Kidney

 

The Kidney

The kidney is a retroperitoneal organ responsible for fluid balance, waste excretion, and endocrine function (renin, erythropoietin, vitamin D activation). The functional unit is the nephron.

Microscopic Structures

Structure Key Feature
Renal Corpuscle Glomerulus + Bowman’s capsule; site of blood filtration.
Proximal Tubule Simple cuboidal with prominent brush border (reabsorption).
Loop of Henle Concentrates urine via the countercurrent multiplier system.
Distal Tubule Lacks brush border; sensitive to aldosterone.

The Juxtaglomerular Apparatus (JGA)

The JGA is critical for blood pressure regulation and consists of three cell types:

  • Macula Densa: Specialized cells in the distal tubule that sense NaCl concentration.
  • Juxtaglomerular (JG) Cells: Modified smooth muscle cells in the afferent arteriole that secrete renin.
  • Extraglomerular Mesangial Cells: Provide structural/functional communication between the macula densa and JG cells.

High-Yield Exam Pearl:

The macula densa acts as a sensor: low NaCl delivery to the distal tubule (indicating low GFR/hypotension) triggers the release of renin from the JG cells, initiating the RAAS cascade to increase blood pressure.