Principles of Renal Physiology

by Christopher J. Lote

Overview

The first edition of this book appeared in 1982. In the preface to that first edi­ tion, I wrote 'This book is based on the lecture course in renal physiology which I give to medical students at the University of Birmingham. The pur­ pose of the book is primarily to set out the principles of renal physiology for preclinical medical students, and it is therefore concerned mainly with normal renal function. However, diseases or abnormalities in other body systems may lead to adaptations or modifications of renal function, so that a good knowl­ edge of renal physiology is essential to the understanding of many disease states, for example the oedema of heart failure or liver disease, or the conse­ quences of haemorrhage and shock. ' The new edition is still based on the lec­ tures which I continue to give at Birmingham University, but over the years the course has gradually changed, to being a system based course covering all aspects of the kidney - the anatomy, physiology, pharmacology and pathology. The new edition of the book, which has been extensively revised and rewritten, reflects this. However, it continues to offer a concise, easily readable format, primarily intended for undergraduate medical and medical science students.

Product Details

ISBN-13:	9789401140867
Publisher:	Springer-Verlag New York, LLC
Publication date:	12/06/2012
Sold by:	Barnes & Noble
Format:	eBook
File size:	7 MB

About the Author

Lote, Chris (Univ of Birmingham)

Table of Contents

1 The body fluids.- 1.1 Introduction.- 1.2 Body water.- 1.3 Body fluid osmolality.- 1.4 Distribution of ions across biological membranes.- 1.5 Fluid exchanges between body compartments.- 1.6 Fluid exchanges between the body and the external environment.- 1.7 Ionic composition of the body fluids.- 1.8 Ion exchanges between the body and the external environment.- 1.9 Body fluid compartments: methods of measurement.- Further reading.- Problems.- 2 Essential anatomy of the kidney.- 2.1 Introduction.- 2.2 General morphology and cellular organization.- 2.3 Blood supply and vascular structure within the kidney.- 2.4 Renal lymphatic drainage.- 2.5 Juxtaglomerular apparatus.- Further reading.- 3 Glomerular filtration.- 3.1 The filter.- 3.2 Glomerular filtration process.- 3.3 Composition of the glomerular filtrate.- 3.4 Filtration fraction.- 3.5 Tubulo-glomerular feedback.- Further reading.- Problems.- 4 Tubular transport.- 4.1 Introduction.- 4.2 Primary and secondary active transport.- 4.3 Ion channels, uniporters and facilitated diffusion.- 4.4 Paracellular movement.- 4.5 Water absorption.- 4.6 Fractional excretion and fractional reabsorption.- Further reading.- 5 The proximal tubule.- 5.1 Morphology of proximal tubule cells.- 5.2 Proximal tubular handling of sodium.- 5.3 Uptake of NaCl and water into peritubular capillaries.- 5.4 Relationship of proximal tubular reabsorption to glomerular filtration rate.- 5.5 Proximal tubular reabsorption of other solutes.- 5.6 Secretory processes in the proximal tubule.- Further reading.- Problem.- 6 The loop of Henle, distal tubule and collecting duct.- 6.1 The loop of Henle.- 6.2 Collecting tubules.- 6.3 Importance of urea in countercurrent multiplication.- 6.4 Further requirements of the countercurrent multiplication mechanism: the vasa recta.- 6.5 Long and short loops of Henle.- 6.6 Regulation of urine concentration.- 6.7 Other hormones affecting distal nephron transport processes.- Further reading.- 7 Renal blood flow and glomerular filtration rate.- 7.1 Measurement of renal blood flow and glomerular filtration rate.- 7.2 Regulation of renal blood flow and glomerular filtration rate.- Further reading.- Problem.- 8 Regulation of body fluid osmolality.- 8.1 Introduction.- 8.2 Osmoreceptors.- 8.3 Regulation of water excretion and water reabsorption.- Further reading.- 9 Regulation of body fluid volume.- 9.1 Introduction.- 9.2 Aldosterone.- 9.3 Renin and angiotensin, and their relationship to aldosterone.- 9.4 Starling forces and proximal tubular sodium reabsorption.- 9.5 Renal nerves.- 9.6 Prostaglandins and other arachidonate metabolites.- 9.7 Atrial natriuretic peptide and urodilatin.- 9.8 Other factors which may be involved in regulating sodium excretion.- 9.9 ADH and the relationship between osmotic regulation and volume regulation.- 9.10 Overall scheme of body fluid volume regulation.- Further reading tc.- 10 Renal regulation of body fluid pH.- 10.1 Introduction.- 10.2 Physiological buffers.- 10.3 Renal regulation of plasma bicarbonate concentration.- 10.4 Regulation of H+ secretion according to acid-base balance requirements.- Further reading.- Problem.- 11 Renal control of body fluid potassium content.- 11.1 Importance of K+ in the body.- 11.2 Regulation of body K+.- 11.3 Hypokalaemia.- 11.4 Hyperkalemia.- Further reading.- 12 Renal regulation of body calcium, magnesium and phosphate.- 12.1 Introduction.- 12.2 Calcium.- 12.3 Phosphate.- 12.4 Calcium and phosphate homeostasis.- 12.5 Magnesium.- Further reading.- 13 Summary of the principal reabsorptive and secretory processes in the nephron segments.- 13.1 Introduction.- 13.2 Sodium.- 13.3 Water.- 13.4 Potassium.- 13.5 Hydrogen ions and HCO—3.- 13.6 Phosphate.- 13.7 Calcium.- 13.8 Glucose.- 13.9 Urea and other nitrogenous waste products.- 14 Disease conditions which alter renal sodium and water reabsorption.- 14.1 Introduction.- 14.2 Oedema.- 14.3 Congestive heart failure.- 14.4 Hypovolaemia and shock.- 14.5 Hypertension.- 14.6 Liver disease.- 14.7 Nephrotic syndrome.- Further reading.- 15 Use of diuretics.- 15.1 Introduction.- 15.2 Osmotic diuretics.- 15.3 Loop diuretics.- 15.4 Thiazides.- 15.5 Aldosterone antagonists.- 15.6 Na channel blockers.- 15.7 Carbonic anhydrase inhibitors.- 15.8 Clinical use of diuretics.- Further reading.- Answers to problems.

Editorial Reviews

3 Stars from Doody

This book is based on the author's lecture course in renal physiology. It is a simplified and easy-to-read review of the subject. This is the fourth edition, and the third was published in 1994. The purpose is to set out the principles of renal physiology for preclinical medical students. The main focus is to review normal renal function. A second objective is to discuss renal adaptation to many disease states. In this newer edition the author provides further integration of renal anatomy, pharmacology, and pathology to renal physiology. The author successfully achieves his goal. This book is written primarily for undergraduate medical and medical science students. It is obvious that the author is very experienced in the subject and has an excellent, easy-to-read style. He does make complex concepts easy to understand. The author follows a traditional sequence of topics in renal physiology. First, he provides a comprehensive review of body fluids composition, followed by the normal function of each segment of the nephron. Subsequently he discusses the role of the kidney in fluids, electrolytes, and acid-base regulation. This book contains a few unique and very desirable features. The figures are very clear and generous in size, which makes fine details easy to depict. The frequent use of ""shaded titles"" and legends to figures and tables is very pleasing to the eyes. The author provides a few ""problems"" to solve at the end of some chapters to further highlight important topics. This book is excellent as a primer in renal physiology. All the major topics are covered in an easy-to-read style. The author clearly has the experience to transform a complex concept intosomething that is easy to understand. This is particularly important to students who are just beginning to learn these materials. This book can be useful to interns and residents who may be struggling in some aspects of renal physiology. In addition, I find it quite suitable as a framework for instructors of renal physiology.

B. Peter Sawaya

A much updated edition (first, 1982) of a compact introductory physiology text on the functions of the liver, including an up-to- date analysis of basic functions of the nephron, as well as a concise survey of the major regulatory mechanisms of salt and water homeostasis. Helpful line diagrams throughout. Annotation c. Book News, Inc., Portland, OR (booknews.com)

Booknews

Reviewer: Pavan Kapadia, M.D. (University of Kentucky College of Medicine)
Description: This is the fifth edition of an introduction to the principles of normal renal physiology and function.
Purpose: The goal is to provide an introduction to and basic review of normal renal physiology and function in a concise format for undergraduate and preclinical medical science students. This edition has been lengthened and revised to include new information about kidney function from the last 10 years.
Audience: The book is intended for premedical and medical students, covering the anatomy, physiology, pharmacology, and pathology of the kidney in a thorough and concise format.
Features: Although no new chapters have been added, each one has been revised and updated to incorporate new information about kidney function, which includes our understanding of the role of the glycocalyx and structural proteins in glomerular filtration; details of tubular transport, tight junctions, and paracellular transport; and an update of the loops of Henle functioning. The book ends with two chapters on the renal pathology associated with various diseases and the use of diuretics. Throughout, basic renal physiology problems and questions reinforce learning, while numerous figures, tables, and pictures reinforce concepts. In addition, special topic boxes highlight important correlations and further reading sections offer important review articles for each topic.
Assessment: This revised edition adequately meets its purpose of introducing renal anatomy, physiology, pharmacology, and pathology to basic medical science students. Each topic is covered in a methodical fashion, with each section building on the previous one. Special topic boxes and renal tubule diagrams offer particularly pertinent information and strong clinical correlations. However, several sections are ambiguous or somewhat confusing, in which case more clarification or images would be beneficial. Also, more high-resolution and color images would likely serve the audience better. Nevertheless, the material is succinct and presented well, making this a good introductory source on nephrology.

Doody's Review Service

From the reviews of the fifth edition:

“A book on the (human) renal system for undergraduate medical and medical science students. … I was pleased to see that up to date references are used … to take account of the developments in renal physiology over the last decade. This is a concise, clearly written, easy to read book that explains complex concepts in a way that makes them easy to grasp. … it provides a solid grounding in renal physiology as it sets out to do.” (Sean McKeag, BTS Newsletter – The British Toxicology Society, Issue 43, Winter, 2013)

“This is the fifth edition of an introduction to the principles of normal renal physiology and function. … The book is intended for premedical and medical students, covering the anatomy, physiology, pharmacology, and pathology of the kidney in a thorough and concise format. … special topic boxes highlight important correlations and further reading sections offer important review articles for each topic. … the material is succinct and presented well, making this is a good introductory source on nephrology.” (Pavan Kapadia, Doody’s Review Service, October, 2012)

From the Publisher