重庆医科大学：《内科学》课程教学课件（PPT讲稿）Generalintroductionofrenaldisease

Kidney and Urinary Disease Tang Lin Nephrology Department The 2nd Affiliated Hospital Kidney and urinary disease

Kidney and urinary disease 1 Kidney and Urinary Disease Tang Lin Nephrology Department The 2nd Affiliated Hospital

General Introduction of Kidney and Urinary Tract Kidney and urinary disease 2

Kidney and urinary disease 2 General Introduction of Kidney and Urinary Tract

Renal Vena cava artery Medulla Aorta Pelvis Cortex Calyx Structure of the kidneys and urinary tract Ureter Bladder Kidney and urinary disease 3

Kidney and urinary disease 3 Structure of the kidneys and urinary tract Bladder Ureter Calyx Cortex Pelvis Medulla Renal artery Aorta Vena cava

Afferent Glomerulus arteriole Efferent arteriole Distal Convoluted tubule Proximal Convoluted tubule Thick Collecting Renal Walled tubule artery Structure of a segment nephron Renal Loop vein of Henle Thin-walled segment Ureter Kidney and urinary disease 4

Kidney and urinary disease 4 Structure of a nephron Thin-walled segment Afferent arteriole Glomerulus Distal Convoluted tubule Proximal Convoluted tubule Collecting tubule Ureter Loop of Henle Renal vein Renal artery Efferent arteriole Thick Walled segment

er Tubulus Vas efferens Urinary Bowman's ula densa space capsule Epithelial afferens Parietal cell epithelium Capillary loops 年ndothelial cell Mesangial cell AngiotensinⅡ Mesangial vasoconstricts matrix Efferent arteriole Afferent Juxtaglomerular arteriole apparatus maler Tubulus Structure of the glomeruli Kidney and urinary disease 5

Kidney and urinary disease 5 Structure of the glomeruli Afferent arteriole Mesangial matrix Mesangial cell Endothelial cell Epithelial cell Urinary space Juxtaglomerular apparatus Efferent arteriole Capillary loops Parietal epithelium Bowman’s capsule Angiotensin Ⅱ vasoconstricts

Endothelial cell GBM Epithelial cell (podocyte) Electron micrograph to show the filtration barrier Podocytes Kidney and urinary disease 6

Kidney and urinary disease 6 Electron micrograph to show the filtration barrier Podocytes Endothelial cell GBM Epithelial cell (podocyte)

Functions of the kidney 1.Keep the balance of total body fluid,electrolyte,acid and alkali. 2.Eliminate metabolic waste products in the body. 3.Remove foreign chemicals from the blood (e.g.drugs, pesticides,food additives.) Kidney and urinary disease

Kidney and urinary disease 7 Functions of the kidney ⒈ Keep the balance of total body fluid, electrolyte, acid and alkali. ⒉ Eliminate metabolic waste products in the body. ⒊ Remove foreign chemicals from the blood (e.g. drugs, pesticides, food additives.)

Functions of the kidney 4.Endocrine function: (1)Erythropoietin EPO erythrocyte stem erythrocytes cells Bone marrow Kidney and urinary disease 8

Kidney and urinary disease 8 Functions of the kidney ⒋ Endocrine function: ⑴ Erythropoietin erythrocyte stem cells erythrocytes EPO Bone marrow

Functions of the kidney 4.Endocrine function: (2)1a-hydroxylase 25a-hydroxylase 1a-hydroxylase enzyme enzyme Vitamin D 25(OH)D3 1,25(OH)2D3 skin liver kidney Kidney and urinary disease 9

Kidney and urinary disease 9 Functions of the kidney ⒋ Endocrine function: ⑵ 1α-hydroxylase skin kidney Vitamin D 25(OH)D3 1,25(OH)2D3 liver 25α-hydroxylase enzyme 1α-hydroxylase enzyme

Functions of the kidney 4.Endocrine function: (3)Renin Angiotensinogen Renin Angiotensin I ACE Angiotensin II Aldosterone Na", K+ Kidney and urinary disease 10

Kidney and urinary disease 10 Functions of the kidney ⒋ Endocrine function: (3) Renin Angiotensinogen Angiotensin Ⅰ Angiotensin Ⅱ Renin Aldosterone ACE Na+ , K+