Renal Physiology

Bruce Koeppen, founding dean of the Frank H. Netter MD School of Medicine at Quinnipiac, recently received two prestigious awards: honored by the Patient is U Foundation - a nonprofit that aims to encourage human communication in health care and support both patients and providers and the (LCME) Liaison Committee on Medical Education's 2019 Distinguished Service Award. Bruce Stanton received the Unsung Hero Award in 2019 from the Cystic Fibrosis Foundation. He played a key role in the development of Vertex modulators and is connected with sparking the creation of a Patient Registry which has had an enormous impact on the length and quality of lives in CF patients.

• INTRODUCTIONCHAPTER 1PHYSIOLOGY OF BODY FLUIDSObjectivesConcept of Steady-State BalancePhysicochemical Properties of Electrolyte SolutionsMolarity and EquivalenceOsmosis and Osmotic PressureOsmolarity and OsmolalityTonicityOncotic PressureSpecific GravityVolumes of Body Fluid CompartmentsComposition of Body Fluid CompartmentsFluid Exchange between Body Fluid CompartmentsCapillary Fluid ExchangeCellular Fluid ExchangeSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 2STRUCTURE AND FUNCTION OF THE KIDNEYSObjectivesStructure of the KidneysGross AnatomyUltrastructure of the NephronUltrastructure of the GlomerulusUltrastructure of the Juxtaglomerular ApparatusInnervation of the KidneysSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 3GLOMERULAR FILTRATION AND RENAL BLOOD FLOWObjectivesRenal ClearanceGlomerular Filtration RateGlomerular FiltrationDeterminants of Ultrafiltrate CompositionDynamics of UltrafiltrationRenal Blood FlowRegulation of Renal Blood Flow and Glomerular Filtration RateSympathetic NervesAngiotensin IIProstaglandinsNitric OxideEndothelinBradykininAdenosineNatriuretic PeptidesAdenosine TriphosphateGlucocorticoidsHistamineDopamineSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 4RENAL TRANSPORT MECHANISMS: NaCl AND WATER ABSORPTION ALONG THE NEPHRONObjectivesGeneral Principles of Membrane TransportGeneral Principles of Transepithelial Solute and Water TransportNaCl, Solute, and Water Reabsorption Along the NephronProximal TubuleHenle's LoopDistal Tubule and Collecting DuctRegulation of NaCl and Water ReabsorptionSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 5REGULATION OF BODY FLUID OSMOLALITY: REGULATION OF WATER BALANCEObjectivesArginine VasopressinOsmotic Control of Arginine Vasopressin SecretionHemodynamic Control of Arginine Vasopressin SecretionArginine Vasopressin Actions on the KidneysThirstRenal Mechanisms for Dilution and Concentration of the UrineMedullary InterstitiumVasa Recta FunctionAssessment of Renal Diluting and Concentrating AbilitySummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 6REGULATION OF EXTRACELLULAR FLUID VOLUME AND NaCl BALANCEObjectivesWhole-Body Na+ BalanceConcept of Effective Circulating VolumeVolume-Sensing SystemsVolume Sensors in the Low-Pressure Cardiopulmonary CircuitVolume Sensors in the High-Pressure Arterial CircuitVolume Sensor SignalsRenal Sympathetic NervesRenin-Angiotensin-Aldosterone SystemNatriuretic PeptidesArginine VasopressinControl of Renal NaCl Excretion During EuvolemiaMechanisms for Maintaining Constant Na+ Delivery to the Distal Tubule in EuvolemiaRegulation of Distal Tubule and Collecting Duct Na+ Reabsorption in EuvolemiaControl of Na+ Excretion with Volume ExpansionControl of Na+ Excretion with Volume ContractionEdemaAlterations in Starling ForcesCapillary Hydrostatic Pressure (Pc)Plasma Oncotic Pressure (?c)Lymphatic ObstructionCapillary PermeabilityRole of the KidneysSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 7REGULATION OF POTASSIUM BALANCEObjectivesOverview of K+ HomeostasisRegulation of Plasma [K+]EpinephrineInsulinAldosteroneAlterations of Plasma [K+]Acid-Base BalancePlasma OsmolalityCell LysisExerciseK+ Excretion by the KidneysCellular Mechanisms of K+ Transport by Principal Cells and Intercalated Cells in the Distal Tubule and Collecting DuctRegulation of K+ Secretion by the Distal Tubule and Collecting DuctPlasma [K+]AldosteroneArginine VasopressinFactors that Perturb K+ ExcretionFlow of Tubular FluidAcid-Base BalanceGlucocorticoidsSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 8REGULATION OF ACID-BASE BALANCEObjectives?Buffer SystemOverview of Acid-Base BalanceRenal Net Acid Excretion?Reabsorption Along the NephronRegulation of H+ SecretionFormation of New Response to Acid-Base DisordersExtracellular and Intracellular BuffersRespiratory CompensationRenal CompensationSimple Acid-Base DisordersMetabolic AcidosisMetabolic AlkalosisRespiratory AcidosisRespiratory AlkalosisAnalysis of Acid-Base DisordersSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 9REGULATION OF CALCIUM AND PHOSPHATE HOMEOSTASISObjectivesCalciumOverview of Ca++ HomeostasisCa++ Transport Along the NephronRegulation of Urinary Ca++ ExcretionCalcium-Sensing ReceptorPhosphateOverview of Pi HomeostasisPi Transport Along the NephronRegulation of Urinary Pi ExcretionIntegrative Review of Parathyroid Hormone and Calcitriol on Ca++ and Pi HomeostasisSummaryKey Words and ConceptsSelf-Study ProblemsCHAPTER 10PHYSIOLOGY OF DIURETIC ACTIONObjectivesGeneral Principles of Diuretic ActionSites of Action of DiureticsResponse of Other Nephron SegmentsAdequate Delivery of Diuretics to Their Site of ActionVolume of the Extracellular FluidDiuretic Braking PhenomenonMechanisms of Action of DiureticsOsmotic DiureticsCarbonic Anhydrase InhibitorsLoop DiureticsThiazide DiureticsK+-Sparing DiureticsAquareticsEffect of Diuretics on the Excretion of Water and Other SolutesSolute-Free WaterK+ ExcretionHCO?ExcretionCa++ and Pi ExcretionSummaryKey Words and ConceptsSelf-Study Problems ADDITIONAL READING A P P E N D I X A INTEGRATIVE CASE STUDIES A P P E N D I X B NORMAL LABORATORY VALUESA P P E N D I X C NEPHRON FUNCTIONA P P E N D I X D ANSWERS TO SELF-STUDY PROBLEMSA P P E N D I X E ANSWERS TO INTEGRATIVE CASE STUDIES A P P E N D I X F REVIEW EXAMINATION APPENDIX G ANSWERS TO REVIEW EXAMINATIONINDEX