges so any type of positive positively charged particles that we might have with inside of the plasma is going to want to what pass through here what are positively charged molecules usually different types of electrolytes like sodium and potassium and calcium and magnesium so that's really really interesting any type of positively charged substances are going to pass through the glomerular basement membrane easily anything that's neutral it's going to be a little bit harder than positively charged species to pass through but it can still pass through any negatively charged species or different types of molecules are going to be repelled and prevented from entering into this actual glomerulin capsule here okay so if it's big enough like large molecular weight proteins are large different solute molecules and they move through the fenestration pores usually protein molecules are negatively charged so they'll be repelled by the glomerular basement membrane so we have two barriers so far part of this filtration membrane so now we've developed what our glomerulus is really made up of so let's actually write those two things out what are the two components one is actually the specifically the endothelial lining which is what fenestrated guys remember that with the fenestration pores which are approximately about 50 to 100 nanometers in diameter which allow for certain things to pass through what's the other component of the glomerulus the other component of the glomerulus is the i'm just going to put glomerular basement membrane gbm right and this is important because he has negatively charged surface which repels negatively charged particles so if you think about like this negatively charged particles are repelled positively charged particles move through any neutral charge will also move through but not as readily as possibly charged particles okay those are the two components of the glomerulus now what about the bowman's capsule okay for the bowman's capsule there's actually two different components one one is actually the parietal and the other one is the visceral layer but specifically these are your podocytes okay so now let's look at this okay so we talked about the finished rate of capillary endothelium we talked about the glomerular basement membrane now we're going to talk about the visceral layer of the bowman's capsule specifically the podocytes these podocytes you know what poto actually means foot so it's foot cells so if you see at the end part it has these little little different foot processes okay these have in between the podocytes so let's say here's a podocyte so let's say this is podocyte one and this is podocyte two podocyte three photocyte four podocyte five in between podocyte one and two there's a specific type of protein molecule look at this you see this it's kind of like inter connecting here so here's another one here's another one interconnecting here's another one between four and three interconnecting and here's one between four and five interconnecting you see what these little orange molecules are that are interconnecting our podocytes this is actually called a very important protein i wouldn't be mentioning if it's not this molecule right here is actually this orange molecule is called nephrine now nephron is important because there are certain types of conditions in glomerulonephritis where you can actually have mutations within this nephron protein why is that significant because you know nephron is really really important for being able to control what's actually making it through what what's so far of what they have to go through to get to this point they'd have to go through the fenestration pores they'd have to make it through the negatively charged glomerular basement membrane and then they have to get between these little things here what's this space right here called between the podocytes here called what's that space they're called that space between the podocytes is actually called the filtration slit and a filtration slit is approximately 25 to 30 nanometers in diameter so now if it's made it through the fenestration pores if it's made it through the negatively charged glomerular basement membrane and if it's less than 25 nanometers approximately 25 to 30 nanometers in diameter it'll make it through but then guess what this nephron proteins only allow for molecules anything that's actually seven to nine nanometers in diameter or less to pass through okay nephron is this protein molecule and he's actually forming this structure around the so this space is the filtration slit but nephron is kind of like a thin protein structure that's spanning that filtration slit and because it's spanning the filtration slit they call this the slit diaphragm okay so it's called the slit diaphragm and a slip diaphragm is composed of nephron and nephrine is only allowing for molecules that are less than seven to nine nanometers to be able to pass through this area okay then what do we have on the outside edges here we have the parietal layer of the bowman's capsule so it's continuous with the visceral layer of bowman's capsule so the podocytes cling to the capillaries and it goes continuous with the prior layer of the boneless capsule to make a nice space so that anything that's filtering out isn't just lost it's collected into this nice little bowman space here okay so what are the two components of the bowman's capsule ready the podocyte layer and has spaces in between the podocytes which are called filtration slits and they're approximately 25 to 30 nanometers in diameter and it has this protein molecule that are in between the podocytes linked together right and nephrine is the component of it it's making the slit diaphragm which is only allowing for molecules that are about less than seven to nine nanometers to make it through this area okay so now let's go ahead and just kind of recap what can actually move through here because we kind of got a basis basic component of everything that's making up this renal corpuscle let's cover what can make it through now okay so we can have plasma proteins let's just represent a as albumin igg antibodies is another different type of protein let's represent our electrolytes like sodium uh potassium chloride uh what else would you have you'd have calcium you'd have magnesium you could have bicarbonate tons of different molecules different types of actual uh electrolyte molecules right what else would you have over here you'd have glucose you'd have amino acids you'd have different types of lipids you'd have urea different types of waste products right like even creatinine or creatinine which is a breakdown product of the muscle skeletal muscles from creatine phosphate you'd have vitamins tons of different molecules in here right and what's one of the more important ones that we should definitely mention water all these are different molecules which are running through our plasma right and this isn't even all of them we could even have other things in there but again the basic component is that you have electrolytes flowing through the plasma you have different types of nutrient sources and waste products flowing through the plasma you have water which is making up like 93 of the plasma and you have different types of plasma proteins okay albumin fibrinogen i could even put in there i could put in the f for fibrinogen if i needed to okay so there's fibrinogen and fibrinogen will also have negatively charged particles on it right different types of amino acids that make it negatively charged now out of these things what did i tell you can actually fit through the fenestration pores anything that's actually less than 50 to 100 nanometers in diameter can pass right through so most of these substances can actually pass through but what did i tell you the glomerular basement membrane has on it negatively charged particles so anything that's negatively charged like these actual what any of these plasma proteins are repelled this is repelled and this is repelled from what the glomerular basement membrane what else did i tell you about the glomerular basement membrane any type of positively charged particles are going to move through faster and easier than negatively charged particles so if you had to compare here bicarbonate it would be a little bit harder to filter right as compared to sodium potassium calcium magnesium and chloride would be harder to filter as compared to potassium but nonetheless these substances are filtered so what would be filtered out here you would have it would actually move through the fenestration pores through the glomerular basement membrane and these particles as long as they're less than what at least 25 to 30 nanometers in diameter as well as if they're less than seven to nine nanometers in diameter what's gonna come out here you're gonna have bicarb you're going to have sodium you're going to have potassium chloride calcium magnesium water is even going to be out here what else would be out here glucose amino acids lipids urea creatinine all these different types of molecules are being filtered out look at all of these things all of these are being filtered out and again what are they running through as a quick recap running through the fenestration pores as long as they're less than 50 to 100 nanometers in diameter anything that's negatively charged is repelled by the glomerular basement membrane they pass through the filtration slits which is about 25 to 30 nanometers in diameter then there's the nephron which is making up that slit diaphragm and as long as any particle is less than seven to nine nanometers in diameter it'll get freely filtered and what are those molecules that are most commonly freely filtered they are glucose amino acids lipids urea creatinine different types of electrolytes even lactic acid and vitamins different types of molecules are filtered out and then where will they go they'll move out here into the actual what proximal convoluted tubule now one more thing before we go into these pressures okay let's say by some chance some type of macromolecule gets through the fenestration pores gets through this actual glomerular basement membrane and gets hung up in this filtration slip by the slit diaphragm what are we going to do with that it's just let's say it's actually dangling let's say here it is let's say somehow albumin is just freaking dangling from this thing okay like a monkey look what happens you see these cells right here these little like piranha-looking cells they're getting ready to frick something up you know what these cells are called they're called mesangial cells so what are these cells here called these little piranha-looking cells they're called mesangial cells now mesangial cells are very very important to the glomerular structure right because they have a couple different properties one is they'll actually phagocytose any type of molecules that get hung up in that actual slit diaphragm which is composed of nephron so that that guy right there he's going to come over and he's going to phagocytose any macromolecules that gets stuck and hung up in that slit diaphragm you know what else he can do he also has contractile activity so he can contract contract what he can contract and control the amount of blood flow that's coming in through the affair and arterial and into the glomerular capillaries we'll discuss that also he has gap junctions gap junctions that connect him to these cells from other cells which are called the macula densa cells what are these cells here called these little violet or maroon cells they're called jg cells specifically juxta glomerular cells if you remember these these are the ones that are producing renin and renin was important for our blood pressure right so they're actually baroreceptors so pressure receptors they pick up different types of changes in pressure when the pressure's low they'll secrete renin and if you remember random was important for being able to maintain our blood pressure okay and he can get signals from who pretend here was that mesangial cell the mesangial cell has little gap junctions that connect him to these actual jg cells and he can allow for different types of positively charged ions to come over here and stimulate him to release random we'll talk about that in the tubular glomerular feedback mechanism okay so we've covered a lot about the actual glomerulus and the bowman's capsule and everything it can filter what allows for it to filter i think we've done pretty good on this now let's come over here and let's cover all the pressures that are involved in this what's actually allowing for this net filtration so what did i say net filtration so what are we going to talk about now we need to talk about the net filtration but you know nothing likes to move on its own it has to get a little bit of a push so you have to apply some pressure okay what is that called then we're going to talk about net filtration pressure because you know when we're talking about things that are being filtered it happens over a given period of time when something is being filtered over a given period of time and where is it occurring it's occurring in the glomerulus so there's what's called a glomerular filtration rate so there's a glomerular filtration rate and generally we describe this as the amount of fluid that's actually being you know plasma volume that's actually being filtered out of the glomerulus and into the bowman's capsule for every one minute so we refer to this as the volume of plasma that's being filtered from the glomerulus for every one minute on average that's about 125 milliliters per minute now some of you might be like where the frick did that come from let me explain to you every about every one minute okay there is approximately 1200 milliliters of plasma flowing through the glomerulus so for every one minute 1200 milliliters is flowing through this area now out of that 1200 milliliters only 625 milliliters per minute are going to be used in this filtration process so 1200 milliliters per minute are passing through here but out of that 1200 milliliters 625 are being used in the filtration process the remaining amount is passing by so now what's actually leaving then so 1200 is coming in 625 is being going to be using this filtration process but 575 milliliters per minute is actually going to be leaving out now here's what's the interesting part out of that 625 milliliters per minute that you're actually going to be coming out of this here's what's crazy only 20 of it is actually going to be filtered okay so 1200 milliliters is passing through here 625 milliliters we're going to use for this filtration process but out of that 625 mils we're only going to really filter 20 percent of it how what is 20 of 625 that is actually 125 milliliters per minute okay that's where we get that glomerular filtration rate okay now that we've done that we know specifically how we get the glomerular filtration rate but now we got to talk about factors that are affecting the glomerular filtration weight what's actually affecting the glomerular filtration rate so in other words what can increase it what can decrease it so on and so forth okay so the first part of it is the net filtration pressure now net filtration pressure is consisting of the forces that are trying to push things out so pressures trying to push things so i'm gonna put pressures uh forcing out okay so let's take a look at those pressures but then it's also dependent upon the difference of the pressures forcing things out minus the pressures pulling things in so pressures pulling in okay let's look at these two different components here because glomerular filtration rate is dependent upon this and something else that we'll talk about in a second okay so look at this first pressure this first pressure here is actually going to be called glomerular hydrostatic pressure now glomerular hydrostatic pressure is actually trying to push things out of this capillary okay so he's trying to push things out of the capillary that's what glomerular hydrostatic pressure is now generally as blood is flowing through here okay so let's say blood is flowing through the afferent arterial right because this is the afferent arterial and this is the efferent arteriole when the blood is flowing through here the glomerular hydrostatic pressure is defined as the pressure that's trying to push the plasma components out of the capillary and into this actual bowman space so that's what glomerular hydrostatic pressure is it's defined as the actual forces that are trying to push the plasma the specific volume of the plasma out of the glomerular glomerular capillaries into the bowmen space this number on average is about 55 millimeters of mercury okay that's the average glomerular hydrostatic pressure now there's another pressure there's a pressure that's exerted by specific types of plasma proteins like albumin albumin is trying to be able to keep things into the blood he doesn't want things to leave the blood okay so this is actually going to be a specific pressure and this pressure we're going to call colloid osmotic pressure and colloid osmotic pressure is exerted by plasma proteins that are being able to try to keep the water into the bloodstream so where is the arrow pointing it's trying to keep the actual water and prevent the water from leaving out into the space so keep it into the blood this colloid osmotic pressure is on average okay on average about specifically 30 millimeters of mercury so about 30 millimeters of mercury okay so 30 millimeters of mercury for the colloid osmotic pressure and that's exerted by who albumin now there's one more as fluid is being filtered out here right think about it like a funnel so here's the fluid and it's trying to filter down into this little funnel right there as the fluid is trying to filter in through this area what happens if you try to pour a lot of fluid into a funnel at once what happens it overflows right same thing is happening here as you start trying to push fluid out into this actual bowman's capsule there's a narrow filtering process here so some of the fluid can start backing up and backing up and backing up and exert a pressure that wants to push things back into the actual capillary what is this pressure call that's trying to push things back into this capillary bed this right here is called capsular hydrostatic pressure this is called capsular hydrostatic pressure so the capsular hydrostatic pressure is the pressure that's being exerted by the actual pressured built up within the bowman's capsule and as it's trying to drain there's a back pressure that tries to push fluid back into the actual glomerular capillaries and this on average is approximately 15 millimeters of mercury okay so now we have all of our basically all these pressures that are pushing things out and all the pressures that are trying to pull or push things in technically there is one more pressure that i could mention here and it's it's zero though so it's not not really necessary to mention it but and the reason why is there's a pressure that you can technically consider out here and then let's say there's a pressure trying to pull things into this actual bowman's capsule that pressure would technically be called the capsular osmotic pressure but what do we say as long as the filtration membrane is nice and actual kept intact and it's not going to have any type of fluctuations in its activity there shouldn't be any type of plasma proteins on this area so if there's no plasma proteins into this area can there really be any osmotic pressure out here no so normally the colloid osmotic pressure in this area is zero millimeters of mercury that's why we don't even really consider this one into the equation okay so now let's come over here and let's look and see what we got now so if we take the pressures trying to force things out or even if you technically think about it the colloidal pressure trying to pull things out what is the pressures associated here so technically we could say the first pressure is the glomerular hydrostatic pressure plus the capsular osmotic pressure technically right what was the glomerular hydrostatic pressure it was approximately 55 millimeters of mercury and then what was the colloid osmotic pressure it was approximately zero millimeters of mercury right assuming normal activity what were the pressures that were trying to pull things in it was the colloid osmotic pressure right and that was actually trying to pull things in via the albumin then there was actually going to be the back pressure of the capsule trying to push things in which is called the capsular hydrostatic pressure what's the colored osmotic pressure on average it's about 30 millimeters of mercury plus the capsular hydrostatic pressure which is about 15 millimeters of mercury if you do 55 minus approximately 45 what's your net filtration pressure 10 millimeters of mercury okay now from this we can derive a specific concept that due to these pressures any fluctuations in your net filtration pressure directly affects your glomerular filtration rate so then other words your net filtration pressure is directly proportional to your glomerular filtration rate so in other words any increase in net filtration pressure increases your gfr any decrease in net filtration pressure decreases your gfr wow you developed a heck of a concept there right okay so there's two components here that are affecting this one is the surface area of the glomerulus okay so surface area of the glomerulus that's one thing the other thing that's going to determine this is also going to be specifically the permeability so the permeability of glomerulus okay so let's say i take two different types of glomeruli one like this all right so there's the aphan arterial that's actually taking the blood in here's the efferent arterial let's draw another one though okay now look at this puppy whoa affair and arterial efferent material what's the difference that you notice between these two this one is a very small surface area so he has a very small surface area there's not much surface area to act upon to filter so this will have a lower glomerular filtration rate right because it has a smaller surface area but if you have a large surface area you have much more surface area for filtration so this would result in a greater glomerular filtration rate that should be almost intuitive right that should make complete sense smaller the surface area the smaller the gfr the greater the surface area the greater the gfr simple is that what could change the surface area certain types of conditions could actually make it a little thicker you know there's actually a condition you've probably heard of it called diabetes but specifically it's called diabetic nephropathy and with diabetic nephropathy there's actually protein in actual specific deposits in this actual glomerulus that make it thicker and as you make it thicker it actually decreases the surface area which can affect the glomerular filtration rate but i'm just giving you a clinical correlation to surface area and how important it is for glomerular filtration rate okay so let's say i take two different types of glomeruli here let's say i take this one same surface area for both of them so look here's another one same surface area for this guy also but look at the difference here watch this let's say that this one only has one two three channels here to filter things out okay three channels while this one over here has one two three four five five channels on the same surface area what's going to happen to this guy's filtration rate this one will have a greater glomerular filtration rate right because he has a lot more permeability this will have a lower glomerular filtration rate because he has less permeability what kind of diseases could affect this you ever heard of glomerulonephritis so there's a condition called glomerulo nephritis and whenever there's damage to the glomerulus it actually can affect the basement membrane and make the basement membrane very very uh it can actually destroy the basement membrane and make it very porous well what happened to the glomerular filtration rate if the actual glomerular basement membrane was affected and very porous you would have a higher glomerular filtration rate you would lose a lot of proteins into the urine okay okay so now as an overall concept here if i were to take surface area and permeability of the actual capillaries and combine them together this actually gives me a specific term this term is called k f and k f stands for filtration coefficient okay so now i can actually derive one last formula that we need here we can say that glomerular filtration rate technically is equal to the net filtration pressure times the filtration coefficient because before we said that net filtration pressure is directly proportional to gfr increase in nfp increases gfr filtration coefficient is dependent upon surface area and permeability of the glomerulus any fluctuations in the filtration coefficient also directly affects the glomerular filtration rate one last thing here guys let's apply a clinical correlation to these actual net filtration pressure because i think that's significant okay so let's say that i take these three different pressures here the most important ones the glomerular hydrostatic pressure the colloid osmotic pressure here and then the capsular hydrostatic pressure what could be certain situations that could affect these things well i told you before that glomerular hydrostatic pressure is directly dependent upon your systemic blood pressure so if your bp is really high if your systemic blood pressure is high what happens to your your glomerular hydrostatic pressure it increases your glomerular hydrostatic pressure what happens if your bp goes down so what happens if you're having hypotension your glomerular hydrostatic pressure goes down it's that simple okay so glomerular hydrostatic pressure is directly dependent upon your systemic blood pressure an increase in blood pressure increases the glomerular hydrostatic pressure whereas a decrease decreases the glomerular hydrostatic pressure what about colloid osmotic pressure let's say that you actually have too many different types of proteins in the blood like there's a condition called multiple myeloma where you have too many different types of proteins in the blood if that happens what happens to the amount of proteins in the blood they go up if the amount of proteins in the blood go up you start holding on to more water in the blood if you hold on to a lot of water what happens the colloid osmotic pressure is going to increase right so this increases colloid osmotic pressure what happens if you have hypoproteinemia so low proteins in the blood so this could be due to maybe someone who's gluten sensitive and they decide to like take and eat how's the pizza and what happens they don't feel good and they have the hershey squirts right so they start losing a lot of substances right or maybe they have some type of actual disease maybe like they have infected by the giardia and they lose a lot of proteins into their actual feces right so what happens then you lose proteins if you lose proteins can you hold on to as much water inside of the bloodstream no so what happens to your colloidal pressure if you lose proteins this decreases colloid osmotic pressure and then what happens then you start losing fluids a lot more than normal into the actual bowman space okay what about capsular hydrostatic pressure well let's say that you get like a freaking massive kidney stone stuck in your nephron loop or something like that right so you get what's called a renal calculi that's greater than five millimeters in diameter and it gets stuck so a renal cow right so just a kidney stone greater than five millimeters in diameter so greater than five millimeters in diameter and it gets stuck in one of the actual nephron loops let's say here's your nephron loop and here's your actual bowman's capsule if you have a stone stuck there what's going to happen to the pressure it's going to start backing up and it's going to start increasing and trying to push things back into the glomerulus so what would that do to your capsular hydrostatic pressure if you had like a kidney stone it's going to increase your capsular hydrostatic pressure there's other conditions too like renal ptosis when the individuals are really really emaciated they don't they lose a lot of weight rapid weight loss their kidneys drop and it kinks up and fluid flows back into their kidneys it's called hydronephrosis that also can cause this problem too so not only can renal calculi do this but also hydro nephrosis due to renal ptosis okay this can also increase capsular hydrostatic pressure and then what would be the result of an increase in capsular hydrostatic pressure you would have more fluid being pushed back into the glomeruli and not as much net filtration all right ninja nerds we covered a lot in this video about glomerular filtration thank you guys for sticking with us and watching this we really appreciate it i hope you guys enjoyed it i hope it all made sense until next time ninja nerds

Channel: Ninja Nerd

Views: 576,070

Rating: 4.9595833 out of 5

Keywords: glomerular filtration, glomerular filtration rate, renal

Id: SVqSqPOcahY

Length: 43min 9sec (2589 seconds)

Published: Fri May 12 2017