Kidney Structure

and Functions

[Link] Shaukat
 Anatomy of the
kidneys
• The two kidneys lie on the posterior wall of
the abdomen,
• outside the peritoneal cavity. Each kidney of
the adult human weighs about 150 grams
and is about the size of a clenched fist.
• The medial side of each kidney
• contains an indented region called the hilum through
which pass the renal artery and vein, lymphatics,
nerve supply, and ureter, which carries the final urine
from the kidney to the bladder, where it is stored until
the bladder is emptied. The kidney is surrounded by a
tough, fibrous capsule that protects its delicate inner
structures.
Anatomy and histology of the
kidneys
• External anatomy
• Renal hilium – depression where ureter emerges along with blood
vessels, lymphatic vessels and nerves
• 3 layers of tissue
• Renal capsule – deep layer – continuous with outer coat of ureter,
barrier against trauma, maintains kidney shape
• Adipose capsule – mass of fatty tissue that protects kidney from trauma
and holds it in place
• Renal fascia – superficial layer – thin layer of connective tissue that
anchors kidney to surrounding structures and abdominal wall
Internal anatomy
• Renal cortex – superficial
• Outer cortical zone
• Inner juxtamedullary zone
• Renal columns – portions of cortex that extend between renal
pyramids
• Renal medulla – inner region
• Several cone shaped renal pyramids – base faces cortex and renal
papilla points toward hilium
• Renal lobe – renal pyramid, overlying cortex area, and ½ of each
adjacent renal column
Anatomy of the kidneys
• Parenchyma (functional portion) of kidney
• Renal cortex and renal pyramids of medulla
• Nephron – microscopic functional units of kidney
• Urine formed by nephron drains into Papillary ducts
• Minor and major calyces
• Renal pelvis
• Ureter
• Urinary bladder
Anatomy of the kidneys
• If the kidney is bisected from top to bottom, the two major
regions that can be visualized are the outer cortex and the
inner medulla regions.
• The medulla is divided into 8 to 10 cone-shaped masses of
tissue called renal pyramids. The base of each pyramid
originates at the border between the cortex and medulla and
terminates in the papilla, which projects into the space of
the renal pelvis, a funnel-shaped continuation of the upper
end of the ureter.
• The outer border of the pelvis is divided into open-ended
pouches called major calyces that extend downward and
divide into minor calyces, which collect urine from the
tubules of each papilla. The walls of the calyces, pelvis, and
ureter contain contractile elements that propel the urine
toward the bladder, where urine is stored until it is emptied
by micturition.
Blood and nerve supply of the
kidneys
• Blood supply
• Although kidneys constitute less than 0.5% of total body mass, they
receive 20-25% of resting cardiac output
• Left and right renal artery enters kidney
• Branches into segmental, interlobar, arcuate, interlobular arteries
• Each nephron receives one afferent arteriole
• Divides into glomerulus – capillary
• Reunite to form efferent arteriole
• Divide to form peritubular capillaries or some have vasa recta
• Peritubular venule, interlobar vein and renal vein exits kidney
• Renal nerves are part of the sympathetic autonomic nervous system
• Most are vasomotor nerves regulating blood flow
Functions
1. Excretion of metabolic waste products and foreign chemicals
2. Regulation of water and electrolyte balances
3. Regulation of body fluid osmolality and electrolyte concentrations
4. Regulation of arterial pressure
5. Regulation of acid-base balance
6. Regulation of erythrocyte production
7. Secretion, metabolism, and excretion of hormones
8. Gluconeogenesis
• The kidneys filter unwanted substances from the
blood and produce urine to excrete them. There
are three main steps of urine formation:
glomerular filtration, reabsorption, and
secretion. These processes ensure that only
waste and excess water are removed from the
body.
[Link] Glomerulus Filters Water and Other Substances from the
Bloodstream

• Each kidney contains over 1 million tiny structures

called nephrons. Each nephron has a glomerulus, the
site of blood filtration. The glomerulus is a network of
capillaries surrounded by a cup like structure, the
glomerular capsule (or Bowman’s capsule). As blood
flows through the glomerulus, blood pressure pushes
water and solutes from the capillaries into the capsule
through a filtration membrane. This glomerular
filtration begins the urine formation process.
[Link] Filtration Membrane
Keeps Blood Cells and Large
Proteins in the Bloodstream
• Inside the glomerulus, blood pressure pushes fluid
from capillaries into the glomerular capsule through a
specialized layer of cells. This layer, the filtration
membrane, allows water and small solutes to pass but
blocks blood cells and large proteins. Those
components remain in the bloodstream. The filtrate
(the fluid that has passed through the membrane)
flows from the glomerular capsule further into the
nephron.
3. Reabsorption Moves
Nutrients and Water Back into
the Bloodstream
• The glomerulus filters water and small solutes out of
the bloodstream. The resulting filtrate contains waste,
but also other substances the body needs: essential
ions, glucose, amino acids, and smaller proteins.
When the filtrate exits the glomerulus, it flows into a
duct in the nephron called the renal tubule. As it
moves, the needed substances and some water are
reabsorbed through the tube wall into adjacent
capillaries. This reabsorption of vital nutrients from
the filtrate is the second step in urine creation.
4. Waste Ions and Hydrogen Ions Secreted
from the Blood Complete the Formation of
Urine
• The filtrate absorbed in the glomerulus flows through the
renal tubule, where nutrients and water are reabsorbed into
capillaries. At the same time, waste ions and hydrogen ions
pass from the capillaries into the renal tubule. This process is
called secretion. The secreted ions combine with the
remaining filtrate and become urine. The urine flows out of
the nephron tubule into a collecting duct. It passes out of the
kidney through the renal pelvis, into the ureter, and down to
the bladder.
Urine Is 95% Water
The nephron – functional units of
kidney
• 2 parts
• Renal corpuscle – filters blood plasma
• Glomerulus – capillary network
• Glomerular (Bowman’s) capsule – double-walled cup surrounding
glomerulus
• Renal tubule – filtered fluid passes into Proximal convoluted tubule
• Descending and ascending loop of Henle (nephron loop)
• Distal convoluted tubule
Nephrons
• Renal corpuscle and both convoluted tubules in cortex, loop of Henle extend into
medulla
• Distal convoluted tubule of several nephrons empty into single collecting duct
• Cortical nephrons – 80-85% of nephrons
• Renal corpuscle in outer portion of cortex and short loops of Henle extend only
into outer region of medulla
• Renal corpuscle deep in cortex and long loops of Henle extend deep into medulla
• Receive blood from peritubular capillaries and vasa recta
• Ascending limb has thick and thin regions
• Enable kidney to secrete very dilute or very concentrated urine
The structure of nephrons and
associated blood vessels
Histology of nephron and collecting
duct
• Glomerular capsule
• Visceral layer has podocytes that wrap projections
around single layer of endothelial cells of glomerular
capillaries and form inner wall of capsule
• Parietal layer forms outer wall of capsule
• Fluid filtered from glomerular capillaries enters
capsular (Bowman’s) space
Renal Tubule and Collecting
Duct
• Proximal convoluted tubule cells have microvilli with brush
border – increases surface area
• Juxtaglomerular apparatus helps regulate blood pressure in
kidney
• Macula densa – cells in final part of ascending loop of Henle
• Juxtaglomerular cells – cells of afferent and efferent
arterioles contain modified smooth muscle fibers
• Last part of distal convoluted tubule and collecting duct
Structures and functions of a
nephron
Glomerular filtration
• Glomerular filtrate – fluid that enters capsular space
• Daily volume 150-180 liters – more than 99% returned to blood plasma via tubular
reabsorption
• Filtration membrane – endothelial cells of glomerular capillaries and podocytes
encircling capillaries
• Permits filtration of water and small solutes
• Prevents filtration of most plasma proteins, blood cells and platelets
• 3 barriers to cross – glomerular endothelial cells fenestrations, basal lamina between
endothelium and podocytes and pedicels of podocytes create filtration slits
• Volume of fluid filtered is large because of large surface area, thin and porous
membrane, and high glomerular capillary blood pressure
Net filtration pressure
• Net filtration pressure (NFP) is the total pressure that promotes
filtration
• NFP = GBHP – CHP – BCOP
• Glomerular blood hydrostatic pressure is the blood pressure of the
glomerular capillaries forcing water and solutes through filtration slits
• Capsular hydrostatic pressure is the hydrostatic pressure exerted
against the filtration membrane by fluid already in the capsular space
and represents “back pressure”
• Blood colloid osmotic pressure due to presence of proteins in blood
plasma and also opposes filtration
Glomerular filtration
• Glomerular filtration rate – amount of filtrate formed in all the renal
corpuscles of both kidneys each minute
• Homeostasis requires kidneys maintain a relatively constant GFR
• Too high – substances pass too quickly and are not reabsorbed
• Too low – nearly all reabsorbed and some waste products not
adequately excreted
• GFR directly related to pressures that determine net filtration
pressure
3 Mechanisms regulating GFR
• Renal autoregulation
• Kidneys themselves maintain constant renal blood flow and GFR using
• Myogenic mechanism – occurs when stretching triggers contraction of
smooth muscle cells in afferent arterioles – reduces GFR
• Tubuloglomerular mechanism – macula densa provides feedback to
glomerulus, inhibits release of NO causing afferent arterioles to
constrict and decreasing GFR
Mechanisms regulating GFR
• Neural regulation
• Kidney blood vessels supplied by sympathetic ANS fibers that release
norepinephrine causing vasoconstriction
• Moderate stimulation – both afferent and efferent arterioles constrict to same
degree and GFR decreases
• Greater stimulation constricts afferent arterioles more and GFR drops
• Hormonal regulation
• Angiotensin II reduces GFR – strong vasoconstrictor of both afferent and
efferent arterioles
• Atrial natriuretic peptide increases GFR – stretching of atria causes release,
increases capillary surface area for filtration
Tubular reabsorption and
tubular secretion
• Reabsorption – return of most of the filtered water and many solutes
to the bloodstream
• About 99% of filtered water reabsorbed
• Proximal convoluted tubule cells make largest contribution
• Secretion – transfer of material from blood into tubular fluid
• Helps control blood pH
• Helps eliminate substances from the body