Renal Disease

The renal capsule and ureters are innervated via T10-12 and L1 nerve roots and renal pain is felt over the corresponding dermatomes.

The renal tubules are lined by epithelial cells, which are cuboidal except in the thin limb of the loop of Henle where they are flat. Proximal tubular cells differ from other cells of the system in possession of a luminal brush border. The cortical portion of the collecting tubules contains two cell types with different functions, namely principal cells and intercalated cells. Fibroblast-like cells in the renal cortical interstitium have been identified and shown to produce erythropoietin in response to hypoxia.

Anatomy of renel Disease

The kidneys are paired organs, 11-14 cm in length in adults (approximately equivalent to the length of three vertebral bodies), 5-6 cm in width and 3-4 cm in depth. Each kidney weighs approximately 150 g. The kidneys lie retroperitoneally on either side of the vertebral column at the level of T12 to L3.

The right kidney lies approximately 1.5 cm lower than the left owing to the presence of the liver. Each kidney moves about 3 cm downwards on inspiration and upwards on expiration. The renal parenchyma comprises an outer cortex and an inner medulla.

The functional unit of the kidney is the nephron of which each contains about one million. Each nephron is made up of a glomerulus, proximal tubule, loop of Henle, distal tubule and collecting duct.

The glomerulus comprises three main cell types: (1) endothelial cells which are fenestrated with 500-1000 Å pores; (2) epithelial cells, visceral and parietal; (3) mesangial cells. Mesangial cells are believed to be related to macrophages of the reticuloendothelial system and have a phagocytic function. They also secrete the mesangial matrix of the glomerulus.

The glomerular capillary basement membrane lies between the endothelial and the visceral epithelial cells. The latter put out multiple long foot processes (podocytes) which interdigitate with those of adjacent epithelial cells. Together the endothelial cells, basement membrane and epithelial cells form the filtration barrier or sieve.

The juxtaglomerular apparatus comprises the macula densa, the extraglomerular mesangial mesangium and the terminal portion of the afferent glomerular arteriole (which contains renin-producing granular cells) together with the proximal portion of the efferent arteriole.

The macula densa is a plaque of cells containing large, tightly packed cell nuclei (hence the name macula densa) within the thick ascending limb of the loop of Henle. This anatomical arrangement is such as to allow changes in the renal tubule to influence behaviour of the adjacent glomerulus.

Renal function, Renal Function Test, Glomerular Filtration Rate, Renal Hypertension, Renal Vein Thrombosis, Renin Angiotensin System, Acute Renal Failure- Acute Tubular Necrosis, Hyperkalemia, Chronic Renal Failure - Renal Osteodystrophy, Peritonitis

Uraemia, Endothelin, Erythropoietin, Prostaglandins, Natriuretic Peptide

Systemic Lupus Erythematosus, Polyarteritis Nodosa, Microscopic Polyangiitis, Wegeners Granulomatosis, Systemic Sclerosis, Amyloidosis, Thrombotic Thrombocytopenic Purpura, Multiple Myeloma (Multiple Myeloma Symptom), Contrast Nephropathy,

Nephrotic Syndrome, Nephritis - Lupus Nephritis, Interstitial Nephritis, Analgesic Nephropathy

Renal Calculus - Hypercalciuria, Nephrocalcinosis, Hyperoxaluria, Bladder Stones, Idiopathic Hypercalciuria, Uric Acid Kidney Stones, Cystine Kidney Stones

Schistosoma Haematobium, Urinary Incontinence, Renal Cell Carcinoma, Nephroblastoma, Von Hippel Lindau Disease

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