Anatomy and Physiology

One of the most complex, beautifully

“engineered” organs of the human body, the
kidneys perform several essential tasks
including the excretion of waste products,
the maintenance of homeostatic balance in
the body and the release of important
hormones. To achieve this, human kidneys
have a highly developed, superbly refined
anatomy and physiology.

KIDNEY

The kidneys are bean-shaped organs that sit

in the back of the lower abdominal cavity on either side of the spinal cord. The organs are
cushioned by perinephric fat, fatty tissue that surrounds the kidneys and adrenal glands to
prevent damage and movement in the abdominal cavity. Under normal conditions,
humans are born with two kidneys, but it is possible to survive with only one as long as
disease or other factors do not strain the organ.

Location and Basic Structure of the Kidneys

The kidneys are located near the vertebral column at the small of the back; the left kidney
lying a little higher than the right. Each is identical in structure and function. They are
bean-shaped, about 10 cm long and 6.5 cm wide. Each kidney comprises an outer cortex
and an inner medulla. The kidney is supplied with oxygenated blood via the renal artery
and drained of deoxygenated blood by the renal vein. In addition, urine produced by the
kidney as part of its excretory function, drains out via narrow “tubules” and the ureter, in
turn connected to the bladder.

Kidney Function

The main function of the kidney is to maintain the fluid, electrolyte, and pH balance of
the body by filtering ions, macromolecules, water, and nitrogenous wastes from the blood
based on the body’s condition. Wastes filtered out of the blood drains from canals in the
kidney into the bladder as urine. Blockage of the drainage system can cause the kidney to
become congested, stretched, and potentially scarred. Functioning kidneys are necessary
to maintain life, and one measure of their function is the glomerular filtration rate. A loss
of kidney function results in the need for dialysis, which is an artificial method of
removing wastes from the blood by running the blood from the body, through an artificial
kidney, and then back into the body.

The Nephron
The main functional unit of the kidney is the nephron. There are approximately one
million nephrons per kidney. The role of nephrons is to make urine by:

• Filtering blood of small molecules and ions such as water, salt, glucose and other
solutes including urea. Large “macromolecules” like proteins are untouched.
• Recycling the required quantities of useful solutes which then re-enter the
bloodstream. (A process called reabsorption)
• Allowing surplus or waste molecules/ions to flow from the tubules/ureter as urine.

Filtration and Reabsorbtion in the Kidneys

During progress through the nephron, some solutes like sodium chloride, potassium and
glucose are reabsorbed, along with water, back into the bloodstream. This maintains a
correct balance of these chemicals within the blood, assisting blood pressure regulation,
for example. The filtration and reabsorbtion of glucose within the kidneys also helps to
maintain correct levels of vital blood sugars. When this regulation breaks down very
serious health consequences can follow.

Urea and uric acid are nitrogen containing waste products from metabolic processes in
the body. These substances are potentially toxic and are partially excreted by the kidneys
to maintain good health. Interestingly, of the filtrate which enters each nephron from the
blood, only about 1% actually leaves the body as urine because of the various
reabsorbtion mechanisms driven by osmosis, diffusion, and active transport.

Tubular Secretion in the Kidneys

Another, less familiar, mechanism for urine production in the kidneys is tubular
secretion. Specialised cells move solutes directly from the blood into the tubular fluid.
For example, hydrogen and potassium ions are secreted directly into the tubular fluid.
This process is “coupled” or balanced by the re-uptake of sodium ions back into the
blood.

ubular secretion of hydrogen ions, augmented by control of bicarbonate levels, is

important in maintaining correct blood pH. When the blood is too acidic (acidosis) more
hydrogen ions are secreted. If the blood becomes too alkaline (alkalosis), hydrogen
secretion is reduced. In maintaining blood pH within normal limits (about 7.35–7.45) the
kidney can produce urine with pH as low as that of acid rain or as alkaline as baking
soda!

The Kidney as an Endocrine Gland

In addition to its excretory and homeostatic roles, the kidneys also release two important
hormones into the blood. These are:

• Erythropoietin which acts on bone marrow to increase the production of red blood
cells
 • Calcitriol which promotes the absorption of calcium from food in the intestine and
acts directly on bones to shift calcium into the bloodstream.

Finally the kidney produces the enzyme renin, an important regulator of blood pressure.

Cardiovascular System

The cardiovascular system can be

thought of as the transport
system of the body. This system
has three main components: the
heart, the blood vessel and the
blood itself. The heart is the
system's pump and the blood
vessels are like the delivery
routes. Blood can be thought of
as a fluid which contains the
oxygen and nutrients the body
needs and carries the wastes
which need to be removed. The
following information describes
the structure and function of the heart and the cardiovascular system as a whole.