Renal Physiology

by Koeppen, Bruce M.

• ISBN13: 9780323034470
• ISBN10: 0323034470
• Edition: 4th
• Format: Paperback
• Copyright: 2006-09-01
• Publisher: MOSBY-YEAR BOOK INC

Summary

This volume in the Mosby Physiology Monograph Series explains the fundamentals of renal physiology in a clear and concise manner. It provides you with a basic understanding of normal kidney function at the cellular and molecular level. Attractively illustrated with clear 2-color diagrams, this volume also facilitates study with learning objectives, overview boxes, chapter summaries, and clinical cases with questions and explained answers. Plus, online access via STUDENT CONSULT makes this an even more powerful learning resource. Stay current with clear, accurate, and up-to-the-minute coverage of the physiology of normal renal function focusing on the needs of the student. Bridge the gap between normal function and disease with pathophysiology content throughout the book. Master the material more easily with learning objectives, overview boxes, key words and concepts, chapter summaries, and clinical cases with questions and explained answers. Understand complex concepts by examining more than 250 clear, 2-color diagrams. Apply what you've learned to real-life clinical situations using featured clinical commentaries. Includes STUDENT CONSULT access at no additional charge, enabling you to consult the book online, anywhere you go · perform quick searches · add your own notes and bookmarks · follow Integration Links to related bonus content from other STUDENT CONSULT titles-to help you see the connections between diverse disciplines · and more!

Table of Contents

Introduction to the Kidney	1	(4)
Physiology of Body Fluids	5	(14)
Objectives	5	(1)
Physicochemical Properties of Electrolyte Solutions	5	(4)
Molarity and Equivalence	5	(1)
Osmosis and Osmotic Pressure	6	(1)
Osmolarity and Osmolality	7	(1)
Tonicity	7	(1)
Oncotic Pressure	8	(1)
Specific Gravity	8	(1)
Volumes of Body Fluid Compartments	9	(1)
Composition of Body Fluid Compartments	10	(1)
Fluid Exchange Between Body Fluid Compartments	11	(4)
Capillary Fluid Exchange	11	(2)
Cellular Fluid Exchange	13	(2)
Summary	15	(1)
Key Words and Concepts	15	(1)
Self-Study Problems	16	(3)
Structure and Function of the Kidneys	19	(12)
Objectives	19	(1)
Structure of the Kidneys	19	(10)
Gross Anatomy	19	(1)
Ultrastructure of the Nephron	20	(4)
Ultrastructure of the Renal Corpuscle	24	(4)
Ultrastructure of the Juxtaglomerular Apparatus	28	(1)
Innervation of the Kidneys	28	(1)
Summary	29	(1)
Key Words and Concepts	29	(1)
Self-Study Problems	30	(1)
Glomerular Filtration and Renal Blood Flow	31	(16)
Objectives	31	(1)
Renal Clearance	31	(3)
Glomerular Filtration Rate	32	(2)
Glomerular Filtration	34	(3)
Determinants of Ultrafiltrate Composition	35	(1)
Dynamics of Ultrafiltration	36	(1)
Renal Blood Flow	37	(4)
Regulation of Renal Blood Flow and Glomerular Filtration Rate	41	(4)
Sympathetic Nerves	41	(1)
Angiotensin II	42	(1)
Prostaglandins	42	(1)
Nitric Oxide	43	(1)
Endothelin	44	(1)
Bradykinin	44	(1)
Adenosine	44	(1)
Natriuretic Peptides	44	(1)
ATP	44	(1)
Glucocorticoids	44	(1)
Histamine	44	(1)
Dopamine	44	(1)
Summary	45	(1)
Key Words and Concepts	46	(1)
Self-Study Problems	46	(1)
Renal Transport Mechanisms: NaCl and Water Reabsorption Along the Nephron	47	(24)
Objectives	47	(1)
General Principles of Membrane Transport	48	(2)
General Principles of Transepithelial Solute and Water Transport	50	(2)
NaCl, Solute, and Water Reabsorption Along the Nephron	52	(12)
Proximal Tubule	52	(9)
Henle's Loop	61	(2)
Distal Tubule and Collecting Duct	63	(1)
Regulation of NaCl and Water Reabsorption	64	(5)
Summary	69	(1)
Key Words and Concepts	70	(1)
Self-Study Problems	70	(1)
Regulation of Body Fluid Osmolality: Regulation of Water Balance	71	(20)
Objectives	71	(2)
Antidiuretic Hormone	73	(6)
Osmotic Control of ADH Secretion	74	(1)
Hemodynamic Control of ADH Secretion	75	(1)
ADH Actions on the Kidneys	76	(3)
Thirst	79	(1)
Renal Mechanisms for Dilution and Concentration of the Urine	80	(7)
Medullary Interstitium	85	(1)
Vasa Recta Function	86	(1)
Assessment of Renal Diluting and Concentrating Ability	87	(2)
Summary	89	(1)
Key Words And Concepts	89	(1)
Self-Study Problems	90	(1)
Regulation of Extracellular Fluid Volume and NaCl Balance	91	(22)
Objectives	91	(1)
Concept of Effective Circulating Volume	92	(1)
Volume-Sensing Systems	93	(6)
Vascular Low-Pressure Volume Sensors	94	(1)
Vascular High-Pressure Volume Sensors	94	(1)
Hepatic Sensors	95	(1)
Central Nervous System Na+ Sensors	95	(1)
Volume Sensor Signals	95	(1)
Renal Sympathetic Nerves	95	(1)
Renin-Angiotensin-Aldosterone System	96	(2)
Natriuretic Peptides	98	(1)
Antidiuretic Hormone	99	(1)
Control of Renal NaCl Excretion During Euvolemia	99	(3)
Mechanisms for Maintaining the Delivery of Na+ to the Distal Tubule Constant	101	(1)
Regulation of Distal Tubule and Collecting Duct Na+ Reabsorption	101	(1)
Control of Na+ Excretion with Volume Expansion	102	(2)
Control of Na+ Excretion with Volume Contraction	104	(2)
Edema	106	(2)
Alterations in Starling Forces	106	(1)
The Role of the Kidneys	107	(1)
Summary	108	(1)
Key Words and Concepts	109	(1)
Self-Study Problems	109	(4)
Regulation of Potassium Balance	113	(16)
Objectives	113	(1)
Overview of K+ Homeostasis	113	(2)
Regulation of Plasma [K+]	115	(2)
Epinephrine	116	(1)
Insulin	116	(1)
Aldosterone	117	(1)
Alterations of Plasma [K+]	117	(1)
Acid-Base Balance	117	(1)
Plasma Osmolality	117	(1)
Cell Lysis	118	(1)
Exercise	118	(1)
K+ Excretion by the Kidneys	118	(2)
Cellular Mechanisms of K+ Secretion by Principal Cells in the Distal Tubule and Collecting Duct	120	(1)
Regulation of K+ Secretion by the Distal Tubule and Collecting Duct	120	(4)
Plasma [K+]	120	(2)
Aldosterone	122	(1)
Antidiuretic Hormone	123	(1)
Factors that Perturb K+ Excretion	124	(4)
Flow of Tubular Fluid	124	(1)
Acid-Base Balance	125	(2)
Glucocorticoids	127	(1)
Summary	128	(1)
Key Words and Concepts	128	(1)
Self-Study Problems	128	(1)
Regulation of Acid-Base Balance	129	(20)
Objectives	129	(1)
The HCO3- Buffer System	130	(1)
Overview of Acid-Base Balance	130	(1)
Net Acid Excretion by the Kidneys	131	(1)
HCO3- Reabsorption Along the Nephron	132	(3)
Regulation of H+ Secretion	135	(2)
Formation of New HCO3-	137	(4)
Response to Acid-Base Disorders	141	(2)
Extracellular and Intracellular Buffers	141	(1)
Respiratory Compensation	142	(1)
Renal Compensation	142	(1)
Simple Acid-Base Disorders	143	(2)
Metabolic Acidosis	143	(1)
Metabolic Alkalosis	144	(1)
Respiratory Acidosis	144	(1)
Respiratory Alkalosis	145	(1)
Analysis of Acid-Base Disorders	145	(2)
Summary	147	(1)
Key Words and Concepts	147	(1)
Self-Study Problems	147	(2)
Regulation of Calcium and Phosphate Homeostasis	149	(14)
Objectives	149	(1)
Calcium	150	(5)
Overview of Ca++ Homeostasis	150	(2)
Ca++ Transport along the Nephron	152	(2)
Regulation of Urinary Ca++ Excretion	154	(1)
Calcium-Sensing Receptor	155	(1)
Phosphate	155	(4)
Overview of Pi Homeostasis	156	(1)
Pi Transport along the Nephron	157	(1)
Regulation of Urinary Pi Excretion	157	(2)
Integrative Review of Parathyroid Hormone, Calcitriol, and Calcitonin on Ca++ and Pi Homeostasis	159	(2)
Summary	161	(1)
Key Words and Concepts	161	(1)
Self-Study Problems	161	(2)
Physiology of Diuretic Action	163	(12)
Objectives	163	(1)
General Principles of Diuretic Action	163	(2)
Sites of Action of Diuretics	164	(1)
Response of Other Nephron Segments	164	(1)
Adequate Delivery of Diuretics to Their Site of Action	164	(1)
Volume of the Extracellular Fluid	165	(1)
Diuretic Braking Phenomenon	165	(1)
Mechanisms of Action of Diuretics	166	(3)
Osmotic Diuretics	166	(1)
Carbonic Anhydrase Inhibitors	167	(1)
Loop Diuretics	167	(1)
Thiazide Diuretics	168	(1)
K+-Sparing Diuretics	168	(1)
Aquaretics	169	(1)
Effect of Diuretics on the Excretion of Water and other Solutes	169	(3)
Solute-Free Water	169	(1)
K+ Excretion	170	(1)
HCO3- Excretion	170	(1)
Ca++ and Pi Excretion	171	(1)
Summary	172	(1)
Key Words and Concepts	173	(1)
Self-Study Problems	173	(2)
Additional Reading	175	(4)
Appendix A Integrative Case Studies	179	(4)
Appendix B Normal Laboratory Values	183	(2)
Appendix C Nephron Function	185	(4)
Appendix D Answers to Self-Study Poblems	189	(14)
Appendix E Answers to Integrative Case Studies	203	(6)
Appendix F Review Examination	209	(14)
Index	223