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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 | |