Part I Clinical Chemistry of the Kidney and Renal-Associated Physiology 1 Kidney Anatomy and Function (Lecture 1) 2 Functions of Kidney A) Regulation of water B) Regulation of electrolytes C) Acid-base regulation D) Elimination of waste products  Metabolic (urea, ammonia, creatinine, etc.  Toxins E) Endocrine  Prostaglandins  Renin-Angiotensin  Erythropoetin F) Regulation of bone growth through regulation of calcium and phosphate excretion  Directly through excretion of these ions  Vitamin D synthesis 3 Components of Urinary System A) 2 Kidneys  Average size for each – 11 cm long x 5-7.5 cm wide x 2.5 cm deep B) 2 Ureters  Tubes consisting of fibrous outer, muscular middle, and mucous inner layers  Average dimension for each – 25-30 cm long, 4-5 cm diameter C) 1 Bladder  Collapsible “bag” that can store up to 0.5 L of urine  Activity controlled by parasympathetic nervous system D) 1 Urethra  Tube through which urine exits the body from the bladder 4 Figure 1 (Chapter 1): The Urinary System 5 C. M. Dienhart Basic Human Anatomy and Physiology’, W. B. Saunders Company: Philadelphia, 1967, p. 172. Figure 2 (Chapter 1): Cross-Sectional View of Kidneys in Body A. P. Spence and E. B. Mason ‘Human Anatomy and Physiology’, The Benjamin/Cummings Publishing Company, Inc.: Menlo Park, CA 1979, p.708. 6 Figure 3 (Chapter 1): Inaccurate Diagram of Kidney Processes 7 Figure 4 (Chapter 1): Accurate Diagram of Kidney Processes 8 Kidney Anatomy Two Types of Kidney Cell Tissues (Renal Parenchyma) A) Cortex  Outer portion of kidney  Brownish pink color, granular appearance  Contains glomeruli and certain tubules (proximal and distal)  75% of renal parenchyma is cortex B) Medulla  Inner portion of kidney  Deeper color with striated patterns, which are coned shaped (each cone called renal pyramid)  8-18 renal pyramids per kidney (Cortex surrounds renal pyramids, above pyramids called cortical archs and in-between called renal columns)  Contains Loop of Henle and collecting ducts 9 10