The functioning of the kidneys is efficiently monitored and regulated by hormonal feedback mechanisms involving the hypothalamus, JGA and to a certain extent, the heart.
Urine formed by the nephrons is ultimately carried to the urinary bladder where it is stored till a voluntary signal is given by the central nervous system (CNS). This signal is initiated by the stretching of the urinary bladder as it gets filled with urine. In response, the stretch receptors on the walls of the bladder send signals to the CNS. The CNS passes on motor messages to initiate the contraction of smooth muscles of the bladder and simultaneous relaxation of the urethral sphincter causing the release of urine. The process of release of urine is called micturition and the neural mechanisms causing it is called the micturition reflex.
An adult human excretes, on an average, 1 to 1.5 litres of urine per day. The urine formed is a light yellow coloured watery fluid which is slightly acidic (pH ~ 6.0) and has a characteristic odour. On an average, 25-30 gm of urea is excreted out per day. Various conditions can affect the characteristics of urine. Analysis of urine helps in clinical diagnosis of many metabolic discorders as well as malfunctioning of the kidney. For example, presence of glucose (Glycosuria) and ketone bodies (Ketonuria) in urine are indicative of diabetes mellitus.
Lungs: Lungs remove large amounts of CO2 (18 litres/day) and also significant quantities of water every day.
Liver: Liver, the largest gland in our body, secretes bile containing substances like bilirubin, biliverdin, cholesterol, degraded steroid hormones, vitamins and drugs. Most of these substances ultimately pass out alongwith digestive wastes.
Skin: The sweat and sebaceous glands in the skin can eliminate certain substances through their secretions. Sweat produced by the sweat glands is a watery fluid containing NaCl, small amounts of urea, lactic acid, etc. Though the primary function of sweat is to facilitate a cooling effect on the body surface, it also helps in the removal of some of the wastes mentioned above. Sebaceous glands eliminate certain substances like sterols, hydrocarbons and waxes through sebum. This secretion provides a protective oily covering for the skin.
Kidney Failure: Malfunctioning of kidneys can lead to accumulation of urea in blood, a condition called uremia, which is highly harmful and may lead to kidney failure. In such patients, urea can be removed by a process called hemodialysis. Blood drained from a convenient artery is pumped into a dialysing unit after adding an anticoagulant like heparin. The unit contains a coiled cellophane tube surrounded by a fluid (dialyzing fluid) having the same composition as that of plasma except the nitrogenous wastes. The porous cellophane membrance of the tube allows the passage of molecules based on concentration gradient. As nitrogenous wastes are absent in the dialysis fluid , these substances freely move out, thereby clearing the blood. The blood is pumped back to the body through a vein after adding anti-heparin to it.
Renal Calculi: Stone or insoluble mass of crystallized salts (oxalates, etc.) formed within the kidney. These produce severe pain if they result in obstruction of urethra. Smaller sized calculi or stones are expelled by the body, while larger ones require surgical procedure to be expelled.
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