Renal Physiology, 6th Edition

Introduction

1. Physiology of Body Fluids
1.1. Objectives
1.2. Concept of Steady-State Balance
1.3. Physicochemical Properties of Electrolyte Solutions
1.4. Molarity and Equivalence
1.5. Osmosis and Osmotic Pressure
1.6. Osmolarity and Osmolality
1.7. Tonicity
1.8. Oncotic Pressure
1.9. Specific Gravity
1.10. Volumes of Body Fluid Compartments
1.11. Composition of Body Fluid Compartments
1.12. Fluid Exchange between Body Fluid Compartments
1.13. Capillary Fluid Exchange
1.14. Cellular Fluid Exchange
1.15. Summary
1.16. Key Words and Concepts
1.17. Self-Study Problems

2. Structure and Function of the Kidneys
2.1. Objectives
2.2. Structure of the Kidneys
2.3. Gross Anatomy
2.4. Ultrastructure of the Nephron
2.5. Ultrastructure of the Glomerulus
2.6. Ultrastructure of the Juxtaglomerular Apparatus
2.7. Innervation of the Kidneys
2.8. Summary
2.9. Key Words and Concepts
2.10. Self-Study Problems

3. Glomerular Filtration and Renal Blood Flow
3.1. Objectives
3.2. Renal Clearance
3.3. Glomerular Filtration Rate
3.4. Glomerular Filtration
3.5. Determinants of Ultrafiltrate Composition
3.6. Dynamics of Ultrafiltration
3.7. Renal Blood Flow
3.8. Regulation of Renal Blood Flow and Glomerular Filtration Rate
3.9. Sympathetic Nerves
3.10. Angiotensin II
3.11. Prostaglandins
3.12. Nitric Oxide
3.13. Endothelin
3.14. Bradykinin
3.15. Adenosine
3.16. Natriuretic Peptides
3.17. Adenosine Triphosphate
3.18. Glucocorticoids
3.19. Histamine
3.20. Dopamine
3.21. Summary
3.22. Key Words and Concepts
3.23. Self-Study Problems

4. Renal Transport Mechanisms: NaCl and Water Absorption Along the Nephron
4.1. Objectives
4.2. General Principles of Membrane Transport
4.3. General Principles of Transepithelial Solute and Water Transport
4.4. NaCl, Solute, and Water Reabsorption Along the Nephron
4.5. Proximal Tubule
4.6. Henle's Loop
4.7. Distal Tubule and Collecting Duct
4.8. Regulation of NaCl and Water Reabsorption
4.9. Summary
4.10. Key Words and Concepts
4.11. Self-Study Problems

5. Regulation of Body Fluid Osmolality: Regulation of Water Balance
5.1. Objectives
5.2. Arginine Vasopressin
5.3. Osmotic Control of Arginine Vasopressin Secretion
5.4. Hemodynamic Control of Arginine Vasopressin Secretion
5.5. Arginine Vasopressin Actions on the Kidneys
5.6. Thirst
5.7. Renal Mechanisms for Dilution and Concentration of the Urine
5.8. Medullary Interstitium
5.9. Vasa Recta Function
5.10. Assessment of Renal Diluting and Concentrating Ability
5.11. Summary
5.12. Key Words and Concepts
5.13. Self-Study Problems

6. Regulation of Extracellular Fluid Volume and NaCl Balance
6.1. Objectives
6.2. Whole-Body Na+ Balance
6.3. Concept of Effective Circulating Volume
6.4. Volume-Sensing Systems
6.5. Volume Sensors in the Low-Pressure Cardiopulmonary Circuit
6.6. Volume Sensors in the High-Pressure Arterial Circuit
6.7. Volume Sensor Signals
6.8. Renal Sympathetic Nerves
6.9. Renin-Angiotensin-Aldosterone System
6.10. Natriuretic Peptides
6.11. Arginine Vasopressin
6.12. Control of Renal NaCl Excretion During Euvolemia
6.13. Mechanisms for Maintaining Constant Na+ Delivery to the Distal Tubule in Euvolemia
6.14. Regulation of Distal Tubule and Collecting Duct Na+ Reabsorption in Euvolemia
6.15. Control of Na+ Excretion with Volume Expansion
6.16. Control of Na+ Excretion with Volume Contraction
6.17. Edema
6.18. Alterations in Starling Forces
6.19. Capillary Hydrostatic Pressure (Pc)
6.20. Plasma Oncotic Pressure (πc)
6.21. Lymphatic Obstruction
6.22. Capillary Permeability
6.23. Role of the Kidneys
6.24. Summary
6.25. Key Words and Concepts
6.26. Self-Study Problems

7. Regulation of Potassium Balance
7.1. Objectives
7.2. Overview of K+ Homeostasis
7.3. Regulation of Plasma [K+]
7.4. Epinephrine
7.5. Insulin
7.6. Aldosterone
7.7. Alterations of Plasma [K+]
7.8. Acid-Base Balance
7.9. Plasma Osmolality
7.10. Cell Lysis
7.11. Exercise
7.12. K+ Excretion by the Kidneys
7.13. Cellular Mechanisms of K+ Transport by Principal Cells and Intercalated Cells in the Distal Tubule and Collecting Duct
7.14. Regulation of K+ Secretion by the Distal Tubule and Collecting Duct
7.15. Plasma [K+]
7.16. Aldosterone
7.17. Arginine Vasopressin
7.18. Factors that Perturb K+ Excretion
7.19. Flow of Tubular Fluid
7.20. Acid-Base Balance
7.21. Glucocorticoids
7.22. Summary
7.23. Key Words and Concepts
7.24. Self-Study Problems

8. Regulation of Acid-Base Balance
8.1. Objectives
8.2. Buffer System
8.3. Overview of Acid-Base Balance
8.4. Renal Net Acid Excretion
8.5. Reabsorption Along the Nephron
8.6. Regulation of H+ Secretion
8.7. Formation of New
8.8. Response to Acid-Base Disorders
8.9. Extracellular and Intracellular Buffers
8.10. Respiratory Compensation
8.11. Renal Compensation
8.12. Simple Acid-Base Disorders
8.13. Metabolic Acidosis
8.14. Metabolic Alkalosis
8.15. Respiratory Acidosis
8.16. Respiratory Alkalosis
8.17. Analysis of Acid-Base Disorders
8.18. Summary
8.19. Key Words and Concepts
8.20. Self-Study Problems

9. Regulation of Calcium and Phosphate Homeostasis
9.1. Objectives
9.2. Calcium
9.3. Overview of Ca++ Homeostasis
9.4. Ca++ Transport Along the Nephron
9.5. Regulation of Urinary Ca++ Excretion
9.6. Calcium-Sensing Receptor
9.7. Phosphate
9.8. Overview of Pi Homeostasis
9.9. Pi Transport Along the Nephron
9.10. Regulation of Urinary Pi Excretion
9.11. Integrative Review of Parathyroid Hormone and Calcitriol on Ca++ and Pi Homeostasis
9.12. Summary
9.13. Key Words and Concepts
9.14. Self-Study Problems

10. Physiology of Diuretic Action
10.1. Objectives
10.2. General Principles of Diuretic Action
10.3. Sites of Action of Diuretics
10.4. Response of Other Nephron Segments
10.5. Adequate Delivery of Diuretics to Their Site of Action
10.6. Volume of the Extracellular Fluid
10.7. Diuretic Braking Phenomenon
10.8. Mechanisms of Action of Diuretics
10.9. Osmotic Diuretics
10.10. Carbonic Anhydrase Inhibitors
10.11. Loop Diuretics
10.12. Thiazide Diuretics
10.13. K+-Sparing Diuretics
10.14. Aquaretics
10.15. Effect of Diuretics on the Excretion of Water and Other Solutes
10.16. Solute-Free Water
10.17. K+ Excretion
10.18. HCO Excretion
10.19. Ca++ and Pi Excretion
10.20. Summary
10.21. Key Words and Concepts
10.22. Self-Study Problems

Additional Reading

Appendix A: Integrative Case Studies
Appendix B: Normal Laboratory Values
Appendix C: Nephron Function
Appendix D: Answers to Self-Study Problems
Appendix E: Answers to Integrative Case Studies
Appendix F: Review Examination
Appendix G: Answers to Review Examination

Index

Bruce M. Koeppen, MD, PhD, Dean, Frank H. Netter MD School of Medicine, Quinnipiac University, Hamden, Connecticut, USA and Bruce A. Stanton, PhD, Andrew C. Vail Professor, Department of Microbiology, Immunology, and Physiology, Geisel School of Medicine, Dartmouth, Hanover, USA