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Structure
Nephron:
functional unit of the kidney. Each
kidney has over a million nephrons.
Composed of:
1. Glomerulus – filtering unit
– network of capillaries originating from the
afferent arteriole
– surrounded by Bowman’s capsule
2. Bowman’s capsule:
– functions as a filter in the formation of
urine
Afferent
Arteriole
Distal Tubule
Glomerulus
Bowman’s Collecting
Capsule Duct
peritubular
Loop of capillaries
Henle
Glomerular Filtration:
• Glomerular filtrate: the fluid that filters through the
glomerulus into Bowman’s Capsule, AKA glomerular
capsule (pressure of blood in the glomerulus causes fluid to
filter through the glomerular capillaries and into Bowman’s
Capsule).
www.kidney.org/K/DOQI
1. If GFR drops, afferent arteriole dilates
to increase glomerular blood flow and
increase pressure, thereby increasing
GFR
2. If GFR drops, renin is released
resulting in the conversion of
angiotensin I to II. The efferent
arteriole constricts, increasing
glomerular pressure, and increasing
GFR.
Functions of the Kidneys
A. Homeostatic Functions
1. Waste excretion (urine formation)
a. Nitrogenous end products: urea, creatinine, uric acid,
etc.
b. Metabolic degradation of peptide hormones: glucagon,
insulin, PTH, growth hormone, FSH, and gastrin.
2. Fluid/electrolyte balance (Na+, K+, water)
3. Acid/base regulation:
• kidneys generate and reclaim filtered bicarbonate, as well
as secrete excess acid to maintain balance.
4. Balance of other electrolytes (Ca++, Mg++,
Phosphate PO4 3-)
B. Non-excretory functions
1. Renin-angiotensin mechanism to control BP
a. Kidney senses decreased BP
4. Sodium:
III. Acute Renal Failure (ARF):
Sudden drop in GFR. Can develop in a previously
healthy person, and last from a few days to several
weeks.
A. Causes
1. Prerenal: sudden drop in blood volume or
renal bloodflow due to severe dehydration,
shock or trauma.
2. Intrinsic: damage to kidney cells 2’ sustained
shock, trauma, surgery, septicemia,
nephrotoxic agents, acute glomerulonephritis.
3. Postrenal: (obstructive) Kidneys can form
urine, but excretion is impeded.
B. Consequences
1. Uremic Syndrome:
a. Azotemia: accumulation of nitrogenous
metabolites in the blood:
b. Uremia
h. Hypocalcemia
i. Hyperphosphatemia, poss. hyperkalemia
j. Metabolic Acidosis
k. Fixed urinary output
l. Edema
m. Altered bone metabolism - Renal
osteodystrophy
5. ESRD End-Stage Renal Disease: GFR <20% of
normal
a. Uremia
b. Kidney replacement therapy required (dialysis
or transplant)
c. Others: hyperchloremia, hypermagnesemia,
hyperuricemia