Anatomy of the Renal System

Stanley N. Morumbe

MSc Renal Nursing

UoN-EAKI
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Anatomy

• Gross/macroscopic/topographic

• Histology/microscopic

• Developmental /embryology

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Anatomical structural organization
• Cell(s)

• Tissue- epithelial, connective, muscular, nervous

• Organ –liver,lungs,heart.

• Organ system –Renal, CVS,RS,GIT,Integumentary

• Organism -Kangaroo, Man, Cow

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 Assignment 101/1:2020
Epithelial tissue
• Types

• Location

• Characteristics/adaptation features

• Functions

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 Lesson objectives:
1. Define nephrology and urology
2. Discuss the kidney under these subheadings:
Gross and microscopic anatomy.
Blood and nerve supply to the kidneys.
Discuss the venous and lymphatic drainage of kidney.
Clinical correlations.

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 Introduction
• Nephrology: Anatomy, physiology and pathology of the

kidneys.

• Urology: Deals with the male and female urinary systems

and the male reproductive system ( uro- urine).

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Renal system

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Renal system organs
• Kidneys 2

• Ureters 2

• Urinary bladder 1

• Urethra 1

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 Kidneys …..Description
• Paired, reddish, bean-shaped organs……concave and convex
sides.

• Location ….. above the waist, btn the peritoneum posterior

wall of the abdomen---retroperitoneal organs.

• T12-L3 and partially protected 11th and 12th pairs of ribs.

• Rt kidney is slightly lower than the left

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 Kidneys …Description
• Adult kidney is 10–12 cm long, 5–7 cm wide and 3cm thick

• Mass 135–150 g. Physiological adult person weighs 70,000g.

• Concave medial border: faces v.column, has indentation(hilum)-

ureter, blood & lymphatic vessels, nerves.

• Convex border: away from the v. column, lateral, continuous..

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 Coverings of the kidney
1. Deep layer/renal capsule
• Smooth, transparent sheet of dense irregular CT
• Continuous with the outer coat of the ureter.
• A barrier against trauma, maintain shape of the kidney.

2. Middle layer/adipose capsule

• Mass of fatty tissue surrounding the renal capsule.
• Protection from trauma and stabilizes the kidney.
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 Coverings of the kidney…
3. Superficial layer/renal fascia
• Thin layer of dense irregular connective tissue
• Anchors the kidney to the surrounding structures
and to the abdominal wall.

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Coverings of the kidneys

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 Clinical correlation
Nephroptosis /floating kidney,
• Is an inferior displacement or dropping of the kidney
• Develops most often in very thin people whose adipose capsule
or renal fascia is deficient.
• Dangerous because the ureter may kink and block urine flow
(Kidney damage) and pain.
• Very common; about 1 in 4 people;10X in F than M.

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Internal structure of the kidney

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 Internal Anatomy of the Kidneys

1. Cortex/rind or bark
• Superficial, light red
• Smooth textured area extending from the renal capsule
to the bases of the renal pyramids and into the spaces
between them.
• It is divided into an outer cortical zone and an inner
juxta-medullary zone.

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Internal Anatomy of the Kidneys
2. Medulla/inner portion
• Deep, darker reddish-brown.
• consists of several cone-shaped renal pyramids.
• The base (wider end) of each pyramid faces the renal cortex,
and its apex (narrower end), called a renal papilla points
toward the renal hilum.

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Internal structure of the kidney
• Portions of the renal cortex that extend between renal pyramids …
renal columns.
• A renal lobe consists of a renal pyramid, its overlying area of renal
cortex, and one-half of each adjacent renal column.

• Renal cortex + renal pyramids=renal parenchyma.

• Within parenchyma are functional units of the kidney (nephrons)

— about 1.2 million.

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 Internal Anatomy of the Kidneys

• Urine formed by the nephrons drains into large papillary ducts,

which extend through the renal papillae of the pyramids.
• Papillary ducts drain to cuplike structures called minor and major
calyces.
• Each kidney has 8 to 18 minor calyces and 2 or 3 major calyces.
• from the major calyces, urine drains into a ………large cavity called
the renal pelvis ( pelv- basin) ………ureter……..urinary bladder.

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Internal Anatomy of the Kidneys
• The hilum expands into a cavity within the kidney called the renal
sinus, which contains part of the renal pelvis, the calyces, and
branches of the renal blood vessels and nerves.

• Adipose tissue helps stabilize the position of these structures in

the renal sinus.

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 Blood Supply to the Kidneys
• Abundantly supplied. ( 150/70,000=0.2% of BW)

• Receive 20–25% of the resting CO via renal

arteries .
• In adults, RBF is about 1250 ml per minute.

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 CARDIAC OUTPUT
• CO=SV*HR
=70-80mls/beat*60-100beats
=70*72
=5040mls

0.25*5040=1260MLS

0.20*5040≈1008MLS

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 Blood Supply to the Kidneys

• Within the kidney, the renal artery… segmental

arteries. Different segments (areas) of the kidney.

• Each segmental artery branches to enter the

parenchyma ( interlobar arteries).

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KIDNEY BLOOD SUPPLY

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 Kidney blood supply
• At the bases of the pyramids, interlobar arteries arch between
medulla and cortex; to form the arcuate arteries.

• Arcuate arteries produce a series of interlobular/cortical radiate

arteries( pass between renal lobules).

• Interlobular arteries enter the renal cortex and give off branches
called afferent arterioles.

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Kidney blood supply

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 Blood supply to the kidney…
• Each nephron receives one afferent arteriole, which divides into a
tangled, ball-shaped capillary network- glomerulus).

• The glomerular capillaries reunite to form an efferent

arteriole(carries blood out of the glomerulus).

• Glomerular capillaries are unique(are positioned btn two

arterioles(portal circulation).

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 Kidney Blood Supply
• The efferent arterioles divide to form the peritubular
capillaries( peri-around), which surround tubular parts of the
nephron in the renal cortex.

• Extending from some efferent arterioles are long loop-shaped

capillaries called vasa recta (vasa vessels; recta straight) that
supply tubular portions of the nephron in the renal medulla.

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Blood supply to the kidney …
• The peritubular capillaries reunite forming peritubular venules and
then interlobular veins, which also receive blood from the vasa
recta.

• Then through the arcuate veins>>> interlobar veins.

• Blood leaves the kidney through a single renal vein that carries
venous blood to the inferior vena cava- IVC.

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Break

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Structure of the nephron

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 Parts of the nephron
Each nephron has two parts:

1. Renal corpuscle composed of the glomerulus and the

glomerular (bowman’s) capsule a double-walled epithelial cup
surrounds the glomerular capillaries.

2. Renal tubule, which has three main sections.PCT, LoH, DCT.

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Parts of the nephron…
• Proximal: attached to the glomerular capsule,

• Distal: part that is further away.

• Convoluted: tightly coiled rather than straight.

• The renal corpuscle and convoluted tubules lie in renal cortex;

• LoH extends into renal medulla, makes a hairpin turn, and then
returns to the renal cortex.

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Parts of the nephron…

• Several DCTs empty into a single collecting duct.

• Collecting ducts then unite into several hundreds of large papillary

ducts, which drain into the minor calyces.

• The loop of Henle dips into the renal medulla, where it is called the
descending limb of the loop of Henle.

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 Types of nephrons
Cortical nephrons:

• Constitute about 85% of nephron population.

• Their corpuscles lie in the outer portion of the renal cortex.

• Short LoH that lie mainly in the cortex.

• Receive their blood supply from peritubular capillaries.

• LOH ….Lack thin ascending limb

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Types of Nephrons
Juxta-medullary nephrons:(juxta- near to).
• Constituted 15–20% of the nephron population.
• Renal corpuscles lie deep in the cortex(close to medulla)
• Long loop of Henle extending into the deepest region of the
medulla.
• The nephron loops are receive blood supply from peritubular
capillaries and vasa recta.

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Nephron tubule

Proximal convoluted tubule (PCT)

• Arises from glomerular capsule
• Longest, most coiled region
• Prominent microvilli…… absorption
• Has much contact with peritubular capillaries

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Nephron Tubule
Nephron loop/Loop of Henle
• “U” – shaped, distal to PCT
• Descending and ascending limbs
• Thick segment-Active transport of salts,High metabolism, many
mitochondria
• Thin segment-Permeable to water, Low metabolism

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Nephron Tubule
Distal convoluted tubule (DCT)
• Coiled, distal to nephron loop
• Shorter and less coiled than PCT
• Very few microvilli
• Contacts afferent and efferent arterioles (regulation imparted)
• Contact with peritubular capillaries

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 Parts of nephron
NB

• The lumen of the thin ascending limb is the same as in other areas
of the renal tubule; it is only the epithelium that is thinner.

• Nephrons with long loops of Henle kidneys to dilute or concentrate

urine.

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Histology of the Nephron & CD

• A single layer of epithelial cells forms the entire wall of the

glomerular capsule, renal tubule, and ducts

• Each nephron part has distinctive histological features that reflect

its particular functions.

• Bowman/Glomerular capsule: has two layers

Visceral
Parietal

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Structure of the renal corpuscle

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Bowman/glomerular capsule

1. Visceral layer

• Made of modified simple squamous epithelial cells called

podocytes.

• Foot like projections (pedicels) wrap around the single layer of

endothelial cells of the glomerular capillaries and form the inner
wall of the capsule.
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Bowman/glomerular capsule

2. Parietal layer

• Consists of simple squamous epithelium and forms the outer wall

of the capsule.

• Fluid filtered from the glomerular capillaries enters the capsular

(Bowman’s) space, the space between the two layers of the
glomerular capsule.

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Podocytes

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Filtration Membrane

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Renal Tubules

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Histology of the nephron and CD

PCT
• Simple cuboidal epithelial cells with prominent microvilli on their
apical surface ..increase SA for reabsorption & secretion.

LoH descending limb and first part of the ascending limb

• Composed of simple squamous epithelium.

Thick ascending limb of LoH

• Composed of simple cuboidal to low columnar epithelium.

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Histology of the Nephron & CD

• Ascending limb of LoH makes contact with the afferent arteriole

serving that renal corpuscle .Because the columnar tubule cells in
this region are crowded together, they are known as the macula
densa.

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Renal Corpuscle

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Histology of the Nephron and Collecting Duct
• Wall of afferent( sometimes efferent) arteriole contains granular/
juxtaglomerular (JG) cells. Helps regulate BP.

• Most part of the DCT is made up of simple cuboidal cells.

• Last part of the DCT and CDs, majorly, principal cells with (ADH)
and aldosterone.

• A smaller number are intercalated cells homeostasis of blood pH.

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Histology of the Nephron and Collecting
Duct
• CDs drain into large papillary ducts,(s. columnar epithelium.

• The no. of nephrons is constant from birth. Any increase in kidney size is due
solely to the growth of individual nephrons. If nephrons are injured or become
diseased, new ones do not form.

• Signs of kidney dysfunction usually do not become apparent until function

declines to less than 25% of normal because the remaining functional nephrons
adapt to handle a larger-than normal load.

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Histology….

• Surgical removal of one kidney, for example, stimulates

hypertrophy (enlargement) of the remaining kidney, which
eventually is able to filter blood at 80% of the rate of two normal
kidneys.

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Applied renal anatomy aspects
• Congenital Anomalies
1. Unilateral/ Bilateral agenesis
2. Horse shoe kidney
3. Congenital poly cystic kidney disease
4. Ectopic kidney
5. Abnormal renal arteries may arise from aorta or
superior mesenteric artery
• Infections
• Renal Failure

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 Take home messages

• Nephron is the functional unit of the kidney.

• About 1.2 million nephrons.

• Kidneys receive about 25 % of the CO.

• JGA is key in blood pressure regulation.

• Nephron is highly adapted structurally to carry out its functions.

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Q&A

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 ASSIGNMENT 101/2:2020

During your SDL read and make short notes on the following:

Question 1:
Anatomy of the body’s lymphatic system.
Describe lymphatic drainage of the kidneys.
Explain functions of lymphatic system.

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 Question 2
Describe:
• The anterior, posterior lateral, superior relations of the
rt and lt kidney.
• Gross and microscopic anatomy the ureters, urinary
bladder and urethra.

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 Question 3

State the four main body tissues.

Describe of the various types of epithelia in respect to: type,
location, characteristic features and function.
Discuss kidney functions under these sub headings:
endocrine, excretory and regulatory and metabolic.

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 Question 4

• Draw a well labelled diagram of a human cell.

• Describe the roles played by various organelles in the cell.
• Describe the structure of the plasma/cell membrane with
special emphasis on its components.
• State role of proteins on the cell wall

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 KIDNEY FUNCTIONS

Filter blood plasma, eliminate metabolic wastes, free radicals, drugs.

Regulate blood volume, pressure, fluid osmolarity.

Regulate PCO2, Acid-Base balance

Secrete renin, erythropoietin (EPO)

Synthesize calcitriol (Vitamin D)

Gluconeogenesis

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Thank You

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