复旦大学：《内科学 Internal Medicine MBBS》课程教学资源（课件讲稿）肾与尿路_Adaptation to injury

General introduction of nephrology Xiaoqiang Ding M.D. Ph.D. Department of nephrology Zhongshan Hospital, Fudan University

General introduction of nephrology Xiaoqiang Ding M.D., Ph.D. Department of nephrology Zhongshan Hospital, Fudan University

Nephrons and the collecting duct system yramid Papila Arcuate Interlobular Cortex Medullary Interlobar Renal arten Short-loop medulla nephron ong-loop Medula Cortex Ureter Renal corpuscle Proximal convoluted tubule convoluted tubule Proximal straight tubule Renal pe cting duct Cut edge of pel 6. Distal straight tubule medullary (thick ascending limb) ElDovior items and derived items e 2007 by Mosby, ina, an afliate of Elsevier Inc

Terminology 口 Kidney, renal 日 Nephrology

Terminology  Kidney，renal  Nephrology

Scope of nephrology a Kidney diseases and other problems of the urinary systems, no requirement for surgery intervention V Glomerular disease nephrotic syndrom glomerulonephritis v Urinary tract infection v Interstitial nephritis V Acute renal failure or chronic renal failure a Blood purification kidney disease or non- kindey disease

Scope of nephrology  Kidney diseases and other problems of the urinary systems, no requirement for surgery intervention √ Glomerular disease：nephrotic syndrom, glomerulonephritis √ Urinary tract infection √ Interstitial nephritis √ Acute renal failure or chronic renal failure  Blood purification: kidney disease or non￾kindey disease

Kidney functions Q excreting meta bolic waste products excreting redundant fluid and sodium ---hypertension eliminating dissoluable metabolic products exogenous drugs and toxins uremia

Kidney functions  excreting metabolic waste products √excreting redundant fluid and sodium ---hypertension √eliminating dissoluable metabolic products, exogenous drugs and toxins ---uremia

Kidney functions 口 Endocrine functions VErythropoiesis---erythropoietin BLood pressure---renin bOne and mineral metablism ---vitD activation D Internal Environment Homeostasis regulation fluid acid-base homeostasis V Acid excretion---metabolic acidosis POtassium excretion---hyperkalemia, hypokalemia

Kidney functions  Endocrine functions √Erythropoiesis---erythropoietin √Blood pressure---renin √Bone and mineral metablism---VitD activation  Internal Environment Homeostasis regulation fluid, acid-base homeostasis √ Acid excretion---metabolic acidosis √ Potassium excretion---hyperkalemia, hypokalemia

Coronal section through a unipapillary kidney Short-looped Long-looped Glomeruli Re nephron nephron artery Cortex Oute medulla Inner medulla Collecting Rena duct veIn Elsevier items and derived items e 2007 by Mosby, Inc an affiliate of Elsevier Inc

Renal corpuscle and juxtaglomerular apparatus Juxtaglomerular AA MD apparatus N MC Bowman's M GBM US U AA Afferent arteriole PE Parietal epithelium MD Macula densa Po Podocyte EA Efferent arteriole E Endothelium N Sympathetic nerve terminals F Foot process Gc Granular cells GBM Glomerular b embrane SMC Vascular smooth muscle cells Us Urinary space Adapted with permiss on tom Kriz w, Kaisshng B: Structural organ zaton of the mammalian kidney, In Seldin D

Peripheral portion of a glomerular lobule Glomerular Podocyte basement Foot processes Capillary Gesang ial Capillary Microfilaments Mesangium Mesangial matrix

GOMe MF a