Renal Physiology Lectures

Kidney Structure and Function

Dana Rohde, PhD

Structure and Function of the Kidney Glomerular Filtration Regulation of RBF and GFR Measurement of GFR and Clearance Reabsorption and Secretion in the Proximal Tubule The Loop of Henle and the Distal Nephron Regulation of Body Fluid Osmolality Regulation of Body Fluid Volume Acid-base Physiology Regulation of Extracellular Potassium Calcium and Phosphorus Handling by the Kidney

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Introduction
I. II. Functions of the Kidney Structure of the Nephron Renal corpuscle Proximal tubule Loop of Henle Distal nephron Juxtaglomerular apparatus III. Renal circulation

I. Functions of the kidney

1. Electrolyte Homeostasis Na+, K+, H+, HCO3-, Cl-, Ca2+, Mg2+ and PO422. Water Homeostasis Maintain the composition of body fluids

Slide 3 EM10 Show a figure before and/or after this slide

Earl Mayeri, 12/25/2002

II. Nephron
3. Excretion of Metabolic Wastes and Drugs in Urine Metabolic wastes: urea, uric acid, creatinine, bilirubin Drugs: aspirin, penicillin, atropine 4. Control of arterial blood pressure Na+ balance Renin secretion Angiotensinogen

Nephron = Renal Corpuscle (glomerulus + Bowmans capsule) + Tubule

ACE

Efferent arteriole Bowman's capsule Bowman's space Glomerulus

Afferent arteriole

renin

Proximal convoluted tubule

Connecting duct

Angiotensin I

Angiotensin II

Distal covoluted tubule

5. Secretion of erythropoietin 80% comes from kidney Normal erythropoiesis requires basal secretion of erythropoietin Hypoxia stimulates erythropoietin secretion via prostaglandin generation 6. Production of 1,25-Dihydroxyvitamin D Active form of vitamin D Participates in Ca2+ homeostasis 7. Gluconeogenesis During prolonged fasting, synthesizes glucose from amino acids

Cortical nephrons (85% ) Juxtamedullary nephrons (15%)

Proximal straight tubule CORTEX Thick ascending limb of loop of Henle

Cortical collecting duct

MEDULLA Descending limb of loop of Henle

Medullary collecting duct

Thin ascending limb of loop of Henle

Boron and Boulpaep Figure 32.2

Over 1 million nephrons per kidney

Nephron and blood supply

Filtration from glomerular capillaries into lumen of nephron (Bowmans capsule) Reabsorption from lumen of nephron to surrounding capillaries. Secretion from peritubular capillaries into the lumen of the nephron

Efferent arteriole Bowman's capsule

Afferent arteriole Glomerulus

A. Renal corpuscle
Bowman's capsule - swelling at beginning of nephron Glomerulus - A tuft of highly convoluted capillaries projects into Bowman's capsule

Bowman's space

Renal corpuscle
Cortical collecting duct

Proximal convoluted tubule

Connecting duct

Distal covoluted tubule Proximal straight tubule CORTEX Thick ascending limb of loop of Henle

MEDULLA Descending limb of loop of Henle

Medullary collecting duct

Thin ascending limb of loop of Henle

Wheaters Figure 16.8

Glomerulus invaginates blind end of tubule. Invaginated epithelium flattens and differentiates into podocytes. Podocytes become closely applied to outer surfaces of the glomerular capillaries. Podocytes = visceral layer of Bowmans capsule Basement membrane of glomerular endothelial cells and podocytes fuse forming glomerular basement membrane. Mesangium - small amount of tissue that remains to support the capillary loops. Glomerular filtrate drains into Bowmans space - the space between the visceral and parietal epithelium.

Renal corpuscle

Renal corpuscle

A: afferent arteriole N: nuclei GBM: glomerular basement membrane C: capillary M: mesangium E: endothelial cell PCT: proximal convoluted tubule S: squamous cells lining Bowmans capsule I: renal interstitium

Wheaters Figure 16.9 Wheaters Figure 16.7

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Renal corpuscle and the filtration barrier

Function: Glomerular filtration Structure of the barrier: Glomerular capillary endothelium, fenestrated Glomerular basement membrane (GBM) Visceral epithelium of Bowmans capsule (podocyte layer)

Mesangial cells

Endothelial cell Basement membrane

Capillary Lumen

Support glomerular capillaries Phagocytes keep barrier clean Contractile contain myofibrils Contraction causes decrease in filtration area Regulated by nerves and hormones Secrete erythropoetin in response to hypoxia
Boron and Boulpaep Figure 32.3

Mesangial cell

Bowman's Space

filtration Podocyte foot processes

Efferent arteriole Bowman's capsule Bowman's space Glomerulus

Afferent arteriole

Proximal convoluted tubule

Connecting duct

B. Proximal Tubule
Cortical collecting duct Medullary collecting duct

C. Loop of Henle
Generates an osmotic gradient necessary for concentrated urine Major site of solute and water reabsorption

Distal covoluted tubule Proximal straight tubule CORTEX Thick ascending limb of loop of Henle

MEDULLA Descending limb of loop of Henle

Thin ascending limb of loop of Henle

Main site of reabsorption Important site of secretion To aid in reabsorption and secretion: Very prominent brush border (large surface area) that projects into the lumen Lots of channels and transporters Large numbers of mitochondria provide the energy for active transport
Proximal convoluted tubule

Efferent arteriole Bowman's capsule Bowman's space Glomerulus

Afferent arteriole

Connecting duct

Distal covoluted tubule Proximal straight tubule CORTEX MEDULLA Descending limb of loop of Henle Thin ascending limb of loop of Henle Thick ascending limb of loop of Henle

Cortical collecting duct

Medullary collecting duct

Slide 13 EM8 Words need revision. Show lots of pics of kidney and nephron near here!
Earl Mayeri, 12/25/2002

Efferent arteriole Bowman's capsule Bowman's space Glomerulus

Afferent arteriole

D. Distal Nephron

Proximal convoluted tubule

Connecting duct

Distal covoluted tubule Proximal straight tubule CORTEX MEDULLA Descending limb of loop of Henle Thin ascending limb of loop of Henle Thick ascending limb of loop of Henle

Cortical collecting duct

E. Juxtaglomerular Apparatus
Efferent arteriole Granular cell
(secretes renin)

Medullary collecting duct

Distal Nephron: distal convoluted tubule, Connecting tubule, and collecting ducts:
CT DCT

Hormonal regulation of reabsorption and secretion Fine tuning of the final composition of the tubular fluid before it is urine
Collecting ducts

Sympathetic nerves lumen Distal convoluted tubule Macula densa Afferent arteriole

Collecting ducts: Principal cells: Na+ and water reabsorption K+ secretion Intercalated cells: alpha cells: H+ secretion beta cells: HCO3- secretion ADH: water reabsorption

Macula densa plus granular cells form the juxtaglomerular apparatus. Macula densa: distal convoluted tubule becomes thickened to form a small plaque. Macula densa senses the composition of tubular fluid. Granular cells: specialized smooth muscle cells in the wall of the afferent arteriole. Granular cells secrete the enzyme (hormone) renin. Important for control of glomerular filtration and the regulation of systemic blood volume and pressure.

Elsevier Ltd. Boron & Boulpaep: Medical Physiology, Updated Edition

Juxtaglomerular Apparatus (JGA)

III. Blood supply of the nephron

JGA
Boron and Boulpaep Figure 32.1

Elsevier Ltd. Boron & Boulpaep: Medical Physiology, Updated Edition

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Summary Blood supply of the nephron

For cortical nephrons: Peritubular capillaries Arise from efferent arterioles Route for the reabsorption and secretion Coalesce into interlobular veins to arcuate veins to interlobar veins to the renal veins For juxtamedullary nephrons: Descending vasa recta (may have some peritubular capillaries too) Arise from efferent arterioles Descend parallel to the loop of Henle deep into the medulla. Maintain hyperosmotic gradient Coalesce into venulae recta (ascending vasa recta) to arcuate veins to interlobar veins to the renal veins

I.

Functions of the Kidney Electrolyte homeostasis, water homeostasis, excretion of wastes, control of blood pressure II. Structure of the Nephron Renal corpuscle - glomerular filtration Proximal tubule - main site of reabsorption Loop of Henle - concentration of urine Distal nephron - water and electrolyte homeostasis Juxtaglomerular apparatus - control of glomerular filtration and regulation of blood volume and pressure III. Renal circulation

Slide 22 EM10 Show a figure before and/or after this slide

Earl Mayeri, 12/25/2002