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Renal system anatomy and physiology
Body fluid compartments
Movement of water between body compartments
TF/Px ratio and TF/Pinulin
Measuring renal plasma flow and renal blood flow
Regulation of renal blood flow
Tubular reabsorption and secretion
Tubular secretion of PAH
Tubular reabsorption of glucose
Tubular reabsorption and secretion of weak acids and bases
Proximal convoluted tubule
Loop of Henle
Distal convoluted tubule
Phosphate, calcium and magnesium homeostasis
Kidney countercurrent multiplication
Free water clearance
Physiologic pH and buffers
Buffering and Henderson-Hasselbalch equation
The role of the kidney in acid-base balance
Acid-base map and compensatory mechanisms
Plasma anion gap
Distal convoluted tubule
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Evan Debevec-McKenneyJustin Ling, MD, MS
If we take a cross-section of the kidney, there are two main parts, the outer cortex and the inner medulla.
If we zoom in, there are millions of tiny tubes called nephrons which go from the outer cortex down into the medulla and back out into the cortex again.
Nephrons filter out harmful substances in the blood so that we can excrete them into the urine.
Each nephron is made up of the glomerulus, or a tiny clump of capillaries, where blood filtration begins. These capillaries have very thin walls and they act like a coffee filter. Red blood cells and proteins are large and stay in the capillaries whereas blood plasma and smaller particles get filtered out.
This filtrate, called tubular fluid, collects in a cup shaped structure containing the glomerulus called the Bowman's capsule.
Together, the glomerulus and the Bowman’s capsule make up the renal corpuscle.
The Bowman’s capsule is connected to the renal tubule which has a few segments: the proximal convoluted tubule, the U- shaped loop of Henle with a descending and ascending limb, and the distal convoluted tubule which empties into the collecting duct, which collects the urine.
Zooming in on the distal convoluted tubule, it’s lined by tubule cells which are similar to the one found in the proximal tubule but they don’t have microvilli.
On one side is the apical surface which faces the tubular lumen. On the other side is the basolateral surface, which faces the interstitium or the space between the tubule and the peritubular capillaries.
The peritubular capillaries run alongside the nephron and return solutes and water that were reabsorbed into the interstitium back into the circulation.
The distal convoluted tubule is split up functionally into the early distal convoluted tubule and the late distal convoluted tubule which is very similar to the collecting ducts.
The early distal convoluted tubule is impermeable to water, and the tubular fluid contains more sodium than the tubule cells so sodium ends up flowing down its concentration gradient into the tubule cells using various protein channels.
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