The kidney has four main functions: 1. Excretory - forms and excretes urine through glomerular filtration, reabsorption, and secretion 2. Homeostatic - regulates blood volume, pressure, pH and electrolyte concentrations 3. Endocrine - produces hormones like erythropoietin, renin, and prostaglandins 4. Metabolic - performs gluconeogenesis during starvation and metabolizes hormones