Kidney
Dr Hammad Ali Nasir
Recap
KIDNEY
• The kidneys perform several essential
functions in the body, including:
• Excretory Functions
• Regulation of Fluid and Electrolyte Balance
• Acid-Base Balance
• Blood Pressure Regulation
• Endocrine Functions
• Gluconeogenesis
BASIC HISTOLOGICAL PLAN OF
URINARY PASSAGE
• Urinary passage is comprised of minor and major calyces, renal pelvis,
ureter, urinary bladder, and urethra. Their wall is formed of the
following structures:
1.Mucosa – Formed of transitional epithelium (urothelium) lying on
lamina propria.
2.Muscularis – Formed of smooth muscles.
3.Adventitia – Formed of areolar connective tissue, blood vessels
nerves and lymphatics.
Kidney
• Kidney: Compound tubular
gland
• Stroma:
• Collagenous capsule and
interstitial connective tissue
(collagen and reticular fibers)
• 18 lobes, each with many lobules,
demarcated by interlobular arteries
• Parenchyma:
• Cortex: Outer granular zone (renal
corpuscles, convoluted tubules)
• Medulla: Inner striated zone
(parallel blood vessels, straight
tubules)
• Some cortical substances extend into
the medulla as renal columns of
Bertin.
• Some medullary material extends
into the cortex as medullary rays.
• The medulla has 8-18 pyramids,
each containing 400-500 medullary
rays.
1. STROMA
• Formed by collagenous capsule and
interstitial connective tissue (C.T.).
• The interstitial C.T. contains few
collagen fibers and many reticular
fibers.
• Each kidney has about 18 lobes, each
containing multiple lobules,
separated by interlobular arteries.
2. PARENCHYMA
• In vertical section, the kidney has:
• Outer granular zone (Cortex) – Brown-
red granular appearance due to renal
corpuscles and convoluted tubules.
• Inner striated zone (Medulla) – Light-
gray, striated due to parallel-arranged
blood vessels and straight parts of the
renal tubules (LOH).
Kidney Parenchyma
• Medullary Pyramids:
• 8-18 conical masses
• Base is adjacent to cortex while the
apex aka papilla projects into minor
calyx
• Each pyramid with overlying cortex
is called lobe of kidney
• 5-7 pyramids open into one minor
calyx
• 9-10 minor calyces → 2-3 major
calyces → renal pelvis
Uriniferous Tubule
• Uriniferous Tubule:
• Nephron (30-40 mm): Secretes urine
• Collecting Tubule (20 mm): Conveys urine to renal pelvis
• Nephron Types:
• Cortical nephrons: Short Henle's loop
• Juxta-medullary nephrons: Long Henle's loop
Nephron Structure
• Bowman's Capsule:
• Double-walled (parietal and visceral layers) cup
shaped dilatation
• Parietal layer: covered by simple squamous
epi with reticular fibres then continues with
simple cuboidal epi of PCT
• Visceral layer: Covering glomerulus,
Composed of single layer of squamous
epithelium cells with star shaped cells called
Podocytes
• Podocytes wrap around the capillaries and form
a filtration barrier thus aid in filteration.
• Glomerulus:
• Capillary tufts with afferent and efferent
arterioles
• Basement membrane: Selective barrier for
blood filtration
• Both collectively called Renal Corpuscle or
Malphigian Corpuscle.
Glomerulus
• Capillary Tufts:
• Composed of 50 capillaries
• Located within the Bowman's capsule
• Afferent Arteriole:
• Brings blood into the glomerulus
• Divides into 4-5 main branches, which further
branch into capillaries
• Efferent Arteriole:
• Carries filtered blood away from the glomerulus
• Has a thicker smooth muscle coat than the afferent
arteriole
• Basement Membrane:
• Dual basement membrane (fusion of capillary
endothelium and Bowman's capsule epithelium)
• Acts as a selective barrier for blood filtration
• Mesangial Cells:
• Support the glomerular structure
• Synthesize and maintain the basement membrane
• Proximal Convoluted Tubule (PCT):
• Longest, tortuous part of nephron
• Lined by simple cuboidal epithelium with
brush border
• Cells of PCT are relatively larger than DCT
• Less Caliber
• Loop of Henle (LOH):
• Descending and ascending limbs
• Thin and thick segments
• Thin portions lined by simple squamous
epithelium
• Thick portions lined by simple cuboidal
epithelium
• Distal Convoluted Tubule (DCT):
• Highly tortuous, lined by simple cuboidal
epithelium
• Cells smaller than PCT
Collecting Tubule
• Collecting Tubule:
• Excretory duct in medullary
rays,passing into the medulla
• 6-8 Collecting ducts Joins to form
larger straight ducts called
papillary ducts of Bellini,
which open at the apex of papilla
• Collecting tubules and ducts are
lined by simple cuboidal
epithelium
• Papilla lined by stratified
squamous epithelium
Juxtaglomerular Apparatus
1.Juxtaglomerular Cells:
•Modified smooth muscle cells in the afferent arteriole.
•Contain cytoplasmic granules (renin storage).
•Release renin in response to changes in blood pressure or sodium
concentration.
2.Macula Densa:
•Specialized cells of the distal convoluted tubule.
•These cells are taller.
•Monitor sodium chloride concentration in the filtrate.
•Signal juxtaglomerular cells to release renin if sodium levels are low.
3.Extraglomerular Mesangial Cells:
•Found between the juxtaglomerular cells and macula densa.
•Aid in communication and regulation of blood flow.
Juxtaglomerular Apparatus
• Function:
• Regulates glomerular filtration rate (GFR) through
the renin-angiotensin-aldosterone system (RAAS).
• Helps maintain blood pressure and fluid balance
ID Points
• Renal Corpuscles
• Proximal Convoluted Tubules (PCT)
• Distal Convoluted Tubules (DCT)
• Loop of Henle and collecting ducts.
• Cortex: Granular, Renal Corpuscles and convoluted tubules
• Medulla: Striated, Loop of Henle and collecting tubules
Thank you
