ANATOMY AND PHYSIOLOGY

THE KIDNEY

The kidneys are the primary

functional organ of the renal
system. They are essential in
homeostatic functions such as
the regulation of electrolytes,
maintenance of acid-base
balance, and the regulation of
blood pressure (by maintaining
salt and water balance). They
serve the body as a natural
filter of the blood and remove wastes that are excreted through the urine.

They are also responsible for the reabsorption of water, glucose, and amino acids, and
will maintain the balance of these molecules in the body. In addition, the kidneys
produce the hormones including calcitriol, erythropoietin, and the enzyme renin, which
are involved in renal and hemotological physiological process.

A sagital section of the kidney reveals three distinct regions called pelvis, medulla and
cortex (from inside out).

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The three major regions of the kidneys:

1. Renal cortex - the space between the medulla and the outer capsule

2. Renal medulla - contains the majority of the nephrons, the main functional
component of the kidney that filters fluid from blood.

3. Renal pelvis - connects the kidney with the circulatory and nervous systems from the
rest of the body.

NEPHRON

The basic functional unit of the kidney is the nephron. Each nephron is an independent
urine-forming unit. Each kidney contains approximately one million nephrons.

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 STRUCTURE MAJOR FUNCTIONS
 Vascular (capillary) component of renal
corpuscle. Filters (by hydrostatic pressure)
GLOMERULUS
water, dissolved substances (minus most plasma
proteins, blood cells) from blood plasma.
 Initial tubular component of nephron.
GLOMERULAR CAPSULE Transports glomerular filtrate to proximal
tubule.
 Reabsorbs (by active transport) Na+, K+, Ca2+,
amino acids, uric acid, ascorbic acid, ketone
bodies, glucose.
PROXIMAL CONVOLUTED
 Reabsorbs (by osmosis) water.
TUBULE
 Reabsorbs (by diffusion) urea.
 Actively secretes substances such as penicillin,
histamine, organic acids, organic bases.
 Reabsorbs (by active transport) Na+.
 Reabsorbs (by electrochemical gradient) Cl-,
DESCENDING LOOP OF THE
SO4^2-.
NEPHRON
 Reabsorbs (by osmosis) water.
 Reabsorbs (by diffusion) urea.
ASCENDING LOOP OF THE  Reabsorbs (by active transport) Na+, Cl-
NEPHRON  Reabsorbs (by electrochemical gradient) HCO3-
DISTAL  Reabsorbs (by active transport) Na+
 Reabsorbs (by electrochemical gradient) PO4^3-,
Cl-, SO4^2-, HCO3-
CONVOLUTED TUBULE  Reabsorbs (by osmosis) water.
 Reabsorbs (by diffusion) urea.
 Actively secretes H+
 Reabsorbs (by active transport) Na+
 Reabsorbs (by osmosis, under control of ADH)
COLLECTING DUCT water.
 Actively secrets H+ and K+
 Actively reabsorbs K+

PHYSIOLOGY OF THE KIDNEYS

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Urine Formation

Urine is a waste byproduct formed form the excess water and metabolic wastes
molecules during the process of renal system filtration.

Urine is formed in three steps:

1. Filtration - blood enters the afferent arteriole and flows into the glomerulus where
filterable blood components, such as water and nitrogenous waste, will move towards
the inside of the glomerulus, and non-filterable components, such as cells and serum
albumin, will exit via the efferent arteriole. These filterable components accumulate in
the glomerulus to form the glomerular filtrate. About 20% of the total blood pumped by
the heart each minute will enter the kidneys to undergo filtration; this is called filtration
fraction. The remaining 80% of the blood flows through the rest of the body to facilitate
tissue perfusion and gas exchange.

2. Reabsorption - the next step is reabsorption, during which molecules and ions will be
reabsorbed into the circulatory system. The fluid passes through the components of the
nephron (the proximal/distal convoluted tubules, loop of Henle, the collecting duct) as
water and ions are removed as fluids osmolarity (ion concentration) changes. In the
collecting duct, secretion will occur before the fluid leaves the ureter in the form of
urine.

3. Secretion - during secretion some substances such as hydrogen ions, creatinine, and
drugs - will be removed from the blood through peritubular capillary network into the
collecting duct. The end product of all these processes is urine, which is essentially a
collection of substances that has not been reabsorbed during glomerular filtration or
tubular reabsorption.

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