All About Kidneys

Anatomy and Structure

Location: Kidneys are located on either side of the spine, just below the ribcage, in the retroperitoneal space.

Shape and Size: Each kidney is bean-shaped, typically about 10-12 cm.

Components:

  • Renal Cortex: The outer layer containing nephrons, the functional units of the kidney.
  • Renal Medulla: The inner region with pyramids that transport urine into the calyces. 🔸 Renal Pelvis: A funnel-shaped structure where urine collects before entering the ureter.
  • Nephrons: Each kidney has about 1 million nephrons, consisting of:
  • Glomerulus: A network of capillaries that filters blood.
  • Tubules: Responsible for reabsorption and secretion to form urine.


Functions of the Kidneys

Filtration:

  • Filters about 50 gallons (180 liters) of blood daily to remove waste and excess substances.
  • Produces urine, which contains water, salts, and metabolic waste (e.g., urea, creatinine).

Regulation of Homeostasis:

  • Electrolyte Balance: Regulates levels of sodium, potassium, calcium, and magnesium.
  • Acid-Base Balance: Maintains blood pH by excreting hydrogen ions and reabsorbing bicarbonate.

Hormone Production:

  • Erythropoietin (EPO): Stimulates red blood cell production in the bone marrow.
  • Renin: Regulates blood pressure via the renin-angiotensin-aldosterone system (RAAS).
  • Active Vitamin D: Converts calcidiol into calcitriol to regulate calcium and phosphorus metabolism.

Blood Pressure Regulation:

  • Controls fluid volume and sodium levels, influencing blood pressure.

Detoxification:

  • Removes drugs and toxins from the bloodstream.


Diagnostic Tools

Blood Tests:

  • Creatinine: Measures waste product levels to assess kidney function.
  • Blood Urea Nitrogen (BUN): Indicates waste accumulation.
  • eGFR (Estimated Glomerular Filtration Rate): Evaluates overall kidney function.

Urine Tests:

  • Urinalysis: Checks for proteins, blood, or infection.
  • 24-Hour Urine Collection: Measures urine output and substance excretion.

Imaging:

  • Ultrasound: Visualizes kidney size and structure.
  • CT/MRI Scans: Identifies abnormalities like stones or tumors.
  • Biopsy: Examines kidney tissue for disease.


Common Kidney Disorders

  • Acute Kidney Injury (AKI): A sudden decrease in kidney function, often reversible.
  • Chronic Kidney Disease (CKD): A gradual loss of kidney function over time.
  • Kidney Stones: Solid mineral and salt deposits forming in the kidney.
  • Polycystic Kidney Disease (PKD): A genetic disorder causing cyst formation, impairing kidney function.
  • Urinary Tract Infections (UTIs): Often involve the kidneys when untreated, leading to pyelonephritis.
  • Glomerulonephritis: Inflammation of the glomeruli, leading to proteinuria and hematuria.


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Resource Person: Akmal K. Ishak

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