The Kidney: a Designed System for Plasma Homeostasis
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Role of New Podocyte-Associated Proteins in the Renal Ultrafiltration Barrier
From the DEPARTMENT OF LABORATORY MEDICINE Karolinska Institutet, Stockholm, Sweden ROLE OF NEW PODOCYTE-ASSOCIATED PROTEINS IN THE RENAL ULTRAFILTRATION BARRIER Angelina Schwarz Stockholm 2019 All previously published papers were reproduced with permission from the publisher. Published by Karolinska Institutet. Printed by Universitetsservice US-AB 2019. © Angelina Schwarz, 2019 ISBN 978-91-7831-452-2 Cover: confocal microscopy image of a mouse glomerulus (front) and electron microscopy image of a podocyte (back) Role of new podocyte-associated proteins in the renal ultrafiltration barrier THESIS FOR DOCTORAL DEGREE (Ph.D.) By Angelina Schwarz Principal Supervisor: Opponent: Assoc. Prof. Jaakko Patrakka, MD, PhD Prof. Rachel Lennon, MD, PhD Karolinska Institutet University of Manchester Department of Laboratory Medicine School of Biological Sciences Division of Pathology/ICMC Division of Cell Matrix and Regenerative Medicine Co-supervisor(s): Lwaki Ebarasi, PhD Examination Board: Karolinska Institutet Assoc. Prof. Sergiu-Bogdan Catrina, MD, PhD Department of Laboratory Medicine Karolinska Institutet Division of Pathology/ICMC Department of Molecular Medicine and Surgery Division of Growth and Metabolism Mark Lal, PhD AstraZeneca Prof. Bengt Fellström, MD, PhD Bioscience, Cardiovascular, Renal and Uppsala University Metabolism, Innovative Medicines Biotech Unit Department of Medical Sciences Division of Nephrology Assoc. Prof. Taija Mäkinen, PhD Uppsala University Department of Immunology, Genetics and Pathology Division of Vascular Biology ABSTRACT Chronic kidney disease (CKD) is a major health problem and an economical burden affecting people worldwide. The main causes of CKD are diabetes and hypertension and patient numbers keep increasing. In many cases, CKD is progressive leading to end stage renal disease (ESRD), a condition that can be treated only through chronic dialysis or renal transplantation. -
Ward's Renal Lobule Model
Ward’s Renal Lobule Model 470029-444 1. Arcuate artery and vein. 7. Descending thick limb of 12. Collecting tubule. 2. Interlobular artery and vein. Henle's loop. 13. Papillary duct of Bellini. 3. Afferent glomerular arteriole. 8. Thin segment of Henle's 14. Vasa recta. loop. 4. Efferent glomerular arteriole. 15. Capillary bed of cortex (extends 9. Ascending thick limb of through entire cortex). 5. Renal corpuscle (glomerulus Henle's loop. plus Bowman's capsule). 10. Distal convoluted tubule. 16. Capillary bed of medulla (extends 6. Proximal convoluted tubule. 11. Arched connecting tubule. through entire medulla). MANY more banks of glomeruli occur in the cortex than are represented on the model, and the proportionate length of the medullary elements has been greatly reduced. The fundamental physiological unit of the kidney is the nephron, consisting of the glomerulus, Bowman's capsule, the proximal convoluted tubule, Henle's loop, and the distal convoluted tubule. The blood is filtered in the glomerulus, water and soluble substances, except blood proteins, passing into Bowman's capsule in the same proportions as they occur in the blood. In the proximal tubule water and certain useful substances are resorbed from the provisional urine, while some further components may be added to it by secretory activity on the part of the tubular epithelium. In the remainder of the tubule, resorption of certain substances is continued, while the urine is concentrated further by withdrawal of water. The finished urine flows through the collecting tubules without further change. Various kinds of loops occur, varying in length of the thin segment, and in the level to which they descend into the medulla. -
L25 Kidney2 to Post
Vert Phys PCB3743 Kidney 1 Fox Chapter 17 part 1 © T. Houpt, Ph.D. 1 Kidney Function Remove waste chemicals, while reabsorbing nutrients 1. Filter plasma from blood (including water & water-soluble nutrients) 2. Reabsorb Na+ : essential to maintain high extracellular [Na+] 3. Reabsorb H20 : essential to maintain body fluid volume 4. Reabsorb glucose and other nutrients 5. Reabsorb HCO3 / secrete H+ to maintain pH 2 Toxicity of Ammonia (NH3) 1. NH3 -> NH4+ very basic 2. NH3 is metabolic poison • Fish allow NH3 to diffuse into surrounding water • Birds & Reptiles convert NH3 to uric acid, which is not water soluble and is excreted in the feces. • Mammals convert NH3 to urea (CH4N2O), which is non-toxic and water soluble for excretion by kidney 1828: first organic synthesis: the production of urea without living tissue. → AgNCO + NH4Cl (NH2)2CO + AgCl 3 Krebs Cycle http://hyperphysics.phy-astr.gsu.edu/hbase/biology/tca.html 4 Too much ammonia removes a-ketoglutarate from Krebs cycle, so starves cells of ATP http://www.ucl.ac.uk/~ucbcdab/urea/amtox.htm 5 Urea - waste product of excess amino acid metabolism amino acid metabolism toxic! 2 liver ammonia + CO 6 Chapter 17: Anatomy of the Kidney Kidney Function Filter excess and waste chemicals (water soluble) from the blood. (excess water, Na+, urea, glucose > 200 mg/100ml) Kidney Structures cortex (bark): reddish brown, lots of capillaries medulla (inner region): striped with capillaries & collecting ducts; divided into renal pyramids urine -> collecting ducts -> minor calyces -> major calyces calyx; calyces -> renal pelvis-> ureters -> urinary bladder -> urethra “cup” high surface area for exchange, then to storage and outside ren- Latin for kidney nephro- Greek for kidney -uria - problem with urine, e.g. -
The Distal Convoluted Tubule and Collecting Duct
Chapter 23 *Lecture PowerPoint The Urinary System *See separate FlexArt PowerPoint slides for all figures and tables preinserted into PowerPoint without notes. Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Introduction • Urinary system rids the body of waste products. • The urinary system is closely associated with the reproductive system – Shared embryonic development and adult anatomical relationship – Collectively called the urogenital (UG) system 23-2 Functions of the Urinary System • Expected Learning Outcomes – Name and locate the organs of the urinary system. – List several functions of the kidneys in addition to urine formation. – Name the major nitrogenous wastes and identify their sources. – Define excretion and identify the systems that excrete wastes. 23-3 Functions of the Urinary System Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Diaphragm 11th and 12th ribs Adrenal gland Renal artery Renal vein Kidney Vertebra L2 Aorta Inferior vena cava Ureter Urinary bladder Urethra Figure 23.1a,b (a) Anterior view (b) Posterior view • Urinary system consists of six organs: two kidneys, two ureters, urinary bladder, and urethra 23-4 Functions of the Kidneys • Filters blood plasma, separates waste from useful chemicals, returns useful substances to blood, eliminates wastes • Regulate blood volume and pressure by eliminating or conserving water • Regulate the osmolarity of the body fluids by controlling the relative amounts of water and solutes -
Pecularities of Renal Blood Flow
4.3. Peculiarities of renal blood flow 263 and endoplasmic reticulum and secretory granules. physiologic capacity is variable, it varies about Some of these granules are considered to be specific 300 ml. The urinary bladder wall consists of three secretory granules containing renin the other gran- muscle coats, the lining of a superfiacial layer of flat ules do not contain renin, but it is suggested, that cells, and a deep layer of cuboid cells. In the region renin could be deposited in these cells in a non gran- of trigonum vesicae urinariae is an inner sfincter. ular form. The man urethra is divisible into three portions: In the juxtaglomerular triangle cells called lacis prostatic, membranous and cavernous. The female cells occur designated also as extraglomerular mesan- urethra is short. It’s lining consists of pavement ep- gial, or Goormaghtig’s cells. They have numerous ithelium. microvilli forming a fine network. The interstitium consists of cells and cell-free sub- stance. Interstitial cells resemble in their struc- ture to fibroblasts. They contain lipoid drops of prostaglandin precursors and a system of fibrils, 4.3 Peculiarities of renal probably identical with elastic fibrils. The thicker fibres cross the juxtaglomerular cells entering the blood flow Bowman’s capsule and the podocytes. 4.2.2 The urinary outflow tract Concerning the blood flow the kidneys are exep- Urine from collecting ducts is excreted into the renal tional organs. The peculiarity of renal haemody- pelvis, passing calyces renales minores et maiores. namics is a consequence of the fact, that the kid- From the renal pelvis is the urine transported into neys have 100 times greater blood flow than other the urinary bladder by the contractive activity of organs and tissues in human organism. -
Vascular Heterogeneity in the Kidney
Vascular Heterogeneity in the Kidney Grietje Molema, PhD,*,‡ and William C. Aird, MD*,§ Summary: Blood vessels and their endothelial lining are uniquely adapted to the needs of the underlying tissue. The structure and function of the vasculature varies both between and within different organs. In the kidney, the vascular architecture is designed to function both in oxygen/nutrient delivery and filtration of blood according to the homeostatic needs of the body. Here, we review spatial and temporal differences in renal vascular phenotypes in both health and disease. Semin Nephrol 32:145-155 © 2012 Published by Elsevier Inc. Keywords: Kidney, vasculature, endothelial cells, heterogeneity he blood vasculature has evolved to meet the kidney is configured not only to deliver oxygen and diverse needs of body tissues. As a result, the nutrients, but also to process blood for filtration. As a Tstructure and function of blood vessels and their result, renal blood flow is much greater than that which endothelial lining show remarkable heterogeneity both would be necessary to meet the metabolic demands of between and within different organs (reviewed by the organ: the kidneys comprise less than 1% of body Aird1,2). In most organs, blood vessels are organized in weight, but receive 25% of the cardiac output (re- prototypic series: arteries serve as conduits for bulk flow viewed by Evans et al3). Renal blood flow is five times delivery of blood; arterioles regulate resistance and thus that of basal coronary artery blood flow, yet renal blood flow; capillaries -
Aandp2ch23lecture.Pdf
Chapter 23 Lecture Outline See separate PowerPoint slides for all figures and tables pre- inserted into PowerPoint without notes. Copyright © McGraw-Hill Education. Permission required for reproduction or display. 1 Introduction • Urinary system rids the body of waste products • Kidneys also play important roles in blood volume, pressure, and composition • The urinary system is closely associated with the reproductive system – Shared embryonic development and adult anatomical relationship – Collectively called the urogenital (UG) system 23-2 Functions of the Urinary System • Expected Learning Outcomes – Name and locate the organs of the urinary system. – List several functions of the kidneys in addition to urine formation. – Name the major nitrogenous wastes and identify their sources. – Define excretion and identify the systems that excrete wastes. 23-3 Functions of the Urinary System Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. Diaphragm 11th and 12th ribs Adrenal gland Renal artery Renal vein Kidney Vertebra L2 Aorta Inferior vena cava Ureter Urinary bladder Urethra Figure 23.1a,b (a) Anterior view (b) Posterior view • Urinary system consists of six organs: two kidneys, two ureters, urinary bladder, and urethra 23-4 Functions of the Kidneys • Filter blood plasma, excrete toxic wastes • Regulate blood volume, pressure, and osmolarity • Regulate electrolytes and acid-base balance • Secrete erythropoietin, which stimulates the production of red blood cells • Help regulate calcium levels by participating in calcitriol synthesis • Clear hormones from blood • Detoxify free radicals • In starvation, they synthesize glucose from amino acids 23-5 Retroperitoneal Position of the Kidney Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. -
The Urinary System Part
Dr. A. K.Goudarzi, D.V.M. Ph.D Faculty of Veterinary Medicine Department of Basic Sciences Renal cortex Renal Renal pyramid medulla Renal pelvis Renal Ureter Renal artery vein Inferior Kidney vena cava Aorta Urinary Ureter bladder Urethra Urinary system Organ system that produces, stores, and carries urine Includes two kidneys, two ureters, the urinary bladder, two sphincter muscles, and the urethra. Humans produce about 1.5 liters of urine over 24 hours, although this amount may vary according to the circumstances. Increased fluid intake generally increases urine production. Increased perspiration and respiration may decrease the amount of fluid excreted through the kidneys. Some medications interfere directly or indirectly with urine production, such as diuretics. Function of urinary system Excretion Keeping homeostasis Keeping acid-base balance Secretion (rennin, kallikrein, erytropoetin) Excreted products: Product of the metabolism Water Hormones Vitamins Toxic substances Function of urinary system Other functions : maintaining the proper osmolarity of body fluids maintaining proper plasma volume helping to maintain proper acid-base balance excreting wastes of body metabolism excreting many foreign compounds producing erythropoietin and renin converting vitamin D to an active form Function of kidney Each kidney is supplied by a renal artery and renal vein. The kidney acts on the blood plasma flowing through it. As urine is formed, it drains into the renal pelvis and is channeled into the ureter. The urine -
Activation of the Renin-Angiotensin System and Chronic Hypoxia of the Kidney
175 Hypertens Res Vol.31 (2008) No.2 p.175-184 Review Activation of the Renin-Angiotensin System and Chronic Hypoxia of the Kidney Masaomi NANGAKU1) and Toshiro FUJITA1) Recent studies emphasize the role of chronic hypoxia in the kidney as a final common pathway to end-stage renal failure (ESRD). Hypoxia of tubular cells leads to apoptosis or epithelial-mesenchymal transdifferenti- ation, which in turn exacerbates the fibrosis of the kidney with the loss of peritubular capillaries and sub- sequent chronic hypoxia, setting in train a vicious cycle whose end-point is ESRD. While fibrotic kidneys in an advanced stage of renal disease are devoid of peritubular capillary blood supply and oxygenation to the corresponding region, imbalances in vasoactive substances can cause chronic hypoxia even in the early phase of kidney disease. Among various vasoactive substances, local activation of the renin-angiotensin system (RAS) is particularly important because it can lead to the constriction of efferent arterioles, hypo- perfusion of postglomerular peritubular capillaries, and subsequent hypoxia of the tubulointerstitium in the downstream compartment. In addition, angiotensin II induces oxidative stress via the activation of NADPH oxidase. Oxidative stress damages endothelial cells directly, causing the loss of peritubular capillaries, and also results in relative hypoxia due to inefficient cellular respiration. Thus, angiotensin II induces renal hypoxia via both hemodynamic and nonhemodynamic mechanisms. In the past two decades, considerable gains have been realized in retarding the progression of chronic kidney disease by emphasizing blood pres- sure control and blockade of the RAS. Chronic hypoxia in the kidney is an ideal therapeutic target, and the beneficial effects of blockade of RAS in kidney disease are, at least in part, mediated by the amelioration of local hypoxia. -
URINARY SYSTEM ANATOMY Metabolism of Nutrients by the Body
URINARY SYSTEM ANATOMY Adapted from Human Anatomy & Physiology – Marieb and Hoehn (9th ed.) OVERVIEW Metabolism of nutrients by the body produces wastes that must be removed from the body. Although excretory processes involve several organ systems (e.g., lungs excrete carbon dioxide), it is mainly the urinary system that removes nitrogenous wastes from the body. The urinary system is also responsible for maintaining the electrolyte, acid-base, and fluid balances of the blood and is thus a major, if not the major, homeostatic organ system of the body. The primary organs in the urinary system are the paired kidneys (Figure 1). To properly do their job, the kidneys act first as blood “filters”, and then as blood “processors”. They allow toxins, metabolic wastes, and excess ions to leave the body in the urine, while retaining needed substances and returning them to the blood. In addition to the kidneys, the urinary system also includes the ureters, which transport the urine from the paired kidneys to the urinary bladder where it is collected and stored. Once the bladder is full, the urine exits the body via the urethra. Figure 1: Major organs of the urinary system. Marieb & Hoehn (Human Anatomy and Physiology, 9th ed.) – Figure 25.1 BI 336 – Advanced Human Anatomy and Physiology Western Oregon University FUNCTIONAL ANATOMY Kidney The paired kidneys lie in a retroperitoneal position (between the dorsal body wall and the parietal peritoneum) in the superior lumbar region. Extending approximately from T12 to L3, the kidneys receive some protection from the lower part of the rib cage. The right kidney is slightly lower than the left kidney because it is “crowded” by the liver. -
Unit 4: Excretion; Structure of Nephron, Mechanism of Urine Formation, Counter-Current Mechanism
CBCS THIRD SEM GENERAL UNIT 4: EXCRETION; STRUCTURE OF NEPHRON, MECHANISM OF URINE FORMATION, COUNTER-CURRENT MECHANISM By: Dr. Luna Phukan Excretion is a process by which metabolic waste is eliminated from an organism. In vertebrates this is primarily carried out by the lungs, kidneys and skin. This is in contrast with secretion, where the substance may have specific tasks after leaving the cell. Excretion is an essential process in all forms of life. For example, in mammals urine is expelled through the urethra, which is part of the excretory system. In unicellular organisms, waste products are discharged directly through the surface of the cell. In animals, the main excretory products are carbon dioxide, ammonia (in ammoniotelics), urea (in ureotelics), uric acid (in uricotelics), guanine (in Arachnida) and creatine. The liver and kidneys clear many substances from the blood (for example, in renal excretion), and the cleared substances are then excreted from the body in the urine and feces. Structure of Nephron. , The nephron is the functional unit of the kidney. This means that each separate nephron is where the main work of the kidney is performed. A nephron is made of two parts: 1.a renal corpuscle, which is the initial filtering component, and The renal corpuscle consists of a tuft of capillaries called a glomerulus and an encompassing Bowman's capsule 2.a renal tubule that processes and carries away the filtered fluid. Renal corpuscle The renal corpuscle is the site of the filtration of blood plasma. The renal corpuscle consists of the glomerulus, and the glomerular capsule or Bowman's capsule. -
Can the Dogs. Preliminary Partial Or Complete Curred Despite Functioning
426 CLUTE AND FITZGERALD: ELECTROSHOCK THERAPY [Canad.OM. A.J of thrombosis than is the suture method. REFERENCES 1. GRANT, J. C. B.: A Method of Anatomy, Wm. Wood Suture anastomosis is associated with more & Co., p. 404, 1939. 2. ROBERTS, J. T., BROWN, R. S. AND ROBERTS, G.: dissection and trauma which increases the Federation Proc., 2: 90, 1943. 3. ADRIO, M.: Medico-Chirurgicale, 15: 559, 1938. incidence of thrombosis. End-to-end right 4. BECK, C. S., STANTON, E., BATINCHOK, W. AND LEITER, E.: J. Am. M. Ass., 137: 436, 1948. common carotid to coronary sinus one week 5. BLUM, L. AND GROSS, L.: J. Thoracic Surg., 5: 522, 1937. after sinus ligation, at the moment, seems to be 6. SHANER, R. F.: Personal Communication. 7. BLALOCK, A. AND JOHNS, T.: Personal Communication. the most satisfactory method. 8. ROBERTSON, H. F.: Surgery, 9: 1, 1941. 9. OTTo, J. L.: Am. Heart J., 4: 64, 1928. 10. GROSS, L., BLUM, L. AND SILVERMAN, G.: J. Exper. The frequency and severity of left ventricu- Med., 65: 1, 91, 1937. 11. GREGG, D. E. AND SHIPLEY, R. E.: Am. J. Physiol., lar ecchymosis is a major obstacle if this pro- 151: 13, 1947. 12. ROBERTS, J. T., SPENCER, F. D. AND BROWNE, R. S.: cedure is to be applied to the human heart. It Federation Proc., 2: 90, 1943. may be that the human cardiac veins can 13. HALPERT, B.: Heart, 15: 129, 1930. tolerate sudden arterial pressure better than can the dogs. Preliminary partial or complete sinus occlusion may prepare the cardiac veins ANURIA FOLLOWING ELECTROSHOCK for blood under arterial pressure.