Kidney Structure and Functions

Aljane Ramclaire I. Lim

Kesh Mangolare

FUNCTIONS OF URINARY SYSTEM

 Urinary System is the major excretory system of the body

 Some organs in the other systems also eliminate wastes, but they are not able to compensate in
case of kidney failure
 The urinary system consists of two kidneys, two ureters, the urinary bladder and the urethra
 Each kidney’s waste products are carried by a ureter to a single urinary bladder. The waste is
emptied from the urinary bladder by the urethra
 The kidney each filter a large volume of blood
 Waste from the blood is collected and for urine
 As the kidneys form urine to excrete this waste, they also accomplish several other important
functions:
o Excretion. The kidneys remove waste products from the blood. This conversion requires
the reabsorption of most of the fluid back into the blood, along with useful molecules
and ions. The resulting fluid contains metabolic wastes, toxic molecules, and excess ions.
Additional waste products are secreted into the fluid, eventually forming urine.
o Regulation of blood volume and pressure. The kidneys play a major role in controlling
the extracellular fluid volume in the body by producing either a large volume of dilute
urine or a small volume of concentrated urine, depending on the hydration level of the
body. Consequently, the kidneys regulate blood volume and hence blood pressure.
o Regulation of blood solute concentrations. The kidneys help regulate the concentration
of primarily the major ions – Na+, Cl-, K+, Ca2+, HCO3-, and HPO42-; they also regulate other
solute concentration such as urea
o Regulation of extracellular fluid pH. The kidneys secrete variable amounts of H + to help
regulate the extracellular fluid acidity
o Stimulation of red blood synthesis. The kidneys secrete the hormone erythropoietin,
which stimulates the synthesis of red blood cells in red bone marrow
o Activation of vitamin D. The kidneys play an important role in controlling blood levels of
Ca2+ by activating vitamin D

ANATOMY OF THE KIDNEYS

 The kidneys are retroperitoneal and are located on each side of the vertebral column
 They extend from the lower portion of the rib cage at the level of the last thoracic vertebra to
the third lumbar vertebra.
 The liver is superior to the right kidney to be slightly lower than the left.
 The kidneys are bean-shaped, and each measure about 11 cm long, 5 cm wide, and 3 cm thick,
which is about size of a clenched fist,
 They weighed about 130 g
 Each kidney is surrounded by an outer layer of connective tissue, called the renal tissue
 Surrounding the outside of the capsule is called adipose tissue, which cushion and protects the
kidneys
 A thin layer of connective tissue, the renal fascia, surrounds the adipose tissue and helps anchor the
kidneys to the abdominal wall
 The hilum is a small area on the concave, medial side of the kidney that is continuous with an
adipose and connective tissue-filled cavity called the renal sinus
 The hilum is where structures enter and exit the kidney then pass through the renal sinus.
 These structures help the kidney performs its function. The hilum structures are the renal artery and
nerves which enter the kidney and the renal vein and ureter, which exit the kidney

INTERNAL ANATOMY AND HISTOLOGY OF THE KIDNEYS

 To fully appreciate the function of the kidneys, we must first understand their ultrastructure
 The kidneys are organized into major regions; (a) an outer cortex and (b) an inner medulla
 The bases of several cone-shaped renal pyramids are located at the boundary between the
cortex and the medulla. The tips of the renal pyramids project toward the center of the kidney
 A funnel-shaped structure called a calyx surrounds the tip of each renal pyramid
 The calyces from all the renal pyramids join to form a larger funnel called the renal pelvis. The
renal pelvis then narrows to form a small tube, the ureter, which exits the kidney and connects
to the urinary bladder

STRUCTURE OF A NEPHRON

o The nephron is the functional unit of the kidney, and each kidney has approximately 1.3
million nephrons.
o Each nephron consists of:
(1) a renal corpuscle in the cortex
(2) a proximal convoluted tubule in the cortex
(3) a loop of Henle with sections in both the cortex and the medulla
(4) a distal convulsed tubule in the cortex
 The filtered fluid then flows into the proximal convoluted tubule. From the
proximal convoluted tubule, the filtered fluid flows into the loop of Henle.

TYPES OF NEPHRONS

There are two types of nephrons in the kidney

(1) Juxtamedullary nephrons,

- have renal corpuscle that are found near the medulla.
- They have long hoops of Henle, which extend depend into the medulla
- Longer loops of Henle are well adapted for water conservation
(2) Cortical nephrons
 - Have renal corpuscle that are distributed throughout the cortex
- Their loops of Henle are shorter than those juxtamedullary nephrons and are
closer to the outer edge of the cortex

RENAL CORPUSCLE

 The filtration portion of the nephron is housed in the renal corpuscle

 The renal corpuscle consists of:
(1) Bowman capsule, is the enlarged end of nephron, which is indented to form
a double-walled chamber
(2) Glomerulus, is a tuft of capillaries that resembles a ball of yarn. It lies within
the indentation of Bowman capsule
 The cavity of the Bowman capsule opens into the proximal convoluted tubule, which
carries fluid away from the capsule
 The inner layer of the Bowman capsule consists of specialized cells called podocytes,
which wrap around the glomerular capillaries
 The outer layer of the Bowman capsule consists of simple squamous epithelial cells
 The glomerular capillaries have pores in their walls, and the podocytes have
numerous cell processes with gaps between them

FILTRATION MEMBRANE

 The filtration membrane consists of:

(1) The endothelium of the glomerular capillaries
(2) The podocytes
(3) The basement membrane
 In the first step of urine formation, fluid, consisting of water and solutes smaller
than proteins, passes from the blood in the glomerular capillaries through the
filtration membrane into the Bowman capsule
 The fluid that is forced across the filtration membrane is called filtrate
 An afferent arteriole supplies blood to the glomerulus for filtration
 An efferent arteriole transports the filtered blood away from the glomerulus
 An important regulatory structure called the juxtaglomerular apparatus, is located
next to the glomerulus
 The juxtaglomerular apparatus consists of unique set of afferent arteriole cells and
specialized cells in the distal convoluted cells that are in close contact with each
other. These specialized cells include the following:
1. A cuff of specialized smooth muscle cells found at the point where the
afferent arteriole enters the renal corpuscle. These smooth muscle cells are
called juxtaglomerular cells.
2. A part of the distal convoluted tubule of the nephron lies between the
afferent and efferent arterioles next to the renal corpuscle. In this section of
the distal convoluted tubule, there is a group of specialized cells called the
macula densa
RENAL TUBULE

The renal tubule continues from Bowman capsule and consists of the following parts

(a) Proximal convoluted tubule

- The wall of the proximal convoluted tubule is composed of simple cuboidal
epithelium
- The proximal convoluted tubule cells rest on a basement membrane, which
form the outer surface, which forms the outer surface of the tubule
(b) Loop of Henle
- Every loop of Henle has two limbs;
(1) The descending limb, the portion of the loop of Henle that extends into the
medulla becomes very thin near the bend of the loop. The lumen in the thin
part narrows, and an abrupt transition occurs from simple cuboidal
epithelium to simple squamous epithelium
(2) The ascending limb, the first part of the ascending limb is thin and made of
simple squamous epithelium. Soon, however, it becomes thicker, and
simple cuboidal epithelium replaces the simple squamous epithelium. The
thick part of the ascending limb returns toward the renal corpuscle and
ends by transitioning to the distal convoluted tubule near the macula densa.
(c) Distal convoluted tubule
- The distal convoluted tubule is not as long as the proximal convoluted tubules.
- The epithelium is simple cuboidal, but the cells are smaller than the epithelial
cells in the proximal convoluted tubules and do not possess a large number of
microvilli
(d) Collecting ducts
- Several distal convoluted tubules connect to a single collecting duct, which is
composed of simple cuboidal epithelium.
- The collecting duct, which is larger in diameter than other segments of the
nephron, form much of the medullary rays and extend through the medulla
toward the tips of the renal pyramids.

ARTERIES AND VEINS OF THE KIDNEYS

 The pathways of blood flow through the kidney are an essential part of the process
of urine formation
 Blood from the abdominal aorta enters the renal artery, which branches extensively
within the kidneys into smaller arteries
 The smallest arteries give rise to afferent arterioles in the renal cortex
 They give rise to several branches
1. The interlobar arteries pass between the renal pyramids.
2. The arcuate arteries branch from the interlobar arteries. They arch between
the cortex and the medulla
3. Interlobular arteries branch off the arcuate arteries and project into the
cortex.
 4. The afferent arterioles arise from branches of the interlobular arteries. The
afferent arterioles lead into the glomerular capillaries
5. Efferent arterioles extend from the glomerular capillaries.
6. The peritubular (around the tubes) capillaries branch from the efferent
arterioles. They surround the proximal convoluted tubules, the distal
convoluted tubules, and the loops of Henle.

- The vasa recta are specialized portions of the peritubular

capillaries that extend deep into the medulla of the kidney and
surround the loops of Henle and collecting ducts.

FUNCTIONS OF KIDNEY

URINE PRODUCTION

o The primary function of the kidney is regulation of body fluid composition.

o The kidney is the organ that sorts the substances from the blood for either removal in
the urine or return to the blood. Substances that are waste products, toxins, and excess
materials are permanently removed from the body, whereas other substances need to
be conserved to maintain homeostasis.
o The structural components that perform this sorting are the nephrons, the functional
units of the kidney.
o If you have ever decided to organize your “junk” drawer in your desk or kitchen, you
may realize just how difficult it is to quickly sort through all its contents. In fact, you may
have found yourself simply emptying the drawer onto a table and then sorting the
contents one by one as you place objects into a “save” group or a “throw away” group
o . In a sense, the kidney uses the same approach when regulating blood composition. The
“throw away” items end up in the urine, and the “save” items go back into the blood.
Urine is mostly water and some organic waste products, as well as excess ions
o There are three major steps in urine production
1. Filtration/Glomerular Filtration - Filtration is a nonspecific process whereby
materials are separated based on size or charge.
 A simple example of size filtration is demonstrated by a drip coffeemaker. In this
case, the driving force of filtration is gravity. The kidneys also use size filtration
to remove substances from the blood by filtering it, but in this case, the driving
force of this filtration is blood pressure.
 The importance of filtration is indicated by the large percentage of blood that is
sent through the kidneys compared with other organs
 No matter the type of size-based filter, there is one commonality: They all
require a force to enhance movement through it.
 For example, for a coffee maker, as noted earlier, the force is gravity. For the
filtration membrane, three forces, or pressures, determine the amount of
filtrate formed. The combination of these three pressures is called filtration
pressure. The three pressures contributing to filtration pressure are:
 The glomerular capillary pressure (GCP) is an outward pressure from
blood pressing on the capillary walls. This is simply blood pressure. The
 GCP forces fluid and solutes out of the blood into the Bowman capsule.
This GCP is higher than that in other capillaries of the body. The higher
GCP is due to the smaller diameter of the efferent arteriole compared to
that of the afferent arteriole and glomerular capillaries. When the
diameter of a vessel decreases, the resistance to blood flow through the
vessel is greater. The efferent arteriole has a smaller diameter than the
afferent arteriole and glomerular capillary. Thus, as the blood flows
from the larger-diameter afferent arteriole through the glomerular
capillaries to the smaller-diameter efferent arteriole, the blood pressure
increases in the glomerular capillaries. Consequently, filtrate is forced
across the filtration membrane into the lumen of the Bowman capsule.
The GCP is approximately 50 mm Hg compared with approximately 30
mm Hg at the arterial end of other capillary beds.
 The capsular hydrostatic pressure (CHP) is an inward pressure that
opposes filtration. This pressure is due to the force of filtrate volume on
the wall of the Bowman capsule. CHP is comparable to blood pressure in
that they are both due to fluid volume in a tube or chamber. The CHP
usually measures about 10 mm Hg.
 The blood colloid osmotic pressure (BCOP) is also an inward pressure
that opposes filtration. It is due to the osmotic pressure of plasma
proteins in the glomerular capillaries. The presence of these proteins
draws fluid back into the glomerular capillary from the Bowman
capsule. The BCOP is greater at the end of the glomerular capillary than
at its beginning because there is a higher protein concentration at the
end of the glomerulus. The average BCOP is approximately 30 mm Hg.
2. Tubular Reabsorption,
 the return of water and solutes in the filtrate to the blood
 It takes place from the renal tubules into the peritubular capillaries
 In a 24-hour period, the kidneys from 150 to 180 liters of filtrate, and
normal urinary output in that time is 1 to 2 liters.
 Therefore, it becomes apparent that most of the renal filtrate does not
become urine.
 Approximately 99% of the filtrate is reabsorbed back into the blood in the
peritubular capillaries. Only about 1% of the filtrate will enter the renal
pelvis as urine
 Most reabsorption and secretion (about 65%) take place in the proximal
convoluted tubules, whose cells have microvilli that greatly increase their
surface area. The distal convoluted tubules and collecting tubules are also
important sites for the reabsorption of water
 There two steps of Tubular reabsorption
o The first step is the passive or active movement of water and
dissolved substances from the fluid inside the tubule through the
tubule wall into the space outside.
 o The second step is for water and these substances to move through
the capillary walls back into your bloodstream, again, either by
passive or active transport
3. Tubular Secretion
 Tubular secretion is the movement of nonfiltered substances from the blood
into the filtrate
 These substances include toxic by-products of metabolism and drugs or
molecules not normally produced by the body
 As with tubular reabsorption, tubular secretion can be either active or
passive.
 For example, ammonia is a toxic by-product of protein metabolism. It is
produced when the epithelial cells of the renal tubule remove amino groups
from amino acids, which diffuse into the lumen of the renal tubule
 Hormones that influence reabsorption of water
o Aldosterone is secreted by the adrenal cortex in response to a high
blood potassium level, to a low blood sodium level, or to a decrease in
blood pressure. When aldosterone stimulates the reabsorption of Na +
ions, water follows from the filtrate back to the blood. This helps
maintain normal blood volume and blood pressure.
o Atrial natriuretic peptide (ANP), which is secreted by the atria of the
heart when the atrial walls are stretched by high blood pressure or
greater blood volume. ANP decreases the reabsorption of Naions by the
kidneys; these remain in the filtrate, as does water, and are excreted. By
increasing the elimination of sodium and water, ANP lowers blood
volume and blood pressure.
o Antidiuretic hormone (ADH) is released by the posterior pituitary gland
when the amount of water in the body decreases. Under the influence
of ADH, the distal convoluted tubules and collecting tubules are able to
reabsorb more water from the renal filtrate. This helps maintain normal
blood volume and blood pressure, and also permits the kidneys to
produce urine that is more concentrated than body fluids. Producing a
concentrated urine is essential to prevent excessive water loss while still
excreting all the substances that must be eliminated.
o If the amount of water in the body increases, however, the secretion of
ADH diminishes, and the kidneys will reabsorb less water. Urine then
becomes dilute, and water is eliminated until its concentration in the
body returns to normal. This may occur following ingestion of excessive
quantities of fluids.