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Introduction to the Kidney | |
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Physiology of Body Fluids | |
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Objectives | |
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Physicochemical Properties�of Electrolyte Solutions | |
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Molarity and Equivalence | |
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Osmosis and Osmotic Pressure | |
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Osmolarity and Osmolality | |
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Tonicity | |
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Oncotic Pressure | |
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Specific Gravity | |
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Volumes of Body Fluid Compartments | |
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Composition of Body Fluid Compartments | |
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Fluid Exchange Between Body Fluid Compartments | |
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Capillary Fluid Exchange | |
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Cellular Fluid Exchange | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Structure and Function of the Kidneys | |
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Objectives | |
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Structure of the Kidneys | |
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Gross Anatomy | |
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Ultrastructure of the Nephron | |
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Ultrastructure of the Glomerulus | |
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Ultrastructure of the Juxtaglomerular Apparatus | |
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Innervation of the Kidneys | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Glomerular Filtration and Renal Blood Flow | |
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Objectives | |
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Renal Clearance | |
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Glomerular Filtration Rate | |
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Glomerular Filtration | |
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Determinants of Ultrafiltrate Composition | |
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Dynamics of Ultrafiltration | |
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Renal Blood Flow | |
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Regulation of Renal Blood Flow and Glomerular Filtration Rate | |
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Sympathetic Nerves | |
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Angiotensin II | |
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Prostaglandins | |
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Nitric Oxide | |
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Endothelin | |
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Bradykinin | |
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Adenosine | |
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Natriuretic Peptides | |
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ATP | |
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Glucocorticoids | |
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Histamine | |
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Dopamine | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Renal Transport Mechanisms: NaCl and Water�Reabsorption Along the Nephron | |
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Objectives | |
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General Principles of Membrane Transport | |
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General Principles of Transepithelial Solute and Water Transport | |
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NaCl, Solute, and Water Reabsorption Along the Nephron | |
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Proximal Tubule | |
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Henle's Loop | |
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Distal Tubule and Collecting Duct | |
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Regulation of NaCl and Water Reabsorption | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Regulation of Body Fluid Osmolality: Regulation of Water Balance | |
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Objectives | |
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Antidiuretic Hormone | |
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Osmotic Control of�AVP Secretion | |
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Hemodynamic Control of�AVP Secretion | |
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AVP�Actions on the Kidneys | |
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Thirst | |
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Renal Mechanisms for Dilution and Concentration of the Urine | |
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The Role of Urea | |
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Vasa Recta Function | |
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Assessment of Renal Diluting and Concentrating Ability | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Regulation of Extracellular Fluid Volume and NaCl Balance | |
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Objectives | |
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Concept of Effective Circulating Volume | |
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Volume-Sensing Systems | |
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Volume Sensors in the Low-Pressure Cardiopulmonary Circuit | |
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Volume Sensors in the High-Pressure Arterial Circuit | |
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Hepatic Sensors | |
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Central Nervous System Na+ Sensors | |
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Volume Sensor Signals | |
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Renal Sympathetic Nerves | |
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Renin-Angiotensin-Aldosterone System | |
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Natriuretic Peptides | |
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AVP | |
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Control of Renal NaCl Excretion During Euvolemia | |
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Mechanisms for Maintaining�Constant Na+ Delivery to the Distal Tubule | |
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Regulation of Distal Tubule and Collecting Duct Na+ Reabsorption | |
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Control of Na+ Excretion with Volume Expansion | |
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Control of Na+ Excretion with Volume Contraction | |
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Edema | |
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Alterations in Starling Forces | |
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The Role of the Kidneys | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Regulation of Potassium Balance | |
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Objectives | |
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Overview of K+ Homeostasis | |
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Regulation of Plasma�[K+] | |
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Epinephrine | |
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Insulin | |
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Aldosterone | |
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Alterations of Plasma�[K+] | |
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Acid-Base Balance | |
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Plasma Osmolality | |
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Cell Lysis | |
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Exercise | |
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K+ Excretion by the Kidneys | |
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Cellular Mechanisms of K+ Transport by Principal Cells and Intercalated Cells in the Distal Tubule and Collecting Duct | |
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Regulation of K+ Secretion by the Distal Tubule and Collecting Duct | |
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Plasma [K+] | |
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Aldosterone | |
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Arginine vasopressin (AVP) | |
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Factors that Perturb K+ Excretion | |
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Flow of Tubular Fluid | |
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Acid-Base Balance | |
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Glucocorticoids | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Regulation of Acid-Base Balance | |
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Objectives | |
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The HCO3- Buffer System | |
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Overview of Acid-Base Balance | |
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Renal Net Acid Excretion | |
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HCO3- Reabsorption Along the Nephron | |
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Regulation of�H+ Secretion | |
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Formation of New HCO3- | |
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Response to Acid-Base Disorders | |
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Extracellular and Intracellular Buffers | |
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Respiratory Compensation | |
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Renal Compensation | |
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Simple Acid-Base Disorders | |
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Metabolic Acidosis | |
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Metabolic Alkalosis | |
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Respiratory Acidosis | |
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Respiratory Alkalosis | |
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Analysis of Acid-Base Disorders | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Regulation of Calcium and Phosphate Homeostasis | |
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Objectives | |
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Calcium | |
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Overview of Ca++ Homeostasis | |
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Ca++ Transport along the Nephron | |
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Regulation of Urinary Ca++ Excretion | |
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Calcium-Sensing Receptor | |
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Phosphate | |
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Overview of Pi Homeostasis | |
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Pi Transport along the Nephron | |
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Regulation of Urinary Pi Excretion | |
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Integrative Review of Parathyroid Hormone, Calcitriol, and Calcitonin on Ca++ and Pi Homeostasis | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Physiology of Diuretic Action | |
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Objectives | |
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General Principles of Diuretic Action | |
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Sites of Action of Diuretics | |
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Response of Other Nephron Segments | |
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Adequate Delivery of Diuretics to Their Site of Action | |
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Volume of the Extracellular Fluid | |
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Diuretic Braking Phenomenon | |
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Mechanisms of Action of Diuretics | |
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Osmotic Diuretics | |
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Carbonic Anhydrase Inhibitors | |
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Loop Diuretics | |
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Thiazide Diuretics | |
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K+-Sparing Diuretics | |
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Aquaretics | |
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Effect of Diuretics on the Excretion of Water and Other Solutes | |
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Solute-Free Water | |
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K+ Excretion | |
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HCO3- Excretion | |
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Ca++ and Pi Excretion | |
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Summary | |
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Key Words and Concepts | |
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Self-Study Problems | |
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Additional Reading | |
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Integrative Case Studies | |
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Normal Laboratory Values | |
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Nephron Function | |
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Answers to Self-Study Problems | |
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Answers to Integrative Case Studies | |
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Review Examination | |