Anatomy : -There are 2 kidneys , they are bean shaped and reddish brown.- They are located between the peritoneum and the posterior wall of the abdomen.
They are located between the peritoneum and the posterior wall of the abdomen.- Dimensions : 4 x 2 x 1 inches
Cortex: superficial layer.Medulla : Inner portion , arranged in pyramids , there are 8 – 18 pyramids per
kidney separated by renal columns. The apex of each pyramid extends towardthe renal pelvis and forms a papilla which projects into minor calyces → majorcalyces, which in turn unite to form renal pelvis.The nephron : the functional unit of the kidneyThere are approximately one million nephrons in each kidney.The number of nephrons is constant from birth.It consists of
Nephron and more information about kidneys
The number of nephrons is constant from birth.
. Renal corpuscle : Bowman’s capsule & the glomerulus within it : It is the site of
2. Proximal convoluted tubule.
3. Loop of henle.
4. Distal convoluted tubule
.5. Collecting duct : drains into the renal pelvis
Renal blood flow :- The kidneys get 20 – 25 % of cardiac output.- Renal artery divides to form interlobar arteries ( that run between the medullarypyramids ) → arcuate arteries (run in the corticomedullary junction) → interlobulararterioles ( run in the cortex ) → Afferent arterioles → Glomeruli → Efferentarterioles which divide into the vasa recta and the peritubular capillaries , this is anetwork of capillaries which allows movement of fluids and solutes out of thetubules.Functions :Regulation of water & electrolyte balance.
Regulation of acid base balance.Excretion of water soluble waste : urea , uric acid , creatinine , drugs ……Endocrine : Renin – angiotensin system , erythropoietin , vitamin D activation.Glomerular filtration rate : It is the volume of fluid filtered from the renal glomerular capillaries intoBowman’s capsule per minute.In an average man : GFR = 125 ml/min. In women : 10% less than those of men.Clinically , GFR is often measured to determine the renal function.Although the GFR is about 180 L / day , our urine output is only 1-2 L/day (which is good or else we’d spend the day in the bathroom )
a)to prove the condition.b) To asses the severity.c) Investigation for the cause.
Urinalysis : physical , chemical , microscopic ( details : see later ) Urine culture & sensitivity : for UTI2- Blood investigations :
K : 3.5 – 5 mEq/Lo
CBC. Na
k
, Ca ,
P .o Urea
creatinine , PH
after that’s
Renal function test :
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For glomerular function : Measurement of :i. Serum Creatinine ( N : 0.7 – 1.4 ) :it’s produced from muscle cells at a constant rate , so its plasmaconcentration depends on its excretion, which reflects GFR.Small change in creatinine are associated with large change in GFR,and so plasma creatinine is an insensitive marker of early renal
disease.
Blood urea ( N : 20 – 40 mg% ) :Less reliable as it is affected by dietary protein & liver failure.iii. Creatinine clearance :Volume of plasma which is cleared from creatinine in one minute.
other
Inulin clearance : inulin is a small molecule, freely filtered by the glomeruli& with no tubular secretion.Chromium-labelled EDTA.For tubular function :Specific gravity & urine osmolality.Urine concentration test.Urine dilution test .Renal imaging :i. Plain X-ray of urinary tract.ii. Renal ultrasound : it demonstratesa)
Bipolar renal length ( 8.5 – 13.5 cm ) :In CRF : the kidneys are small. The exceptions are :
MCQPolycystic kidney disease : large with multiple cysts.Diabetic nephropathy , Amyloidosis : normal size.
in ARF : the kidneys are normal size , enlargement may occur due toswelling. b) Doppler ultrasound is useful to assess renal blood flow
.c) Renal stones, mass lesions , cysts.iii. Intravenous urography
( IVU ) & ascending pyelography.iv. CT , MRI .
v. Isotope renography ( e.g. MAG3, Hippuran , DTPA )vi. Renal biopsy.5- Investigations for the causeAddiction-Free Nation Program should consider in capsule series its 1st priority, as it has been proved that almost all internal medicine seekers are addicted to it.lifeofway.com
here all about kidneys information and how to find treatment by test examination and more important details here About kidney
gfr
test name
nephron
Vitals
and Electrolyte balance and imbalance
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