身体从血液中过滤药物并通过称为药物排泄的多步骤过程消除它们
肾脏是药物消除的主要途径
大多数药物以原形或以尿液中的药物代谢物形式排出体外
一般来说，健康专业人士将肾脏过滤血液的能力称为肾功能
肾单位，肾脏的功能和解剖单位，
过滤血液，调节体液量和 pH 值，并控制体内电解质水平
每个肾单位包含肾小体和肾小管
肾小体包括鲍曼囊和肾小球
肾小管由近端小管组成，
亨利环，
远端小管,
和集合管
各成分均在肾脏药物排泄中发挥作用，
肾脏过滤并消除体内药物的四步过程
这些步骤是：肾小球滤过，
被动肾小管重吸收，
肾小管主动分泌和排泄
血液通过直径较大的血管流入肾小球
比从肾小球排出血液的血管
这种直径差异会产生过滤血液中废物所需的高血压
肾小球起到分子筛的作用
水中的废料通过筛子，
而大多数正常蛋白质和细胞都保留在血液中
肾小球滤过从血液中去除低分子量药物
水、溶质和离子的被动重吸收过程始于近端小管，
继续在亨利环中，
并终止于远端和集合管
水溶性药物停留在肾小管内，
而未结合和脂溶性药物主要通过肾小管重吸收
重吸收后，脂溶性药物通过血流到达肝脏
其中某些肝酶，
例如细胞色素P450酶复合物，
将它们代谢成更易溶于水的形式
在这里，我们展示了戊巴比妥代谢过程的一个例子
有些药物不通过肾小球从血液中过滤
相反，肾小管壁上有特殊的阴离子和阳离子泵
主动将药物从血液转运至肾小管和集合管
来自集合管的尿液穿过输尿管
它被收集并储存在膀胱中直到从体内排出
虽然肾脏是药物消除的主要途径，
也可能发生药物排泄
哺乳期妇女通过母乳，
通过肺部呼气，
释放到胆汁中，
通过唾液和汗液消除

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The body filters drugs from the bloodstream and eliminates them in a multi step process called medication excretion
身体从血液中过滤药物并通过称为药物排泄的多步骤过程消除它们
The kidneys are the major route for drug elimination
肾脏是药物消除的主要途径
Most drugs exit the body either unchanged or as drug metabolites in urine
大多数药物以原形或以尿液中的药物代谢物形式排出体外
Generally health professionals refer to the ability of the kidneys to filter blood as renal function
一般来说,健康专业人士将肾脏过滤血液的能力称为肾功能
Nephrons the functional and anatomical units of the kidney
肾单位,肾脏的功能和解剖单位,
filter blood regulate fluid volume and pH and control levels of electrolytes in the body
过滤血液,调节体液量和 pH 值,并控制体内电解质水平
Each nephron contains a renal corpuscle and renal tubule
每个肾单位包含肾小体和肾小管
The renal corpuscle includes the Bowman capsule and glomerulus
肾小体包括鲍曼囊和肾小球
And the renal tubule is composed of the proximal tubule
肾小管由近端小管组成,
loop of Henle
亨利环,
distal tubule
远端小管,
and collecting duct
和集合管
Each component plays a role in renal drug excretion
各成分均在肾脏药物排泄中发挥作用,
a four step process that allows the kidneys to filter and eliminate drugs from the body
肾脏过滤并消除体内药物的四步过程
These steps are glomerular filtration
这些步骤是：肾小球滤过,
passive tubular reabsorption
被动肾小管重吸收,
active tubular secretion and excretion
肾小管主动分泌和排泄
Blood flows into the glomerulus via a blood vessel larger in diameter
血液通过直径较大的血管流入肾小球
than the vessel draining blood from the glomerulus
比从肾小球排出血液的血管
This difference in diameter creates the high blood pressure necessary to filter wastes from the blood
这种直径差异会产生过滤血液中废物所需的高血压
The glomerulus functions as a molecular sieve
肾小球起到分子筛的作用
Waste materials in water pass through the sieve
水中的废料通过筛子,
while most normal proteins and cells are kept in the bloodstream
而大多数正常蛋白质和细胞都保留在血液中
Glomerular filtration removes low molecular weight drugs from the bloodstream
肾小球滤过从血液中去除低分子量药物
The process of passive reabsorption of water solutes and ions begins in the proximal tubule
水、溶质和离子的被动重吸收过程始于近端小管,
continues in the Henle loop
继续在亨利环中,
and ends in the distal and collecting ducts
并终止于远端和集合管
Water soluble drugs stay in the tubule
水溶性药物停留在肾小管内,
while unionized and lipid soluble drugs are primarily reabsorbed across renal tubules
而未结合和脂溶性药物主要通过肾小管重吸收
After reabsorption lipid soluble drugs travel through the bloodstream to the liver
重吸收后,脂溶性药物通过血流到达肝脏
where certain liver enzymes
其中某些肝酶,
such as the cytochrome P450 enzyme complex
例如细胞色素P450酶复合物,
metabolize them into more water soluble forms
将它们代谢成更易溶于水的形式
Here we show an example of this process through the metabolism of pentobarbital
在这里,我们展示了戊巴比妥代谢过程的一个例子
Some drugs are not filtered from the blood via the glomerulus
有些药物不通过肾小球从血液中过滤
Instead special anionic and cationic pumps in the walls of the renal tubule
相反,肾小管壁上有特殊的阴离子和阳离子泵
actively transport the drugs from the blood into the tubules and collecting duct
主动将药物从血液转运至肾小管和集合管
Urine from the collecting ducts travel through the ureters
来自集合管的尿液穿过输尿管
where it is collected and stored in the urinary bladder until elimination from the body
它被收集并储存在膀胱中直到从体内排出
Although the kidneys are the major route for drug elimination
虽然肾脏是药物消除的主要途径,
medication excretion can also occur
也可能发生药物排泄
in lactating women through their breast milk
哺乳期妇女通过母乳,
exhalation through the lungs
通过肺部呼气,
release into bile
释放到胆汁中,
and elimination through saliva and sweat
通过唾液和汗液消除