Renal Physiology 1

Dr. Bikesh Pandey

Body Fluid & Kidney
 Body fluid
(60% of body weight)

Intracellular fluid Extracellular fluid

(20%)
（ 40% ）

Interstitial fluid Plasma

(15%) （ 5 ％）
3
 plasma

interstitial
ICF
 Fluid Input and Output
Daily Input of Water

• Water is added to the body by two major sources:

– Ingested

• 2100 ml/day

– Synthesized in the body

• Result of oxidation of carbohydrates - 200 ml/day

 Fluid Input and Output
Daily Output of Water

• Water is lost by :

– Insensible water loss

• Termed so, because we are not consciously aware of it

• Eg: Evaporation through skin & respiratory system

• 700 ml/day

– Sweating
 Fluid Input and Output
Daily Output of Water

• Water is lost by :
– Feces
• 100 ml/day

– Urine
• 0.5 L/day – 20 L/day
• Average 70 Kg person - 1.4 L/day
3 PM
Anatomy & Histology of Urinary System
 Organization of Urinary System
It includes:

• Two kidneys

• Two ureters

• One bladder

• One urethra
 Function of the Urinary System

• Maintanance of fluid volume & thus blood

pressure.

• Regulation of electrolyte balance

– Eg: Sodium, Potassium, Calcium…….

• Removal of waste product from the body

– Eg: Urea, Uric acid…….

 Function of the Urinary System

• Regulation of “Acid-Base” balance.

• Production of “Erythropoietin” to stimulate

production of RBC in bone marrow.

• Regulation of Vitamin D in our body

……………….
 Kidney

• Bean-shaped

• Retroperitoneal

• Right kidney is lower than the left one

• Adrenal gland rests upon each kidney

 Kidney
There are three layers of coverings surrounding each
kidney from the outside to the inside :

• The Renal fascia

(Also encloses adrenal gland)

• The Adipose capsule

• The Fibrous capsule

 Kidney

Each kidney consists of:

• An outer, Renal
Cortex

• An inner, Renal
Medulla
 Kidney
• Extension of renal
cortex, the Renal
Column projects into
the inner aspect of the
kidney, dividing the
Renal medulla into
triangular shaped
Renal Pyramids.
 Kidney
• Their apices form the Renal Papillae, which indent the Minor calices.

• Minor Calyces are 7-8 in number on each kidney.

• Minor calices unite to form a Major Calyx. They are 2-3 in number on each
kidney.

• Two or three major calices unite to form the Renal Pelvis, which is the
funnel shaped superior end of the Ureters.

• The Renal sinus is a space that extends into the kidney from the Hilum.

• The foramina On the tip of renal papillae are termed the papillary foramina.
The urine formed in the kidney passes through these foramina into the minor
calices.
 Nephrons: Functional Unit of the Kidney

Includes

• Renal corpuscle

• Tubular section

– Proximal convoluted tubule

– Loop of Henle

– Distal convoluted tubule

• Collecting duct
 Nephron
Two types of nephrons

• Cortical nephron
– 80-85% of nephrons are cortical nephrons.
– Renal corpuscles are in outer cortex and loops of
Henle lie mainly in cortex.
• Juxtamedullary nephrons
– 15-20% of nephrons are juxtamedullary nephrons.
– Renal corpuscles close to medulla and long loops
of Henle extend into deepest medulla
 Renal Corpuscle

Provides for filtration of plasma from glomerular capillary.

• Renal glomerulus

• Bowman's capsule
Renal Corpuscle
 Renal glomerulus
• A tightly-coiled capillaries network.

• The endothelial cells are fenestrated.

• Capillaries are divided into :

– Afferent arteriole – Brings blood / wider

– Efferent arteriole – takes away blood / narrower

 Bowman's Capsule
Divided into two layers

• Parietal or capsular layer - simple squamous epithelium

• Visceral layer - podocytes

Podocytes
Tubular section
PCT Loop of Henle DCT Collecting
Tubule
Cuboidal Thick descending Cuboidal Simple cuboidal
Round nucleus Similar to PCT Lighter cytoplasm to columnar
Strong acidophilic Round nucleus Light staining
Thin descending / cytoplasm
Brush border No brush border
Thin ascending Clear boundary
Less microvilli
Simple squamous Lumen is largest

Thick ascending
Simple cuboidal
 Juxtaglomerular apparatus
 located at the vascular pole of the renal corpuscles
 consist of juxtaglomerular cells, macula densa
and extraglomerular mesangial (polar cushion)
cells
 function: control water and electrolyte balance;
regulate blood pressure;
produce erythropoietin
 Juxtaglomerular Apparatus

3 parts:

(1) Macula densa - cells of distal

tubule

(2) Juxtaglomerular (JG) cells -

modified smooth muscle cells
(myoepithelioid) in arteriole.
(3) Extraglomerular mesangium
Importance of Juxtaglomerular Apparatus

• By secreting prorenin:

– Controls water and electrolyte balance

– Regulates blood pressure

• Produces erythropoietin
The - End