I am a medical student. I have one friend who is persuing his MBBS degree in Taishan Medical UNiversity. I got these notes from him. These notes are by Dr. Bikesh, He is a famous lecturer of TMU. These notes have helped me a lot and i also watch his lecture videos , which are great; highly simple and huge content. I am uploading with Renal physiology. If you want some other topics i would upload for you. "Let the Knowledge be spread" Dr. Bikesh

1. Renal Physiology 1Renal Physiology 1
Dr. Bikesh Pandey

2. Body Fluid & KidneyBody Fluid & Kidney

3. 3
Body fluidBody fluid
(60% of body weight)(60% of body weight)
Interstitial fluidInterstitial fluid
(15%)(15%)
Extracellular fluidExtracellular fluid
(20%)
Intracellular fluidIntracellular fluid
（ 40% ）
PlasmaPlasma
（ 5 ％）

4. ICF
plasma
interstitial

5. Fluid Input and OutputFluid Input and Output
Daily Input of Water
• Water is added to the body by two major sources:
– Ingested
• 2100 ml/day
– Synthesized in the body
• Result of oxidation of carbohydrates - 200 ml/day

6. Fluid Input and OutputFluid Input and Output
Daily Output of Water
• Water is lost by :
– Insensible water lossInsensible water loss
• Termed so, because we are not consciously aware of it
• Eg: Evaporation through skin & respiratory system
• 700 ml/day
– SweatingSweating

7. Fluid Input and OutputFluid Input and Output
Daily Output of Water
• Water is lost by :
– FecesFeces
• 100 ml/day
– UrineUrine
• 0.5 L/day – 20 L/day
• Average 70 Kg person - 1.4 L/day

10. 3 PM

11. Anatomy & Histology of Urinary SystemAnatomy & Histology of Urinary System

12. Organization of Urinary SystemOrganization of Urinary System
It includes:It includes:
• Two kidneys
• Two ureters
• One bladder
• One urethra

13. Function of the Urinary SystemFunction of the Urinary System
• Maintanance of fluid volume & thus blood
pressure.
• Regulation of electrolyte balance
– Eg: Sodium, Potassium, Calcium…….
• Removal of waste product from the body
– Eg: Urea, Uric acid…….

14. Function of the Urinary SystemFunction of the Urinary System
• Regulation of “Acid-Base” balance.
• Production of “Erythropoietin” to stimulate
production of RBC in bone marrow.
• Regulation of Vitamin D in our body
……………….

15. KidneyKidney
• Bean-shaped
• Retroperitoneal
• Right kidney is lower than the left one
• Adrenal gland rests upon each kidney

16. KidneyKidney
There are three layers of coverings surrounding each
kidney from the outside to the inside :
• The Renal fascia
(Also encloses adrenal gland)
• The Adipose capsule
• The Fibrous capsule

17. KidneyKidney
Each kidney consists of:
• An outer, Renal
Cortex
• An inner, Renal
Medulla

18. KidneyKidney
• Extension of renal
cortex, the Renal
Column projects into
the inner aspect of the
kidney, dividing the
Renal medulla into
triangular shaped
Renal Pyramids.

19. KidneyKidney
• Their apices form the Renal Papillae, which indent the Minor calices.
• Minor Calyces are 7-8 in number on each kidney.
• Minor calices unite to form a Major Calyx. They are 2-3 in number on each
kidney.
• Two or three major calices unite to form the Renal Pelvis, which is the
funnel shaped superior end of the Ureters.
• The Renal sinus is a space that extends into the kidney from the Hilum.
• The foramina On the tip of renal papillae are termed the papillary foramina.
The urine formed in the kidney passes through these foramina into the minor
calices.

21. Nephrons: Functional Unit of the KidneyNephrons: Functional Unit of the Kidney
Includes
• Renal corpuscleRenal corpuscle
• Tubular sectionTubular section
– Proximal convoluted tubule
– Loop of Henle
– Distal convoluted tubule
• Collecting ductCollecting duct

22. NephronNephron
Two types of nephrons
• Cortical nephron
– 80-85% of nephrons are cortical nephrons.
– Renal corpuscles are in outer cortex and loops of
Henle lie mainly in cortex.
• Juxtamedullary nephrons
– 15-20% of nephrons are juxtamedullary nephrons.
– Renal corpuscles close to medulla and long loops
of Henle extend into deepest medulla

24. Renal CorpuscleRenal Corpuscle
Provides for filtration of plasma from glomerular capillary.Provides for filtration of plasma from glomerular capillary.
• Renal glomerulus
• Bowman's capsuleBowman's capsule

25. Renal CorpuscleRenal Corpuscle

26. Renal glomerulusRenal glomerulus
• A tightly-coiled capillaries network.
• The endothelial cells are fenestrated.
• Capillaries are divided into :
– Afferent arteriole – Brings blood / wider
– Efferent arteriole – takes away blood / narrower

27. Bowman's CapsuleBowman's Capsule
Divided into two layersDivided into two layers
• Parietal or capsular layerParietal or capsular layer - simple squamous epithelium- simple squamous epithelium
• Visceral layerVisceral layer - podocytes- podocytes

28. PodocytesPodocytes

29. Tubular sectionTubular section

30. PCTPCT Loop of HenleLoop of Henle DCTDCT CollectingCollecting
TubuleTubule
Cuboidal
Round nucleus
Strong acidophilic
Brush border
Thick descending
Similar to PCT
Thin descending /
Thin ascending
Simple squamous
Thick ascendingThick ascending
Simple cuboidal
Cuboidal
Lighter cytoplasm
Round nucleus
No brush border
Less microvilli
Simple cuboidal
to columnar
Light staining
cytoplasm
Clear boundary
Lumen is largest

31. Juxtaglomerular apparatusJuxtaglomerular apparatus
 located at the vascular pole of the renal corpuscles
 consist of juxtaglomerular cells, macula densa
and extraglomerular mesangial (polar cushion)
cells
 function: control water and electrolyte balance;
regulate blood pressure;
produce erythropoietin

32. Juxtaglomerular ApparatusJuxtaglomerular Apparatus
3 parts:3 parts:
(1)(1) Macula densaMacula densa - cells of distal- cells of distal
tubuletubule
(2)(2) Juxtaglomerular (JG) cellsJuxtaglomerular (JG) cells --
modified smooth muscle cellsmodified smooth muscle cells
(myoepithelioid) in arteriole.(myoepithelioid) in arteriole.
(3)(3) Extraglomerular mesangiumExtraglomerular mesangium

33. Importance of Juxtaglomerular ApparatusImportance of Juxtaglomerular Apparatus
• By secreting prorenin:
– Controls water and electrolyte balance
– Regulates blood pressure
• Produces erythropoietin

34. The - EndThe - End