Anatomy of the Kidneys

Understanding how the urinary system helps maintain homeostasis by removing harmful substances
from the blood and regulating water balance in the body is an important part of physiology. Your
kidneys, which are the main part of the urinary system, are made up of millions of nephrons that act
as individual filtering units and are complex structures themselves. The ureters, urethra, and urinary
bladder complete this intricate system.

The urinary system helps maintain homeostasis by regulating water balance and by removing
harmful substances from the blood. The blood is filtered by two kidneys, which produce urine, a fluid
containing toxic substances and waste products. From each kidney, the urine flows through a tube,
the ureter, to the urinary bladder, where it is stored until it is expelled from the body through
another tube, the urethra.

The kidneys are surrounded by three layers of tissue:

 The renal fascia is a thin, outer layer of fibrous connective tissue that surrounds each kidney
(and the attached adrenal gland) and fastens it to surrounding structures.

 The adipose capsule is a middle layer of adipose (fat) tissue that cushions the kidneys.

 The renal capsule is an inner fibrous membrane that prevents the entrance of infections.

Inside the kidney, three major regions are distinguished, as shown in Figure 1:

 The renal cortex borders the convex side.

 The renal medulla lies adjacent to the renal cortex. It consists of striated, cone‐shaped
regions called renal pyramids (medullary pyramids), whose peaks, called renal papillae, face
inward. The unstriated regions between the renal pyramids are called renal columns.

 The renal sinus is a cavity that lies adjacent to the renal medulla. The other side of the renal
sinus, bordering the concave surface of the kidney, opens to the outside through the renal
hilus. The ureter, nerves, and blood and lymphatic vessels enter the kidney on the concave
surface through the renal hilus. The renal sinus houses the renal pelvis, a funnel‐shaped
structure that merges with the ureter.

Blood and nerve supply

Because the major function of the kidneys is to filter the blood, a rich blood supply is delivered by
the large renal arteries. The renal artery for each kidney enters the renal hilus and successively
branches into segmental arteries and then into interlobar arteries, which pass between the renal
pyramids toward the renal cortex. The interlobar arteries then branch into the arcuate arteries,
which curve as they pass along the junction of the renal medulla and cortex. Branches of the arcuate
arteries, called interlobular arteries, penetrate the renal cortex, where they again branch into
afferent arterioles, which enter the filtering mechanisms, or glomeruli, of the nephrons.