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ILOS

By the end of this lecture the student should be able to:

 Give an account of the different functions of the kidneys and


their role in homeostasis.

 Describe the different parts of the nephron and their location


within the cortex and medulla.

 Describe the ultrastructure of the juxtaglomerular apparatus and


its physiological significance.
Introduction
The kidneys have several major regulatory
functions:
1. Homeostasis:
Keep constant composition of blood and ECF(Na+ ,
K+ , Ca++,…ect) through excretion of excess water
and solutes.
2. Excretion of metabolic waste
products:
Urea, uric acid and creatinine.
3. Excretion of foreign chemicals: e.g. drugs

4. Endocrine functions :

a) Regulation of erythrocyte production:


erythropoietin hormone, which regulates
production of R.B.Cs.
b) Regulation of 1,25-Dihydroxy vit. D3 production.

c) Production of prostaglandin (autocrine hormones).


5. Regulation of acid-base balance by:

a) Elimination of acids produced from the


metabolism of proteins such as sulphuric and
phosphoric acid.

b) Regulation of the buffer stores in the body( NaHCO3).


6. Regulation of arterial blood pressure:

a) Renin-angiotensin system.

b) Regulation of ECF volume.

7. Regulation of blood glucose level

(gluconeogenesis)
Nephron as a functional Unit:

The functional unit of the kidney is the nephron.


There are approximately 1.3 million nephrons in each
human kidney.
Each nephron is capable of forming urine, i.e. acts as a
functional unit.
Each nephron is composed of:

Glomerulus

Renal tubule
GIomerulus

It is formed of a tuft of


capillaries (glomerular
capillaries) contained within
the dilated blind end of the
renal tubule known as
(Bowman's capsule).

The capillaries are supplied


by an afferent arteriole and
drained by a narrower efferent
arteriole.
The the capillary pressure =60 mmHg.

The glomrulus is a high pressure capillary bed.


Renal tubule

It is a thin tube, which is subdivided into functionally and


morphologically distinct segments:

Proximal Distal
Loop of
Convoluted convoluted
Henle
Tubule tubule
1- Proximal convoluted tubule

It is about 15 mm long that lies in the cortex.


The wall of the proximal convoluted tubule is
made up of a single layer of cells that are united by
apical tight junction.
Between the bases of the cells, there are
extensions of the extracellular space called the
lateral intercellular space.
•The luminal edges of the cells have a brush
border due to the presence of many microvilli
2- Loop of Henle

It is a U - shaped
extension of the proximal
convoluted tubule that dips in
the renal medulla. Each loop
consists of:
i) Descending limb.
ii) Ascending limb
Thin segment of the loop of Henle:

Composed of the descending limb and the lower half


of the ascending limb made up of flat cells.

Thick segment of the loop of Henle:

•The remaining half f the ascending limb made up


of cuboidal cells .
3- The Distal Convoluted Tubule:

•It lies in the cortex and is


about 5 mm long. Its
epithelium is lower than that
of the proximal tubule.

•There is no distinct brush


border, but there are few
microvilli.
4- Collecting Ducts:

The distal tubules coalesce to form


collecting ducts that pass through the renal
cortex and medulla to empty into the pelvis
of the kidney .
Types of nephrons
There are two types of nephrons according to the
location of the glomeruli in the cortex:

1) Cortical Their glomeruli lie


Nephrons in the outer cortex.

Their glomeruli lie


2) Juxtamedullary deeper in the renal
Nephrons cortex, near the
medulla.
Cortical nephrons Juxtamedullary nephrons

Percentage of the total 85% 15%


number
Glomeruli In the outer portion of the renal Deep in the renal cortex near the
cortex. medulla.

Loop of Henle Short & penetrate a short Long & dips deeply into the
distance into the medulla no medullary pyramids.
further than the junction between
the inner & outer medulla.

Vascular structures The tubule is surrounded by a Vasa recta which are specialized
supplying tubule network of peritubular U - shaped peritubular
capillaries. capillaries that lie side by side
with loop of Henle. In addition
to the peritubular capillary
network