Physiology

4.9

December 2, 2011
Dr. Jerez

Plenary: Kidney Function Test

OUTLINE
I. 24-Hour Input-Output Determination
II. Concentration Test
III. Dilution Test
IV. Effects of the Intake of Different Fluids

I. 24-HOUR INPUT-OUTPUT DETERMINATION

Compare the fluid intake and urine output. What do you observe
with the total volume of intake and output?
o The subject had more fluid intake than urine output. If we are
to consider the fact that the body secretes an average of
1500ml/day (30-60ml urine output per hour) then his above-
than-normal urine output is the body's way of compensating
for the increased fluid intake of 3650ml.
Correlate the urine volume, color and specific gravity. What are
your conclusions?
o Increase in activity will decrease urine output due to
sympathetic nervous system conserving needed fluids for the
increased activity. When we are in a cold environment, blood
flow to our internal organs is increased to keep our organs
warm. The increase in blood flow to the kidneys causes more
blood to be filtered thus producing more urine.
How would your activity and the ambient temperature affect the
urine volume?
o Increase in activity will decrease urine output due to
sympathetic nervous system conserving needed fluids for the
increased activity. When we are in a cold environment, blood
flow to our internal organs is increased to keep our organs
warm. The increase in blood flow to the kidneys causes more
blood to be filtered thus producing more urine.

II. CONCENTRATION TEST

What is the relationship of urine volume with color, transparency,

and specific gravity?
o Increase in urine volume:
Increase in Transparency (more clear)
Lower Specific Gravity
Lighter in Color
o Decrease in urine volume:
Decrease in Transparency (more turbid)
Higher Specific gravity
Darker in color
From Dr. Jerez:
o Do not equate the color of the urine with its transparency. They
are different and should be both reported.
o Examples: Yellow and Turbid or Dark Yellow and Clear, etc.
o Tip: Look at your samples against a white background

By means of a flow chart, trace the sequence of events on how
the kidneys are able to concentrate the urine

Increase Plasma Osmolarity

Contraction of Osmoreceptors

Increased Stimulation of Pituitary Gland

Release of More ADH

Concentrated Urine

Decrease Plasma Osmolarity

Bloating of Osmoreceptors

Decreased Stimulation of Pituitary Gland

Decreased Release pf ADH

Dilute Urine

From Dr. Jerez:
o Do not trace the pathway of the water being reabsorbed.
o Instead, show the effects of an increase and decrease in plasma
osmolarity on the osmoreceptors and ADH secretion.

III. DILUTION TEST

By using a flowchart, trace the events that bring about dilute
urine (from the intake of water to voiding of dilute urine)

ingestion of the water

increased circulating blood volume or
decreased plasma osmolality

detected by osmoreceptor

decreased impulses going to the posterior pituitary (where the ADH
is stored)

decreased release of ADH

kidneys react to ADH by conserving water (since there is no ADH
released there is no water to be reabsorbed which would lead to
diluted urine)

Enumerate factors which may affect volume of urine
o Fluid intake (increase or decrease)
o Temperature
o Activity
o Underlying Medical Condition (liver and kidney)
o menstarution (causes water to retain hence lesser volume)
o alcohol which produces diluted urine in larger amounts
o drinks with caffeine
o amount of aldosterone

IV. EFFECTS OF THE INTAKE OF DIFFERENT FLUIDS

Greatest volume: buko juice (from our group), very sweet juice
(plenary)
Lowest specific gravity : very sweet juice
Faintest color: very sweet juice and buko juice

Carlos, Carrasco, Castillo M., Castillo F., Catolico, Cauyan, Chang, Chavez M., Chavez T.

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 Black coffee, plain tea, mountain dew, regular coke, unsweetened

choco contain caffeine
o Caffeine causes ADH resulting to in absorption of water
and sodium resorption and thus diluted water and urine
output
Buko juice causes pressure diuresis
o plasma volume that lead to in filtration which makes the
bladder distended causing high volume of urine
o Contains high potassium and water content
Very sweet juice causes osmotic diuresis
o High urine output because presence of high sugar level causes
an increase in filtration as sugar takes water with it and thus
large volume of water
o May transport maximum of sugar = presence of sugar in
urine

Carlos, Carrasco, Castillo M., Castillo F., Catolico, Cauyan, Chang, Chavez M., Chavez T.

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