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Extrarenal Excretion

For medical students2 min readUpdated 2026-10-10

Extrarenal excretion represents a complex of physiological processes that ensure the elimination of metabolic waste products, water, and foreign compounds from the body without the involvement of the renal filter. The primary load in this system is borne by the lungs, sweat glands, and gastrointestinal tract, which, together with the kidneys, regulate the osmotic pressure of the blood.

LungsEliminate about 0.5 liters of water per day in the form of vapor
SkinSecretes up to 0.4 liters of fluid via sweat glands
GI tractExcretes approximately 0.1 liters of water per day along with feces
ExceptionSympathetic fibers of sweat glands release acetylcholine

Excretory Function of the Lungs

The respiratory system plays a crucial role in the removal of volatile compounds and water vapor. The mechanism of water elimination is based on a humidity gradient: inhaled air is generally not saturated with vapor, but upon reaching the alveoli, it becomes saturated due to evaporation from their vast surface area. As a result, exhaled air has 100% humidity. Through this pathway, the body loses approximately 0.5 L of water daily.

In addition to fluid, the pulmonary barrier excretes:

Excretion via Sweat Glands

The integumentary system participates in excretion primarily through the activity of sweat glands, which are distributed across the entire body surface. Their highest density is observed on the palms, soles, and in the axillary regions. The daily volume of eliminated water reaches 0.4 L.

In its qualitative composition, sweat resembles urine: it contains salts and end products of metabolism. The specific odor of the secretion is imparted by ammonia, and the acidic pH reaction of the medium is due to the presence of hydrogen ions. Urea and uric acid are also excreted with sweat.

The main difference between sweat and urine is a significantly lower concentration of substances. This is because sweat glands completely lack the concentration and reabsorption mechanisms typical of renal tubules.

Neurochemical Feature of Innervation

The activity of sweat glands is strictly controlled by the nervous system: sweating is invariably enhanced during sympathetic nervous system activation. However, a major physiological paradox lies here.

Traditionally, postganglionic fibers of the sympathetic nervous system release the neurotransmitter norepinephrine. The innervation of sweat glands is a unique exception to this rule—here, the terminals of postganglionic sympathetic fibers release acetylcholine. This fact is of critical importance in clinical pharmacology when selecting medications that affect sweating.

Role of the Gastrointestinal Tract

The excretory function of the GI tract is not limited solely to the evacuation of undigested food residues. Throughout the pathway of chyme transit and feces formation, the epithelial cells of the stomach, small intestine, and large intestine actively transport metabolic products from the bloodstream into the lumen of the digestive tube.

With feces, the body loses about 0.1 L of water per day and eliminates:

Frequently asked questions

Which other organs and tissues, besides the lungs, skin, and GI tract, participate in extrarenal excretion?

In addition to these structures, the salivary glands and liver participate in extrarenal excretion.

  • Salivary glands (gl. parotis, gl. submandibularis, gl. sublingualis) possess an excretory function and are capable of clearing substances from the blood into saliva (nitrogen metabolism products and inorganic ions).
  • Liver participates in the elimination of bilirubin, which is a hemoglobin breakdown product excreted with newly formed bile.
Why is sweat significantly less concentrated than urine?

Unlike renal nephrons, sweat glands lack physiological mechanisms for the reabsorption of water and the concentration of secretions.

Which neurotransmitter is released at nerve terminals stimulating sweating?

Postganglionic sympathetic fibers supplying sweat glands release acetylcholine, which is an exception for the sympathetic nervous system.

Is the excretory function of the intestine limited only to the removal of undigested food?

No, epithelial cells of the stomach and intestine also actively secrete metabolic products (e.g., urea and uric acid) from the blood into the GI lumen.

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