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Functions
1.Regulation of Water & Electrolyte Balance2.Excretion of Metabolic Waste Products3.Excretion of Foreign Chemicals & Drugs4.Regulation of Arterial Blood Pressure5.Regulation of Erythropoiesis6.Regulation of Vitamin D7.Gluconeogenesis
Structure
the kidneys are paired organs lying in the retroperitoneal spacemedial border =
 hilum
→
renal pelvis and ureterthe renal pelvis subdivides into major
 calyxes
, then minor calyxes projecting to a renal
 pyramid 
 divided into outer
 cortex
and inner
 medulla
medulla inner and outer zones are due to the boundary of thin segments (below)the cortex is granular, due to ~ 1-1.2 million
 nephrons
per kidneythe
 glomerulus
is composed of capillary loops invaginated in Bowman's capsuleglomerulus also contains
 mesangial cells
in a central glomerular tuftthese contain myofilaments and may contract altering GFRBowman's capsule joins the proximal tubule, a single layer of epithelial cells lying on a basementmembrane (BM)
 Filtration Barrier
1.capillary endothelium- fenestrated2.basement membrane- homogeneous glycoprotein/mucopolysaccharide3.capsular epithelial cells, podocytes & foot processesthe foot processes are covered with
 glycosialoproteins
which partially occlude the slitsthese are
 negatively
charged, hence present a charge-selective barrierthere are also extremely thin diaphragms which bridge the slits at the BM
Renal Physiology
 
Tubules
1.proximal tubule (PT)* histologically 3 segmentsi.pars convolutaii.pars recta2.loop of Henle- 3 partsi.descending thin limbii.ascending thin limbiii.ascending thick limb3.macula densa- passing between arterioles of own glomerulus4.distal tubule (DT)- also termed the late distal tubulei.distal convoluted tubuleii.connecting segmentiii.initial collecting tubule
Collecting System
1.cortical collecting tubule2.medullary collecting tubule3.papillary collecting ductsthese drain into a
 calyx
of the renal pelvis, then to the ureter & bladder
 Blood Supply
1.renal artery2.interlobar arteries3.arcuate arteries4.interlobular arteries5.afferent arterioles- parallel series from each interlobular artery6.glomerular capillaries7.efferent arterioles8.peritubular capillaries- nonspecific
 NB:
interlobular, arcuate, interlobar and renal veins parallel arteries
Renal Physiology
2
 
 Regional Differences
nephrons are not homogeneous and vary according to the location of the glomerulus in thecortex,a.superficial cortical nephrons- all
 short looped 
b.midcortical nephrons- mixturec.juxtamedullary nephrons- all
long looped 
 the efferent arterioles of the
 juxtamedullary glomeruli
are long and form vascular bundlesextending and branching into the medullathe descending
vasa recta
extend to the inner medulla, networking and forming a
 countercurrentexchanger
with the ascending vasa rectathe interstitial cells increase in size and number from cortex to papilla
Juxtaglomerular Apparatus
 Def'n:
= an aggregation of three cell types,1.
 granular cells
differentiated smooth muscle cells of 
 afferent
arteriolessecretory vesicles contain
 renin
2.extraglomerular
 mesangial cells
- continuous with the mesangium3.
 macula densa cells
terminal part of thick ascending limb LOHprobably control both renin secretion and GFR
 NB:
JGA has a rich
 sympathetic
nerve supply
Intrarenal Hormone Synthesis
a.angiotensin II- intrarenally generatedb.prostaglandins- esp. PGE
2
and prostacyclinc.kinins- lysyl bradykinin, bradykinind.erythropoeitine.Vit.D- hormone not a vitamin- not synthesized but biotransformed
Renal Physiology
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Tyler S. Huang

page 48 is very useful!

reply09 / 24 / 2011
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