Development of the renal system

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Development of the renal system

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Development of the renal system
Ureter, bladder and urethra histology
Kidney histology
Renal system anatomy and physiology
Body fluid compartments
Hydration
Movement of water between body compartments
Horseshoe kidney
Renal agenesis
Potter sequence
Posterior urethral valves
Multicystic dysplastic kidney
Polycystic kidney disease
Vesicoureteral reflux
Alport syndrome
Urinary incontinence
Urinary incontinence: Pathology review
Neurogenic bladder
Bladder exstrophy
Antidiuretic hormone
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Diabetes insipidus and SIADH: Pathology review
Diabetes insipidus
Nephrotic syndromes: Pathology review
Nephritic and nephrotic syndromes: Clinical
Nephritic syndromes: Pathology review
Minimal change disease
Hydronephrosis
Glomerular filtration
Measuring renal plasma flow and renal blood flow
Renal clearance
TF/Px ratio and TF/Pinulin
Regulation of renal blood flow
Sodium homeostasis
Kidney countercurrent multiplication
Urea recycling
Tubular reabsorption and secretion
Tubular reabsorption and secretion of weak acids and bases
Tubular secretion of PAH
Tubular reabsorption of glucose
Distal convoluted tubule
Loop of Henle
Proximal convoluted tubule
Renin-angiotensin-aldosterone system
Free water clearance
Amyloidosis
IgA nephropathy (NORD)
Poststreptococcal glomerulonephritis
Rapidly progressive glomerulonephritis
Lupus nephritis
Potassium homeostasis
Hypophosphatemia
Hyperphosphatemia
Hypermagnesemia
Hypomagnesemia
Hypocalcemia
Hypercalcemia
Hyperkalemia
Hypokalemia
Hyponatremia
Hypernatremia
Phosphate, calcium and magnesium homeostasis
The role of the kidney in acid-base balance
Acid-base disturbances: Pathology review
Physiologic pH and buffers
Renal tubular acidosis
Renal tubular acidosis: Pathology review
Metabolic acidosis
Metabolic and respiratory acidosis: Clinical
Respiratory acidosis
Metabolic alkalosis
Plasma anion gap
Respiratory alkalosis
Metabolic and respiratory alkalosis: Clinical
Acid-base map and compensatory mechanisms
Ornithine transcarbamylase deficiency
Kidney stones: Pathology review
Nitrogen and urea cycle
Goodpasture syndrome
Erythropoietin
Vitamin D
Kidney stones
ACE inhibitors, ARBs and direct renin inhibitors
Kidney stones: Clinical
Hypokalemia: Clinical
Renal tubular defects: Pathology review
Urinary tract infections: Clinical
Urinary tract infections: Pathology review
Lower urinary tract infection
Proteus mirabilis
Staphylococcus saprophyticus
Enterobacter
Klebsiella pneumoniae
Serratia marcescens
Pseudomonas aeruginosa
Renal artery stenosis
Thiazide and thiazide-like diuretics
Carbonic anhydrase inhibitors
Osmotic diuretics
Loop diuretics
Potassium sparing diuretics
Acute kidney injury: Clinical
Renal azotemia
Postrenal azotemia
Prerenal azotemia
Chronic kidney disease
Acute tubular necrosis
Renal papillary necrosis
Medullary cystic kidney disease
Chronic kidney disease: Clinical
Congenital renal disorders: Pathology review
Medullary sponge kidney
Chronic pyelonephritis
Acute pyelonephritis
Neisseria gonorrhoeae
Chlamydia trachomatis
Urethritis
Prostatitis
Schistosomes
Hemolytic-uremic syndrome
Thrombotic thrombocytopenic purpura
Renal cortical necrosis
Renal cell carcinoma
Angiomyolipoma
WAGR syndrome
Nephroblastoma (Wilms tumor)
Non-urothelial bladder cancers
Transitional cell carcinoma
Electrolyte disturbances: Pathology review
Renal failure: Pathology review
Renal and urinary tract masses: Pathology review
Transplant rejection
Graft-versus-host disease
Non-corticosteroid immunosuppressants and immunotherapies
Hypertension
BK virus (Hemorrhagic cystitis)

Transcript

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The renal system starts developing during week 4 of intrauterine life.

At this point, the embryo is made up of three primitive germ layers: the ectoderm, the mesoderm and the endoderm.

The mesoderm also has three parts: the paraxial mesoderm, which flanks the embryo’s future vertebral column; the intermediate mesoderm, which is just lateral to the paraxial mesoderm; and the lateral plate mesoderm, which is the most lateral of all.

The intermediate mesoderm on either side of the embryo condenses to form a cylindrical structure called the urogenital ridge.

This ridge runs parallel to the embryo’s future vertebral column, and it gives rise to both the urinary and genital systems.

The portion of the urogenital ridge called the nephrogenic cord develops into the urinary structures.

Now, during the development of the urinary system, there are three sets of structures that emerge from the nephrogenic cord, and they form in a craniocaudal fashion—from head to tail-end.

The first structure to emerge from the nephrogenic cord is the pronephros, which appears in the neck region of the embryo at the beginning of week 4.

The pronephros consists of the pronephric duct and the nephrotomes in front of it.

The pronephric duct is basically a pipe that runs down the length of the nephrogenic cord, and the nephrotomes are small chunks of tissue that break off from the nephrogenic cord.

However, the pronephros doesn’t produce urine, and regresses by the end of week 4.

Before the pronephros completely disappears, a second set of structures called the mesonephros appears in the thoracic and upper lumbar region of the nephrogenic cord.

The mesonephros has a mesonephric duct and mesonephric tubules in front of it.

The mesonephric duct develops off of the pronephric duct, making it longer so that it reaches all the way to the cloaca, which is the last part of the primitive digestive tract.

So for a short while, the urinary and digestive system share a common exit.

Just like the nephrotomes, the mesonephric tubules break off as chunks of tissue from the nephrogenic cord.

The mesonephric tubules are hollow, S-shaped tubes.

On one end, they connect to the mesonephric duct, and at the other end, the tubule forms a cup shape called a Bowman’s capsule around a clump of capillaries called a glomerulus.

This primitive structure extracts fluid from the capillaries and the fluid flows down the duct to form urine, which drains through the mesonephric duct into the cloaca.

This system is in place until week 10, when the permanent kidneys take over and the mesonephros regresses.

Around week 5, the metanephros develops, and it forms the permanent kidneys—so for a couple of weeks, the metanephros and mesonephros coexist.

The metanephros forms in the pelvic region.

First, intermediate mesoderm near the mesonephric duct differentiates into metanephric mesoderm, sometimes called the metanephric blastema.

The metanephric mesoderm produces growth factors that travel to the mesonephric duct; in response, the duct sprouts a small bud called the ureteric bud, which is connected to the mesonephric duct through the ureteric stalk.

Over time, the ureteric bud lengthens and it secretes growth factors that causes the metanephric mesoderm to grow.

This is called reciprocal induction, because the metanephric mesoderm and the ureteric bud promote each other’s growth.

Eventually, the ureteric bud reaches the metanephric mesoderm and grows into it, like two lovers running (albeit very slowly) towards one another.

The metanephric mesoderm surrounds the end of the ureteric bud, leaving just the ureteric stalk uncovered.

The ureteric stalk lengthens and forms the ureter around week 6.

Key Takeaways

The renal system starts to form at about week 4 of gestation from a portion of the urogenital ridge called the nephrogenic cord. The nephrogenic cord gives rise to three overlapping developmental stages: the pronephros, the mesonephros, and the metanephros. Pronephros consists of an early and nonfunctional system, which regresses by week 4. Next is the mesonephros, which functions as a primitive excretory system in the embryo. Most tubules regress by week eight and are replaced by the metanephros. Metanephros give rise to actual kidneys, which appear at around week five, and become mature enough to secrete urine around week ten.