Renal embryology

and microanatomy
Dr Iain Keenan
Senior Lecturer in Anatomy
iain.keenan@newcastle.ac.uk
@dr_keenan
Links to Case 3
• Urinary tract infection
• Kidney damage
• Kidney failure
• Chronic kidney disease (CKD)
• Impact of diabetes on Kidney function

• To understand the clinically relevant physiology of the kidneys it is

important to appreciate renal gross anatomy and microanatomy.
• To understand development kidney abnormalities it is important to
appreciate clinically relevant embryology
 Learning outcomes
• Apply an understanding of the histology of the kidneys and urinary tract
when describing functional renal microanatomy
• Apply an understanding of the embryology of the kidneys and urinary
tract when describing congenital renal abnormalities [covered in the
pre-work tutorial]
Gross structure of kidney
Sectra Case P041

Search ‘P041’
 Distal convoluted tubule
Proximal convoluted tubule (PCT)
(PCT)

INTERLOBULAR Bowman’s capsule

ARTERY (blind end of

Renal cortex nephron)

and medulla: CORTEX

Arrangement MEDULLA Cortical collecting

duct
of nephrons Thin descending limb
Medullary collecting duct
Thin ascending limb
LOOP OF HENLE
 Nephron INTERLOBULAR
ARTERY

AFFERENT
ARTERIOLE BOWMAN’S
CAPSULE
GLOMERULUS
PROXIMAL
• Structure-function EFFERENT
ARTERIOLE
TUBULES

relationships in
parts of nephron MESANGIUM LOOP OF
HENLE

DISTAL
PERITUBULAR TUBULES
CAPILLARIES

COLLECTING
ducts
Gross structure of kidney
 Interlobar artery Arcuate
artery

Blood
supply to Branch of Renal
artery

the kidney Interlobular artery

Branch of Renal
artery
 GLOMERULUS GLOMERULUS

AFFERENT ARTERIOLE

EFFERENT ARTERIOLE

EFFERENT INTERLOBULAR
ARTERIOLE ARTERY

PERITUBULAR PLEXUS
Associated with PCT and DCT

Arcuate vein

AFFERENT ARCUATE
ARTERIOLE ARTERY

Vasa recta
Associated
with Loops of
Henle

INTERLOBULAR
ARTERY

Carmine-gelatin injection specimen allows visualisation of vessels

Glomerulus
CORTICAL
NEPHRON GLOMERULUS
(80% of total AND
nephrons) MESANGIUM
CORTEX

JUXTAMEDULLARY
NEPHRON
(20% of total
nephrons)

OUTER
MEDULLA

INNER
MEDULLA
Glomerulus
Bowman’s
Urinary
capsule
space

Tubular pole
(proximal
tubule)

Glomerulus

Efferent
Afferent
arteriole
arteriole
Sectra Case P003

Search ‘P003’
 Glomerulus Mesangium

Red blood cells in

glomerular
MESANGIUM capillaries
• Mesangium means
‘between capillaries’

• Provides support for

glomerular capillaries
MESANGIUM
 Mesangium PODOCYTE – interlocking
foot like processes

Lamina rara externa Lamina densa

BASEMENT
MEMBRANE – Lamina rara interna
secreted by Filtration slit
endothelium and (between
podocytes processes)

FENESTRATED
ENDOTHELIUM

MESANGIUM
 CORTICAL
PROXIMAL
Cortex CONVOLUTED
TUBULE
LABYRINTH

CORTEX

OUTER
MEDULLA

INNER
MEDULLA
Cortical labyrinth
Juxtaglomerular apparatus

Mesangial Renin has

cells function in
Efferent arteriole
regulating blood
Juxtaglomerular (JG) pressure
Lacis cells cells secrete renin
Type of Mesangial cell
(support/phagocytosis) Afferent arteriole
Cortical labyrinth
Proximal
convoluted
tubule
PCT Lumen
Wall
Thick walls: Coarse
control of reabsorption
67% of all H2O, HCO3, Microvilli
Na, Cl, 100% of glucose
Coarse control involves a large volume
reabsorption in the proximal convoluted
tubule
Fine control involves channel-regulated
activity in the distal convoluted tubule
and collecting Case
duct 2
Medulla

CORTEX

OUTER
MEDULLA
MEDULLA
LOOP
INNER OF
MEDULLA HENLE
Medulla
Loop of Henle (Thin limb)

Loop of Henle (Thick limb)

Interstitial
cells

Collecting
duct
Vasa recta
 Loop of Henle
Loop of
Henle

• High power electron

micrograph shows Loop of
simple structure Henle
 Right kidney Left kidney

Lower
urinary Ureter Ureter
tract

Bladder
 Lower urinary tract

• Consists of: Urothelium

• Renal pelvis
• Ureters Submucos
a
• Bladder
Loose spiral
• Urethra muscle
Tight spiral (longitudinal)
muscle
• All have this (circular)
general structure
 Ureters Smooth
muscle

• Lined with urothelium

(epithelium) Stellate
• Urine forced down ureters to ‘star-shaped’
bladder by peristalsis lumen

• Peristalsis requires
contraction of smooth muscle
- ureter walls are highly
muscular
Urothelium
Sectra Case P039

Search ‘P039’
 Urinary bladder

Structure allows distension

• Urothelial epithelium
• Submucosal layer Submucosa
(Fibrocollagen) Smooth muscle

• Smooth muscle (three

layers)
Urothelium
Sectra Case P040

Search ‘P040’
 Functional properties of urothelium
Superficial layer large and rounded in non-distension
• Urothelium structure
changes depending on
volume of urine Non-distended
urothelium
• Impenetrable to urine, (cells are
even when stretched flattened in
distended state)
• Is in non-distended state
when tract is empty
• In distended state when
full of urine
Urothelium cell types

• Stratified epithelium
• Umbrella (dome) cells
• Binucleated
• Large and rounded in non-
distension
• Flattened in distension
• Intermediate cells
• Polygonal
• Basal cells
• Cuboidal
 Learning outcomes
• Apply an understanding of the histology of the kidneys and urinary tract
when describing functional renal microanatomy
• Apply an understanding of the embryology of the kidneys and urinary
tract when describing congenital renal abnormalities [covered in the
pre-work tutorial]
Gross structure of kidney
 Embryological development of the kidney
Pronephros is homologous to the
Three stages: kidneys of lower vertebrates.
Transient (weeks 4-5) and non-
functional in humans.
• PRONEPHROS (FORE)
Mesonephros is homologous to
• MESONEPHROS (MID) the kidneys of fish and
amphibians. Transient (weeks 4-
• METANEPHROS (HIND) 12), limited functionality.
Metanephros is definitive
human adult kidney. Appears
from week 5. Functional by week
12.
 Metanephros
Cranial
PRONEPHROS ‘Hind kidney’

PRONEPHRIC DUCT

MESONEPHROS Each stage of kidney

development arises from
MESONEPHRIC a dorsal band of
DUCT intermediate mesoderm
Caudal

URETERIC METANEPHRIC MASS

BUD
METANEPHROS
5 weeks
 Development of metanephros Week 5

MESONEPHRIC
DUCT

Metanephros is derived
from sub-populations of
intermediate mesoderm:
Mesonephric duct METANEPHRIC MASS
Metanephric mass

Ureteric bud grows out

from mesonephric duct
into the metanephric mass
URETERIC BUD
Branching of ureteric bud Week 6

MESONEPHRIC
DUCT

METANEPHRIC
MASS

URETERIC
BUD
 Further branching of ureteric bud Week 7

Metanephros (ureteric bud and

metanephric mass) detaches from
Major mesonephric duct.
calyx
Mesonephric duct will form male
genital tract (degenerates in
females)
Renal
pelvis Minor
calyx
 Development of metanephros Week 8

LOBULES – containing renal

tubules

Renal tubules will develop

into nephrons and collecting
duct system

Renal
pelvis

Metanephric
duct (Ureter)
 Pelvic origin of kidneys Week 6

Suprarenal
gland Renal
vessels
Abdominal aorta

Transient
Renal vessels
hilum
(ventral) Kidney

Ureter
Bladder
 Migration and rotation of kidneys Week 7-8

Suprarenal gland
Renal vessels

Abdominal aorta
Renal hilum
(medial) Kidney

Transient vessels

Ureter

Bladder
 Final positioning of kidneys Week 9

Suprarenal
gland

Renal hilum Kidney

(medial)
Ureter

Bladder
 Renal agenesis and hypoplasia

• Agenesis/hypoplasia
• Kidneys fail to
develop/grow
• Can be unilateral or
bilateral Agenesis Hypoplasia
Supernumerary structures

Supernumerary
kidney(s) Supernumerary (multiple) renal
Develop from vessels
additional area(s) of • Failure of regression of transient
tissue induced to renal vessels
form ureteric bud and • Ureter can be trapped by vessels
metanephros • Hydronephrosis (build up of urine)
 Renal ectopia
Renal ectopia (ectopic kidney) CROSSED
Failure in migration – kidney can ECTOPIA
remain in pelvis instead of
migrating to posterior abdominal
wall

Abnormal rotation
Hilum faces
ventrally rather
than medially
 Around 1 in 500 births. Right and left kidneys fuse
together at the midline.

Horseshoe kidney Can cause pain, nausea and increased incidence

of renal calculi and urinary tract infections
 Learning outcomes
• Apply an understanding of the histology of the kidneys and urinary tract
when describing functional renal microanatomy
• Apply an understanding of the embryology of the kidneys and urinary
tract when describing congenital renal abnormalities [covered in the
pre-work tutorial]