RENAL AND BODY FLUID

A VIEW FROM HISTOLOGICAL ASPECT

H. Ahmad Aulia Jusuf, MD, PhD
Departement of Histology
Faculty of Medicine University of Indonesia
2011

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INTRODUCTION
Urinary system
consists of
two kidneys
two ureters
a urinary bladder
a urethra

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INTRODUCTION
Functions of urinary system
The maintenance of water and electrolyte homeostasis
Excretion of many toxic metabolic waste products
The end product of urinary system is urine
kidneys
ureter
outside of the body

urinary bladder

urethra

In female
urethra is solely a urinary duct

In male
it also serves as the pathway for ejaculation of the semen

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INTRODUCTION
Functions of urinary system
Has an endocrine function
Renin : regulation of blood pressure
Erythropoietin : stimulation of erythrocyte production

Converting the pro-vitamin D to active vit D

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KIDNEY
Anatomical appearance
a large, reddish, beanshape organ

Location
retroperitoneal area
right side is lower than
left side

Wrapped by the perirenal

fat

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Kidney
Hemisections view
Hillus
Renal artery and vein
lymph vessel
ureter

Cortex
dark-brown and granular
renal corpuscle
proximal and distal
convoluted tubules
medullary rays
(processus of Ferreini)

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KIDNEY
Hemisection view
Medulla
renal pyramids
pyramid-shape,
pale,striated regions
Base of pyramids is
toward to cortex
apex of pyramids is
toward to medulla as
renal papilla
perforated by
ducts of Bellini
Area cribosa

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KIDNEY
Hemisection view
Medulla

Loops of Henle
Collecting tubules
Ducts of Bellini
minor calyces
major calyces
renal pelvis
cortical columns of
Bertini

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URINIFEROUS TUBULES
A functional unit
nephron
renal corpuscle
(Malphigian corpuscle)
glomerulus
Bowmans capsule

Renal tubule
proximal and distal
convoluted tubule
loop of Henle

collecting tubule

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NEPHRON
2 types
cortical nephrons
juxtamedullary
nephrons

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GLOMERULUS
A globular network of
anastomosing capillaries
arise from branches of afferent
glomerular arteriole
invaginates Bowmans capsule

Vascular pole
invested by podocytes
viseral layer of Bowmans
capsule

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GLOMERULUS

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GLOMERULUS
Glomerular capillaries
Fenestrated type capillaries
Endothelium: thin
Round fenestrated >>> (70100nm)
Specific properties
Pore diaphragma (--)
Surface endothelium has
negatively charge
due to the present of
glycoprotein called as
podocalxin

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GLOMERULUS
Glomerular capillaries
the space between glomerular
capillaries are occupied by
mesangium
Connective tissue
Mesangial intraglomerular cells
Extracellular matrix, free from fibrous
elements

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GLOMERULUS
Mesangial intraglomerular
cells
A specialized type of pericytes

Phagocytic cells
may participate in the continuous
turn over of basal lamina
removing its outer portion
containing residues of
filtration, while the lamina
basal is renew on its inner
surface by the endothelial
cells.

Contratile and responds to

angiotensin II and other
vasoconstrictor

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GLOMERULUS
Mesangial intraglomerular
cells
Has a specific receptor for
atriopeptides hormone
secreted by myocardium
Regulating in capillary
vasodilatation

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BOWMANS CAPSULE
Consists of
Visceral layer
Podocytes
Completely invest the
glomerular

Parietal layer
Simple squamous
epithelium
Continuous at the urinary
pole of renal corpuscle
(tubular pole) to the
proximal convoluted tubule

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BOWMAN CAPSULE

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BOWMANS CAPSULE
Podocytes
Has the primary
processes
embrace the capilleries
give the secondary
processes (pedicles)
directly applied to the
lamina rara externa

Filtration slit diaphragma

between pedicles
Small pores

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BOWMANS CAPSULE

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BOWMANS CAPSULE
Podocytes
the plasma membrane
of pedicles has a
prominent glycocalyx
with (-) charged
Significant component
of the filtration barrier

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GLOMERULAR BASEMENT
MEMBRANE
basal lamina
Thicker membrane
Elaborated by both
capillary endothelial
cells and podocytes
Collagen type IV,
fibronectin, laminin and
proteoglycans

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GLOMERULAR BASEMENT
MEMBRANE
ME: 3 layers
Lamina rara externa
Between lamina densa
and viseral layer of
Bowman

Lamina densa
Middle layer
300 nm
Collagen type IV

Lamina rara interna

Between lamina densa
and endothelial cells of
capillaries

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GLOMERULAR FILTRATION
Filtration of blood plasma in glomerulus
A continous process
Essential for elimination of nitrogenous wastes
Control of extracellular fluid composition and
blood volume

Structural components of the filter

The fenestrated endothelium
Basal lamina
Filtration slit diaphragma
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CORTEX OF THE KIDNEY

Covered by
capsule, perirenal connective and adipose
tissues

Consist of
Renal corpuscle
Proximal and distal convoluted tubule
Juxtaglomerular complex
Medullary rays (processes of Ferreini)

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PROXIMAL CONVOLUTED TUBULE

Prox convoluted
tubule
Continuation of pars
parietal of Bowmans
capsule
A coil tube
14 nm in length
Acidophilic stained
Simple cuboidal
epithelium with the
unclear boundaries

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PROXIMAL CONVOLUTED TUBULE

A Coil tube
The nucleus of cells
Round, blue, located
slightly far one to the
others

The cytoplasm
Acidophilic due to the
present of granule
Brush border at the
surface cell toward to
the lumen

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PROXIMAL CONVOLUTED TUBULE

Functions
Reabsoption of
80% of all filtrated fluid from
the tubular filtrate
Protein
amino acid
Glucose
Water
most ions and
electrolyte

All of glucose, amino acids and

protein are reabsorbed
Drains out the fluid with the
normal osmolarity

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DISTAL TUBULE
Distal tubule
subdivided into 2 pars
Pars recta (ascending thick
limb)
continuation of ascending
thin limb of Henles loop
9 to 10 nm in length; 30-40 m
in diameter
located in the outer part of
medulla
not permeable to water and
urea
permeable to sodium and
chloride

Pars convoluted (distal

convoluted tubule)

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DISTAL TUBULE

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DISTAL CONVOLUTED TUBULE

Distal convoluted tubule
Continuation of ascending
thick limb of Henle loop
Located in cortex
Simple cuboidal cells with
the clear boundaries
Nucleus : round, blue
Cytoplasm: basophilic
granule
Brush Border (-)

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DISTAL CONVOLUTED TUBULE

Functions
Reabsoption of sodium
ions from tubular fluid
Secretion of hydrogen
and potassium ions into
tubular fluid (acid-base
balance)
Controlled by hormone
aldosterone

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JUXTAGLOMERULAR APPARATUS
Composed of
Macula densa
Juxtaglomerular cells
Extraglomerular mesangial
(Polkissen or Goormaghtigh
or lacis) cells

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JUXTAGLOMERULAR APPARATUS
Macula densa
Interpose between pars recta
and pars convoluted
Lies between the afferent and
efferent glomerular arterioles
The cells: tall and narrow
The nuclei of these cells
appear to be much closer
together

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JUXTAGLOMERULAR APPARATUS
Functions
Osmoreceptor for sodium
concentration

Juxtaglomerular cells
Modified smooth muscle in
the tunica media of afferent
arteriole close to the renal
corpuscle
Contain the granule
Renin
Erythropoetin

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JUXTAGLOMERULAR APPARATUS
Extraglomerular
mesangial cells
Lacis or polkissen or
Goormaghtigh cells
Located between afferent
and efferent arteriole and
macula densa
Groups of small, flat and
bright cells with
cytoplasmic processes

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JUXTAGLOMERULAR APPARATUS
Functions
Not yet clear
Give the signals of
sodium
concentration
changes
from the macula
densa to the
juxtaglomerular
cells

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JUXTAGLOMERULAR APPARATUS

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THE MEDULLA OF KIDNEY

Composed of a number of
renal pyramids
Loop of Henle
Collecting tubule of koligens
Collecting or papillary duct of
Bellini
Calyx minor

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MEDULLA OF KIDNEY
Collumna renalis of
Bertini
The part of renal
cortex which is
located in the
medulla

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THE LOOP OF HENLE

Consist of
Pars recta of proximal
tubule (the thick
descending limb)
The thin descending
limb
The thin ascending limb
Pars recta of distal
tubule (the thick
ascending limb)

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THE LOOP OF HENLE

The parts of recta
Straight part of
proximal tubule,
extends down to the
outer medulla
Has the same
apperance to the
proximal convoluted
tubule with the smaller
diameter

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THE LOOP OF HENLE

The thin descending
and ascending limb
The appearance similar
to the blood capillary
Simple squamous
epithelium
The lumen is round and
not contain the
erythrocytes

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THE LOOP OF HENLE

Thick ascending limb
The appearance similar to distal convoluted tubule

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COLLECTING TUBULE
OF
KOLIGENS
joins
the distal convoluted
to collecting duct of Bellini
located in medulla
histologically
similar to distal convoluted
tubule
simple cuboidal cells with
visible cell membrane

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Collecting Tubule of Koligens

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PAPILLARY DUCT OF BELLINI

Histologically
simple columnar
epithelium

functions
Passive reabsoption of water
(concentrate the osmolarity of
urine)
influenced by ADH (antidiuretic
hormone /vasopressin)
secretion of H+ and K+
reabsorption of Na+ and HCO3-

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PAPILLARY DUCT OF BELLINI

2 type of cells
Principal cells
Cytoplasm: pale with
scanty organelles
short microvilli and a
single cilium
reabsorb Na+ and
secreted K+

Intercalated cells
cytoplasm: dark due to
mitochondria and
polyribosome >>
reabsorb bicarbonate
and secrete H+

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CALYCES
Calyces
Minor calyx
A funnel-shaped chamber,
accept the urine leaving
the ducts of Bellini at the
area cribrosa
lined by transitional
epithelium
contains a thin smooth
muscle in lamina propria

Major calyx

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RENAL INTERSTITIUM
Cortex of kidney
connective tissue
fibroblast
macrophage

Medulla of kidney
connective tissue >>
fibroblast
macrophage
Laden interstitial cells
prostaglandin
medullipin I

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RENAL VASCULATURE
A. renalis (branch of aorta
abdominalis)
anterior &
posterior branch
segmental
artery
lobar artery
interlobaris artery
arcuate artery
interlobular
artery
afferent artery
Glomerular capillaries
efferent artery
vasa recta
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URETER
Cylindrical tube , 3- 4
mm in diameter, 25-30
cm in length
Histologically
tunica mucosa
transtitional epithelium

tunica muscularis
2/3 proximal
outer: circular
inner: longitudinal

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URETER
Tunica muscularis
1/3 distal
outer : longitudinal
middle: circular
inner: longitudinal

Tunica adventisia
fibrous connective
tissue

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URINARY BLADDER
Organ for storing urine
until the pressure
become sufficient to
induce the the urge for
voiding

consists of
tunica mucosa
transtitional epithelium

lamina propria
collagen and elastic
fibers

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URINARY BLADDER
Tunica muscularis
a thick coat
3 interlaced layers of
smooth muscle
arranged in
anastomosing bundle
difficult to distinguished

Tunica
adventisia/serosa
a dense, irregular
collagen
elastic fibers

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URETHRA
A single tubular
structure
Communicates the
urinary bladder with the
outside
In male
longer than female
Also as a route for
semen

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URETHRA
In female
4-5 cm in length and 5-6
mm in diameter
Lined by
Transtitional epithelium
near the bladder
Stratified squamous non
keratinized epithelium

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URETHRA
In male
15-20 cm in length
3 parts
Pars prostatica
Pars membranous
Pars cavernosa (penile)

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URETHRA
Pars prostatica
3-4 cm in length
Lies entirely in the
prostate gland
Lined by transtitional
epithelium

Pars membranous
1-2 cm in length
Pass through the perineal
membrane
Lined by stratified
columnar epithelium
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URETHRA
Pars cavernosa (penile)
The longest part (about
15 cm ) in length
Located in the corpus
spongiose urethra
Lined by stratified
columnar epithelium
stratified squamous
nonkeratinized epithelium

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