Kidney Correlative anatomy

Kidney Correlative anatomy

Tubule:

Definition: highly specialized structure whose main

function is reabsorption and secretion by cellular
transport
Kidney Correlative anatomy

The tubule reasorbs more than 99% of the glomerular

filtrate
The proximal tubule has extensive reabsorption and
selective secretion (convoluted - S1 and S2, straight -
S3). S2 is primary site for low MW protein resorption
and S3 is primary site for P450.
Thin loop of Henle - reabsorption of fluids
Distal tubule - reabsorption of Na, Cl and acid-base
balance
Collecting duct - reabsorption of fluids, antidiuretic
hormone and acid-base balance
Kidney Correlative anatomy
Kidney Correlative anatomy

Proximal tubule structure:

- L 14-15 mm
- Diam. 50-60 m
- The proximal tubule is divided into two sections
pars convoluta and pars recta
-Cells:
- citoplasmatic microvilli at apical polle
-brush border
- tubular basement membrane
PARS CONVOLUTA
Kidney Correlative anatomy

Proximal convoluted tubule function:

- water reabsorption (ultrafiltration significant reduced by 70 %

- important and homogeneous permeability for water
- reabsorption of solutes:

- Na, bicarbonate, glucose, K, Cl, Ca, aminoacids at the level

of pars convoluta
 Effects of low and high luminal flow on AQP1 expression in isolatedperfused proximal
tubules.

Marcus Pohl et al. JASN 2015;26:1269-1278

2015 by American Society of Nephrology

Kidney Correlative anatomy

Chao EC, et al. Nat Rev Drug Discovery. 2010;9:551-559.

Kidney Correlative anatomy

Chao, EC & Henry RR. Nature Reviews Drug Discovery. 2010;9:551-559.

Kidney Correlative anatomy

Tubular mechanisms involved in achieving acid

base balance

- reabsorption of HCO3- in the PCT

- synthesis and excretion of NH4+ in the PCT
- secretion of H+ in the distal convoluted tubule and
collecting tubule.
Kidney Correlative anatomy

- Proximal convoluted tubule:

- main function in maintaining acid-base balance:

reabsorption of filtered HCO3-
Kidney Correlative anatomy

Proximal convoluted tubule

Tubular lumen Celula tub proximal Blood

Na+ Cl-
HCO3
H+ 3 HCO3

H2CO3 H2CO3 3 Na+

ATP
AC II
AC IV 2 K+

H2O CO2 CO2 H2O

K+

Na+Cl-
H2O
+ -
Kidney Correlative anatomy

- Proximal convoluted tubule:

- reabsorption of ~ 80% of the filtered HCO3-

- production and secretion of NH4+
- decrease in urinary pH from 7.4 to 6.7
PARS RECTA
Kidney Correlative anatomy
Kidney Correlative anatomy

- Fanconi syndrome:

- polyuria
- metabolic acidosis
- glycosuria
- aminoacid-uria
- calciuria
- phosphaturia
Kidney Correlative anatomy

Loop of Henle structure:

- simple squamous epithelium
- thin descending limb is permeable for water in the superior
portion, and for Na and urea in the inferior portion.
- thin ascending limb is impermeable for water and urea, but
permeable for Na.
- thick ascending limb of loop of Henle is impermeable for water
and urea, and permeable for sodium.
Kidney Correlative anatomy

Loop of Henle structure:

Responsible for producing a concentrated urine by forming a

concentration gradient within the medulla of kidney.
When ADH is present, water is reabsorbed and urine is
concentrated.
Counter-current multiplier
Rinichi Anatomie corelativ
Kidney Correlative anatomy

Distal convoluted tubule

structure:
- simple cubic epithelium
- straight and convoluted portions
- macula densa in contact with afferent arteriole
- impermeable for water and urea, and permeable for sodium.
-Sodium reabsorption regulated by aldosterone.
Kidney Correlative anatomy

Collecting duct structure:

- simple cubic epithelium
- permeable for water, urea in the presence of ADH
- Aquaporins (AQP2 under control of ADH)
Kidney Correlative anatomy

- collecting duct
- principal cells: reabs. of Na, H2O and secretion of K
- intercalated cells:
- : secretion of H+ (ATP-ase H+ and ATP-ase H+/ K+)
- : reabsorption of HCO3 in exchange with Cl -
Kidney Correlative anatomy

Collecting duct
A B
FIGURE 2
Light chain cast nephropathy LAMBDA LIGHT CHAINS
BISMUTH INCLUSIONS
BK VIRUS
BK-VIRUS
IH FOR BK-VIRUS