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Structure and function of the kidney 

Structure and function of the kidney

Chapter:
Structure and function of the kidney
Author(s):

A.O. Phillips

and Steve Riley

DOI:
10.1093/med/9780199204854.003.2101_update_001

Update:

Kidney and mineral bone disease—additional information on the role of the kidney in the homeostatic process of calcium metabolism and the recognition of FGF-23 as a contributor to this feedback mechanism.

Updated on 28 Nov 2012. The previous version of this content can be found here.
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date: 24 March 2017

The kidney is responsible for control of water, electrolyte (particularly sodium and potassium), and acid–base balance and for excretion of metabolic wastes, and it has important functions as an endocrine organ, including key roles in renin, vitamin D, and erythropoietin production or metabolism.

The nephron—beginning at the glomerulus, the functional unit of the kidney is the nephron, through which glomerular filtrate passes to be finally excreted as urine. The nephron is divided into anatomically and functionally distinct sections that work together to maintain homeostasis.

Renal function—in simple terms, in an adult human under no particular physiological or pathophysiological stress, about 100 ml of glomerular filtrate is generated from plasma each minute, 99 ml of which is reabsorbed, leaving a urinary volume of 1 ml/min. Metabolic wastes within the plasma (e.g. urea and creatinine) are not reabsorbed (or only some fraction of them), hence they are concentrated in the urine, and some wastes are also secreted into the urine by the renal tubules. The bulk of sodium and water is reabsorbed in the proximal tubules, as are other small molecules that the body retains (e.g. glucose and amino acids), with fine-tuning of sodium and water excretion effected in the distal part of the nephron under the influences of aldosterone and ADH, respectively.

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