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Acid-base map and compensatory mechanisms
Buffering and Henderson-Hasselbalch equation
Physiologic pH and buffers
The role of the kidney in acid-base balance
Plasma anion gap
Renal system anatomy and physiology
Body fluid compartments
Movement of water between body compartments
Measuring renal plasma flow and renal blood flow
Regulation of renal blood flow
TF/Px ratio and TF/Pinulin
Phosphate, calcium and magnesium homeostasis
Free water clearance
Kidney countercurrent multiplication
Distal convoluted tubule
Loop of Henle
Proximal convoluted tubule
Tubular reabsorption and secretion
Tubular reabsorption and secretion of weak acids and bases
Tubular reabsorption of glucose
Tubular secretion of PAH
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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 functional units called nephrons which go from the outer cortex down into the medulla and back out into the cortex again.
These nephrons perform the major function of the kidney, which is to clear harmful substances from the body by filtering the blood.
Each nephron is made up of the glomerulus, or a tiny clump of capillaries, where blood filtration begins.
The stuff that gets filtered into the tubule is called the filtrate, and the rest of it leaves the glomerulus through the efferent arteriole.
Interestingly, the blood that leaves these glomeruli does not enter into venules. Instead the efferent arterioles divide into capillaries a second time. These peritubular capillaries then reunite and at that point the blood enters venules and eventually drains back into the venous system.
Now, The renal tubule is a structure with several segments: the proximal convoluted tubule, the U- shaped loop of Henle with a descending and ascending limb and the distal convoluted tubule, which winds and twists back up again, before emptying into the collecting duct, which collects the final urine.
Now, zooming in on this nephron’s tubule, each one’si lined by brush border cells which have two surfaces. One is the apical surface which faces the tubular lumen and is lined with microvilli, which are tiny little projections that increase the cell’s surface area to help with solute reabsorption.
The other is the basolateral surface, which faces the peritubular capillaries, which run alongside the nephron.
The urine osmolarity is the concentration of urine, and is measured in Osmoles per liter, which is the solute particles that exist in a liter of urine.
To concentrate urine, or increase its osmolarity, nephrons rely on the corticopapillary gradient, which is a concentration gradient that spans from the cortex to the papilla which is the innermost tip of the medulla. In other words there are a lot of solutes in the interstitium with more solutes down here then up here.
Kidney countercurrent multiplication refers to the process in which energy is used to create an osmotic gradient that enables the reabsorption of water from the tubular fluid, so that urine can be concentrated. Countercurrent multiplication creates this gradient by actively moving sodium chloride from the tubular fluid into the interstitial space deep within the kidneys.
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