VII.

Anatomy

and Physiology

Functions
The kidney participates in whole-body homeostasis, regulating acid-base balance,
electrolyte concentrations, extracellular fluid volume, and regulation of blood pressure.
The kidney accomplishes these homeostatic functions both independently and in
concert with other organs, particularly those of the endocrine system. Various endocrine
hormones coordinate these endocrine functions; these include renin, angiotensin II,
aldosterone, antidiuretic hormone, and atrial natriuretic peptide, among others.
Many of the kidney's functions are accomplished by relatively simple mechanisms of
filtration, reabsorption, and secretion, which take place in the nephron. Filtration, which
takes place at the renal corpuscle, is the process by which cells and large proteins are
filtered from the blood to make an ultrafiltrate that will eventually become urine. The
kidney generates 180 liters of filtrate a day, while reabsorbing a large percentage,
allowing for only the generation of approximately 2 liters of urine. Reabsorption is the
transport of molecules from this ultrafiltrate and into the blood. Secretion is the reverse
process, in which molecules are transported in the opposite direction, from the blood
into the urine.
The cortex and the medulla are made up of nephrons; these are the functional
units of the kidney, and each kidney contains about 1.3 million of them.
The nephron is the unit of the kidney responsible for ultrafiltration of the blood and
reabsorption or excretion of products in the subsequent filtrate. Each nephron is made
up of:

A filtering unit- the glomerulus. 125ml/min of filtrate is formed by the kidneys as

blood is filtered through this sieve-like structure. This filtration is uncontrolled.

The proximal convoluted tubule. Controlled absorption of glucose, sodium, and

other solutes goes on in this region.

The loop of Henle. This region is responsible for concentration and dilution of
urine by utilising a counter-current multiplying mechanism- basically, it is waterimpermeable but can pump sodium out, which in turn affects the osmolarity of the
surrounding tissues and will affect the subsequent movement of water in or out of the
water-permeable collecting duct.

The distal convoluted tubule. This region is responsible, along with the
collecting duct that it joins, for absorbing water back into the body- simple maths will
tell you that the kidney doesn't produce 125ml of urine every minute. 99% of the water is
normally reabsorbed, leaving highly concentrated urine to flow into the collecting duct
and then into the renal pelvis
Excretion of wastes

The kidneys excrete a variety of waste products produced by metabolism. These

include the nitrogenous wastes urea, from protein catabolism, and uric acid, from
nucleic acid metabolism
Acid-base homeostasis
Two organ systems, the kidneys and lungs, maintain acid-base homeostasis, which
is the maintenance of pH around a relatively stable value. The kidneys contribute to
acid-base homeostasis by regulating bicarbonate (HCO3-) concentration.
Osmolality regulation
Any significant rise or drop in plasma osmolality is detected by the hypothalamus,
which communicates directly with the posterior pituitary gland. An increase in osmolality
causes the gland to secrete antidiuretic hormone (ADH), resulting in water reabsorption
by the kidney and an increase in urine concentration.