Renal Physiology

What do we have specifically in the TAL?

We have salt reabsorbed by cotransport. In the prescene of ADH in collecting duct, we have reabsorption of water. *This reabsorption of water would never occur if salt and urea were not here.

The base of the renal pyramid is facing the...

cortex of the kidney

Descending limb is going down from ________ to ________.

cortex, medulla

What is creatinine good for?

good measure of kidney function, if these levels are high in urine it is an indication of poor renal función.

Glomerular Filtration Membrane

hydrostatic pressure drives water and solutes across the Glomerular Filtration Membrane and into bowmans space; glomerular filtrate. The capillary has a single layer of endothelial cells. We also have cells that are part of the visceral layer of Bowmans capsule called podocytes. *These have feet like processes called pedicytes. Between the podocytes perform the filtration function of the glomerulus, separating the blood in the capillaries from the filtrate that forms in Bowman's capsule. The glomerular filtration membrane is a fusion of the endothelial cell and podocyte basal laminas. They are forming filtration slits. Creating a filtration membrane. A lot of this is to create this selective phenomenon that is just based on size. Something small can go through it.

What drugs are designed to inhibit NKCC2

loops diuretics (furosemid) inhibit the NKCC2 at the TAL *End up with potassiium in urine

The loop of henle connects

proximal and distal convoluted tubule

__________ reabsorption occurs at rhe DL. ________ reapsorption occurs at the AL.

water, salt

what is bowmans capsule

-3 dimensional sphere -parietal and visceral lining -bowmans space is between the parietal and visceral lining. -The visceral layer surrounds the blood vessel.

Blood Volume Pressure Osmolarity Regulation

-A lot of solute in extracellular fluid, osmoreceptor responds (supraoptic nueorns) -They spit oit ADH -Urinary volume goes down, but osmlairty of urine goes yp -Dilute out extracelljular fluod -Homeostasis

Basic Renal Processes: -Glomerular Filtration -Tubular Reabsorption -Tubular Secretion

-Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids from blood plasma. Its purpose is to filter the blood so that waste products (e.g., urea, uric acid and creatinine) are removed from the circulation. -Tubular reabsorption is the process by which water and solutes (e.g., glucose, amino acids, fatty acids) are moved from the tubular fluid back into the circulating blood. Going from renal tubule to peritubular fluid, which is nothing more than extracellular fluid, and then the peritubular capillary. Since filtration is only a selective process based on size, the purpose of reabsorption is to reabsorb all of the water, ions and nutrients lost during filtration. -Tubular secretion is the transfer of materials from peritubular capillaries to the renal tubular lumen and occurs by active transport and passive diffusion. Its purpose is the opposite process of reabsorption. This secretion is thought of as a "back-up" to filtration, and typically involves the removal of waste products and toxins not removed via the filtration process.

distal convoluted tubule (DCT)

-Reabsorbs sodium ions (regulated by aldosterone) *aldosteorne increase blood volume by increaisng salt. -Reabsorbs calcium ions (regulated by PTH and calcitriol) -Secretionof drugs and toxins

What is going on in hilum of the kidney

-Renal arteries coming in. -Renal vein and ureter comes out of hilum. *The ureters descend down the abdominopelvic region and open up in urinary bladder. *They go behind the bladder.

The Kidney:

-The apex of the pyramid opens up into a minor calyx. The apex is facing the renal pelvis. -The minor calyx will then open up into major vessels which will open up into the major calyz. The major calyz will open into the renal pelvis.

Renal Vasculature

-We have the renal artery coming into the kidney that will branch in smaller vessicles, ultimately will branch into.... -Afferent arteriole will come into bowmans space which will form the glomuerulus which is a capillary network. -Renal corpuscke -Efferent Arteriole -Why isnt this a portal system? *Becuase you have an ateriole and another arterial end-to-end. This is important so you can regulate the filtration pressure going on here of blood in glomeruus.

Basic Kidney Functions: Regulation

-blood volume/pressure -renin-angiotensin aldosterone system (RAAS) -plasma inorganic ions (Na+, K+, Ca2+, Cl- and HCO3-) *electrolyte levels -blood pH (excretion and reabosrption of H+ and HCO3-) *proton and bicarb can play arounfwith this.

Tubular Reabsorption and Secretion

-movement of water and solutes between tubular fluid and peritubular fluid (nephron <-> ECF <-> peritubular capillaries) -water, ions (Na+) and organic nutrietns (glucose, fatty acids, amino acids and fats) are tightly regulated and virtuallly 100% reabsorbed. -wastes are incompletely reabsorbed. Why? *We only absorb 50% of urea bc another 50 of it will be the gradient in the medulla. we call this the urea trap.

Basic Kidney Functions: Excretion

-organic, metabolic waste products from plasma (urea, uric acid and creatinine) -drugs -we find these in urine *blood is filtering throughout kidney to erase organic wastes. *nitrogenous compounds; body has hard time with these compounds so we dump them.

Basic Kidney Functions: Hormone Production

-renin *JG secretes renin in a baroreceptive response. -erythropoietin (EPO) *released from kidney, senses low oxygen. *chemoreceptive response -calcitriol *helps absorption of Ca in small intesine. It raises blood Ca.

What regulates our blood on a minute-to minute basis and a days to weeks basis?

1- pH 2-Kidney

Describe where each renal process occurs in the nephron:

1. Proteins and platelets will stay in the plasma. 2. Have a piece of the glomerulus where filtration is occuring. 3. In the PCT we have: - 60-70% reabsorption of sodium and water. - 100% reabsorption of glucose and amino acids. (FOR EXAM) - Secretion of ions (e.g., ammonium, H+, HCO3-), drugs and toxins caffeine and theophylline cause diuresis by enhancing Na+ and H2O excretion. 4. Now, we have a lot less concentrated stuff going down the Loop of Henle: - 3 regions: descending limb, Henle's loop, ascending limb. - The loop of Henle and the vasa recta work together to concentrate the medullary tissue with solute (salt and urea). -the descending limb is permeable to wter, but impermeable to solute. No solute will be moving across the descending limb but H20. The water is moving back to the medulla, it is being reabsorbed. Going from tubular to peritubular fluid. Since water is leaving, that solute in there is becoming more and more concentrated. -Will use sympoters that use the gradients of solutes in ascending loop. Moving salt into medullary tissue (pumping it). Primarily in juxtamedullary nephrons. This process is reabsorption- tubular to peritubular. 5. Distal Convoluted Tubule (DCT) - Reabsorbs sodium ions (regulated by aldosterone). - Reabsorbs calcium ions (regulated by PTH and calcitriol). - Secretion of drugs and toxins. -A backup filtration 6. Collecting Duct: - Reabsorbs sodium ions (regulated by aldosterone). - Reabsorbs water (regulated by ADH/AVP and aldosterone). - Reabsorbs urea and bicarbonate. - Secretes proton. -The collecting tubule will merge with the collecting duct and noe we see that the collecting duct reabsorbs some water Normally, it is impermeable to water, there is a hormone duct to water called ADH. 7. The medulla is loaded with solute. We have some of the urea to create a gradient here. We want the gradient here because when it is not there and ADH is released, water will never move. You need a gradient and a pathway for diffusion to happen. All that solute is there so ADH can do its job.

we reabsorb ______ of urea back in the body.

50%

_____% of H2O is reabosrbed in PCT. ______% in the descending loop of henle.

50,10

Na is ______% reabsorbed

99.5

How does secretion differ from excretion?

A secretion is a substance that is moved into a body space or onto the surface of the body (e.g., mucus in the lungs, fluid in the kidney and sweat). An excretion is a waste removed entirely from the body (e.g., urine and feces).

What are the functions of peritubular capillaries?

First, these vessels deliver oxygen and nutrients to the epithelial cells. Second, they are responsible reabsorption of tubular fluid and secretion of solutes into the tubular fluid.

Can you mechanistically describe the functions of ADH, aldosterone, PTH, calcitriol and thiazides on the DCT?

ADH increases permeability to water. It does it directly, Goes to collecting duct, create aquaporin in the cells of the duct. When they do this, they are permissive. aldosterone increases the number of sodium-potassium pumps. *Makes them faster, as a result, we reabsorb more Na in blood and dump more K+ in urine. *water will fire Na into the blood. aldosteorne also increases blood volume by increasing salt. It causes you to reabsorb NaCl in DCT, triggered by aldosteorne, watwer follows then BP and BV raises. (INdirect) PTH enhances the synthesis of all transporters within the distal convoluted tubule where it activates calcium absorption. Calcitriol inhibits PTH synthesis therefore inhibits calcium absorption. Thiazide diuretics increases calcium reabsorption at the distal tubule. They inhibit the Na/Cl symporter.

What vessel feeds the glomerulus?

Afferent arteriole.

What is the effect of alcohol on ADH? How does this affect urinary output?

Alcohol inhibits the pituitary secretion of anti-diuretic hormone (ADH), which acts on the kidney to reabsorb water. When ADH levels drop due to alcohol, the kidneys do not reabsorb as much water; consequently, the kidneys produce more urine.

What are all of the functions of angiotensin II?

Angiotensin II constricts resistance vessels thereby increasing systemic vascular resistance and arterial pressure. Stimulates sodium transport (reabsorption) at several renal tubular sites, thereby increasing sodium and water retention by the body. Acts on the adrenal cortex to release aldosterone, which in turn acts on the kidneys to increase sodium and fluid retention. Which increase BV and BP. Stimulates the release of vasopressin (antidiuretic hormone, ADH) from the posterior pituitary, which increases fluid retention by the kidneys. Increased stimulation of thirst centers which increase fluid consumption which will increase blood volume and systemic blood pressure. Increases sympathetic motor tone

Can you explain how ADH works on the kidney to help regulate blood volume and pressure?

Antidiuretic hormone binds to receptors on cells in the collecting ducts of the kidney and promotes reabsorption of water back into the circulation. It puts aquaporins in the membrane and allow reabsorption of water if the gradient is there. The gradient is there as long as you do not inhibit the NKCC2's. In the absence of antidiuretic hormone, the collecting ducts are virtually impermeable to water, and it flows out as urine, which decreases BV and BP. Alcohol inhibits ADH

Describe the function of the JG apparatus

Arterioles have smooth muscled on the outside, the ones that get close to the distal tubule, they have taken on a specialized function. They respond to chemicals and pressure. (chemo and baroceptive). When the JG cells sense inside the vessel that the blood O2 is low, they spit out EPO in afferent arteriole, it cruises in efferent arterioe and gets to circulation. It will then cruise in bone and eventually you will produce more RBCs. They can sense BP too.

Hemodialysis:

Artificial kidney to filter waste out of the blood: -Can take a tube and hook it up to someones artery, a pump that pumps the blood into a thing which is sort like an artificial kidney. -A controlled nephron that is bathed in a solution thats called a dialysis solution. The solution is set up so the gradients are proper for you to filter out waste and maintain everything. -We constantly flush in new solution to get rid of old solution cause our gradients are going to change when waste builds up, -Good blood is filtered back into the venous system.

How much water is reabsorbed by the ascending limb of the loop of Henle? The descending limb?

Ascending limb of the loop of Henle is impermeable to water. Descending limb of the loop of Henle reabsorbs majority of water.

What makes up the tissue of kidney?

Blood vessels and nephrons

Notably at PCT, you can take stuff from your tube and put it right back in ___________________.

Bloodstream

How does a glomerulus differ from a renal corpuscle?

Bowman's capsule + the glomerulus = renal corpuscle.

How do caffeine and theophylline cause diuresis in the PCT?

Caffeine and theophylline stimulate the secretion of renin by inhibition of adenosine receptors and removal of the general inhibitory brake function of endogenous adenosine.

Can you describe how the tubular concentrations of water, ions, nutrients and wastes are altered as they pass through the PCT?

Cells in the hypothalamus detect low water content in blood. ADH is released into blood by the hypothalamus, acting on the distal tubule and collecting duct. This causes more water to be reabsorbed into the peritubular capillary. Therefore, blood volume increases. As the blood becomes more dilute, this is detected by the hypothalamus, causing ADH secretion to stop. So, in other words, the concentration shift is what causes the filtering to happen with ADH helping.

What is central diabetes insipidus?

Central diabetes insipidus is a lack of vasopressin (antidiuretic hormone) that causes excessive production of very dilute urine (polyuria).

What are the primary functions of the collecting duct?

Collecting Duct reabsorbs sodium ions (regulated by aldosterone), reabsorbs water (regulated by ADH/AVP and aldosterone), reabsorbs urea and bicarbonate, and secretes proton.

What are the three types of capillaries?

Continuous, symusodal and fesntrated. Fenstrated capillaries have little windows for filtration.

The cross-sectional anatomy of a kidney?

Cortex: Bowman's capsule, PCTs and DCTs. Medulla: composed of 6-7 renal pyramids containing loops of Henle and collecting ducts. Collecting ducts open into minor calyces which open into major calyces which open into the renal pelvis.

Cortical v. Juxtamedullary Nephrons

Cortical nephrons (80%) and juxtamedullary nephrons (20%). Cortical nephrons have their loops of Henle in the renal medulla near its junction with the renal cortex, while the loops of Henle of juxtamedullary nephrons are located deep in the renal medulla. Both are surrounded by peritubular capillaries and the juxtamedullary nephrons have special peritubular capillaries around their loops of Henle referred to as the vasa recta. Vasa recta is involved in concentrating meduallry tissue with solute; salt and urea. Cortical nephrons are responsible for filtering blood and form urine. Juxtamedullary are responsible for making tissue very concentrated in solute. Cortical nephrons have very short loops of henle in contrast to juxtamedullary.

Clinically, why would we want to inhibit the NKCC2?

Dilute the urine more to reduce BV and thus reduce BP.

What happens if tissue osmolarity is high? Low?

Dilute urine. Concentrated urine.

What vessel drains the glomerulus

Efferent arteriole.

We filter blood in bowmans space?

Essentially, we are brining this blood vessels from the renal artery up into the nephron forming the capillary network. We are basicallu utilizing blood pressure, we are pushing the stuff in out plasma into bowmans space. The junk will follow all the arrows of the nephron. All yuor collecting ducts merge together at the renal pyramids. Now where all urine will drip.

What are the Three Basic Kidney Functions

Excretion, regulation and hormone production

What type of capillaries make up the glomerulus?

Fenestrated capillaries.

Physiologically, what happens when the NKCC2 is inhibited?

Impairment of sodium reabsorption in the thick ascending limb of the loop of Henle.

Renin-Angiotensin-Aldosterone System (RAAS)

In the chemoreceptive function they sense low O2 and spit out EPO. Normal mean arteriole BP during normal BP is usually around 85/90. This normal pressure keeps afferent arteriole dilated. The JG cells sense when it is not stretched or dilated enough. They will spit out renin and renin gets dumped in blood. Renin converts something in plasma called angiotensin II and angiotensin I. A zimogin created by the liver.

Suppose you had severely low blood pressure, how would you expect the JG apparatus to respond?

Juxtaglomerular apparatus cells would secrete a hormone called erythropoietin, release renin, and activate of renin-angiotensin mechanism, which ultimately leads to an increased blood pressure.

Renal Pyramid

Makes up medulla about 6 or 7 of them

Nephrogenic diabetes insipidus?

Nephrogenic is a rare disorder that occurs when your kidneys are unable to concentrate urine.

What is the smallest structural and functional unit of the kidney? How many are there per kidney?

Nephron. ~1 million.

What will bowmans capsule open up into?

PCT- proximal convoluted tube

What happens in the renal pelvis?

Pacemaker cells here that spontaneously generate a rhythmm of smooth muslce contraction, that helps propel down urine.

Pc= Pt= PieC= PieT=

Pc= capillary hydrostatic pressure *blood pressure PT= tissue hydrostatic pressure *If we have a little bit of waste being filled in Bowmans space, we will have pressure going opposite way. PieC= capillary plasma oncotic pressure *Will be relatviely high because of all the solute in blood. PieT=tissue fluid oncotic pressure *Dont have much solute in Bowmans space so this will be small.

What are the functions of the vasa recta?

Peritubular capillaries are responsible reabsorption of tubular fluid and secretion of solutes into the tubular fluid. Vasa recta prevent the solute gradient created in the renal medulla from being washed out (i.e., diluted).

What is polyuria? What can conditions can cause this phenomenon?

Production of abnormally large volumes of dilute urine. Drinking excessive amounts of fluids (polydipsia), particularly water and fluids that contain caffeine or alcohol. It is also one of the major signs of diabetes mellitus. When the kidneys filter blood to make urine, they reabsorb all of the sugar, returning it to the bloodstream.

What renal processes occur in the PCT?

Proximal Convoluted Tubule (PCT) - 60-70% reabsorption of sodium and water, 100% reabsorption of glucose and amino acids, and of ions (ammonium, H+, and HCO3) *involved in regulation of bicarb buffer system; proton and bicarb are being regulated at the PCT to regulate pH. drugs and toxins caffeine and theophylline cause diuresis by enhancing Na+ and H2O excretion.

WHat does the loop of henle serve as?

Recall that the loop of Henle serves to create high osmotic pressure in the renal medulla via the counter-current multiplier system. Such high osmotic pressure is important for the reabsorption of water in the later segments of the renal tubule.

Can you diagrammatically describe the vasculature associated with a nephron?

Renal artery-->segmental artery -->interlobar artery -->arcuate artery (around base of pyramid) -->interlobar artery(jets right down to coretx)-->afferent arteriole(opens into nephron) -->glomerulus --> efferent arteriole(comes out bowmans) -->peritubular capillaries --> interlobar vein --> arcuate vein --> interlobar vein --> segmental vein -->renal vein.

What are peritubular capillaries?

Right next to nephron Capillaries that surround nephron

TAL (thick ascending limb)

Simple epithleium all the way through tubule These cells become cubodal

Three step system for its release: (RAAS)

Sympathetic nerve activation (acting through β1-adrenoceptors). Renal artery hypotension (caused by systemic hypotension or renal artery stenosis). Decreased sodium delivery to the distal tubules of the kidney.

Can you describe the structure and location of the juxtaglomerular (JG) apparatus?

The JG apparatus is a specialized structure formed by modified distal convoluted tubule cells and modified smooth muscle cells of the afferent arteriole.

What is the NKCC2? Where is it located? What is its function?

The Na-K-Cl cotransporter (NKCC) is a protein that aids in the active. transport of sodium, potassium, and chloride into and out of cells. End up with salt in medulla because of a potassium chloride symporter on basal side and a sodium potassium pump on basal side. Located in the apical membrane of the epithelial cells of the thick ascending limb of the loop of Henle. Transport sodium, potassium, and chloride into and out of cells through the loop of Henle.

How much plasma is filtered per day? How much plasma is reabsorbed per day? How much urine is formed per day?

The heart pumps about 5 L blood per min under resting conditions. Approximately 20 percent or one liter enters the kidneys to be filtered. On average, this liter results in the production of about 125 mL/min filtrate produced in men (range of 90 to 140 mL/min) and 105 mL/min filtrate produced 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. Ninety-nine percent of this filtrate is returned to the circulation by reabsorption so that only about 1-2 liters of urine are produced per day.

What is filtered by the glomerulus into Bowman's space?

The blood plasma is filtered through the capillaries of the glomerulus into the capsule. The Bowman's capsule empties the filtrate into the proximal tubule that is also part of the duct system of the nephron. A glomerulus receives its blood supply from an afferent arteriole of the renal circulation.

Can you explain, in detail, the determinant of glomerular filtration pressure (i.e., explain the Starling forces of the glomerulus)?

The forces that favor filtration (movement out of the glomerulus and into Bowman's space) are glomerular hydrostatic pressure (which is essentially blood pressure in the glomerulus; 60 mmHg) and capsular osmotic pressure (which is negligible; 0 mmHg). The forces that favor reabsorption (movement out of the Bowman's space and back into the glomerulus) are glomerular osmotic pressure (which is primarily as the result of plasma albumin; solute in here dragging fluid in; 29 mmHg) and capsular hydrostatic pressure (backflow of pressure in bowmans space; 15 mmHg). If you subtract the forces favoring reabsorption from the forces favoring filtration, you end up with the effective filtration pressure, 16 mmHg.

What remains behind in the blood?

The glomerulus filters proteins and cells (i.e., does not let them pass), which are too large to pass through the membrane channels of this specialized component, from the blood. These large particles remain in the blood vessels of the glomerulus, which join with other blood vessels so that the proteins remain circulating in the blood throughout the body. The small particles like ions, nutrients and nitrogenous wastes pass through the membranes of the glomerulus into Bowman's capsule. These smaller components then enter the membrane-enclosed tubule in essentially the same concentrations as they have in the blood. Hence, the fluid entering the tubule is identical to the blood, except that it contains no proteins or cells.

What are the two structures that make up the renal corpusle

bowmans capusle and glomerules

Where is the JG apparatus located? How does it function in regulating RBC numbers? Blood pressure?

The juxtaglomerular apparatus is a specialized structure formed by the distal convoluted tubule and the glomerular afferent arteriole. It is located near the vascular pole of the glomerulus. Juxtaglomerular apparatus cells secrete a hormone called erythropoietin, which is critical for the production of red blood cells. When systemic blood pressure decreases, there is decreased stretch of JG cells, which leads to their release of renin. Renin release causes the activation of renin-angiotensin mechanism, which ultimately leads to an increased blood pressure.

Can you draw and identify the different regions of the loop of Henle?

The loop of Henle forms a hair-pin structure that dips down into the medulla. It contains four segments: the pars recta (the straight descending limb of proximal tubule), the thin descending limb, the thin ascending limb, and the thick ascending limb. The turn of the loop of Henle usually occurs in the thin segment within the medulla, and the tubule then ascends toward the cortex parallel to the descending limb. The end of the loop of Henle becomes the distal convoluted tubule near its original glomerulus. The loops of Henle run in parallel to capillary loops known as the vasa recta.

What is the nephron?

They are the filtration units of the kidney. Smallest structural and funcional unit of kidney. They will filter blood and drip urine in minor calcyces, collect through calycxes, collect through renal pelvis and thsee persitaltic contractions will drag it into ureter.

Can you describe the organization of a renal corpuscle?

The renal corpuscle consists a fenestrated capillary bed (glomerulus) surrounded by a double-walled capsule (Bowman's capsule).

Suppose a patient has high blood pressure, but cannot use beta blockers because of a low heart rate. With your understanding of renal physiology, what are some other medications that could be employed to treat this individual's hypertension?

Thiazide diuretics. Angiotensin-converting enzyme (ACE) inhibitors. *Wont let I convert to II Angiotensin II receptor blockers (ARBs). *We do not let II bind to receptor Calcium channel blockers. Renin inhibitors. These are all antihypertensives

Can you explain why drinking too much water can be dangerous? What symptoms would an individual exhibit if they were "water intoxicated"?

This can cause a dangerous influx in sodium levels. Sodium balances the fluids in and around your cells. Drinking too much water causes an imbalance, and the liquid moves from your blood to inside your cells, making them swell and sometimes burst. Symptoms Whole body: water-electrolyte imbalance, dizziness, fatigue, or lightheadedness. Gastrointestinal: nausea, vomiting, or water retention. Muscular: abnormality walking, cramping, or muscle weakness. Also common: excess urination, mental confusion, headache, or sleepiness.

Can you describe the anatomical organization of the urinary system?

Two kidneys, two ureters, urinary bladder and urethra.

What are the 2 openenings of bowmans capsule?

Urinary pole- where urine is formed Vascular hole

Describe the nonselective process of the nephron

We're taking this blood vessel that ultimately came f5rom the renal artery, this renal artery is branching into a million nephrons, it forms a capillary network that allows us to push waste out of the blood vessel. We will really push everything out because it is a nonselecetive process. Only selection based on size. Only thing we wont tfilter is RBC, white BC, platlet and almium. All the good and bad stuff gets filtered in the nephron. *When this stuff sits in Bowmans space, its on its way to the toilet. This is concerning, all those nutreints are needed. The amount of glucose in urine is 0. Along the nephron, we will reabsorb and secrete things until we end up with what we want to excrete.

What is the effect of ADH on collecting duct? What effect does ADH have on the solute concentration and volume of urine?

When ADH is present, the collecting duct becomes permeable to water. The high osmotic pressure in the medulla (generated by the counter-current multiplier system/loop of Henle) then draws out water from the renal tubule, back to vasa recta. Increase in ADH will cause a decrease in urine volume but a increase in solute concentration.

Diuretic and BP

You can use a diuretic to decrease BP. *The diuretic blocks the salt contransport. If you dont reabsorb =water. water will continúe on and end up in toilet. Lose blood volume thus BP drops.

What is one of the problems of loop diuretics?

You could lose potassium in urine. A potential problem with duretics. They promote the loss of K= in the urie and this could be temrinal. It is important for cardiac cells in heart. This is why we have potassium sparing diuretics. The inhibit the loss of potassium.

Which arteriole is bigger in diameter than efferent?

afferent

ACE is what converts Angiotensisn converting enzyme

angiotensin I to angiotensin II

Glomuerules is found inside

bowmans capsule