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Function of Kidney
Physiology / Renal / Functional Anatomy
Last Updated: 26th July 2024
Macroscopic Structure of the Kidney
Each kidney is surrounded by a fibrous renal capsule. Internally each kidney is divided into two main layers, the dark outer renal cortex and the inner lighter renal medulla made up of the renal pyramids. The cortex contains the glomerulus and proximal and distal tubules of the nephrons, whilst the loop of Henle and collecting ducts descend into the medulla.
The renal vessels, lymphatics and nerves enter the medial border of the kidney via the hilum.
The ureters arise from the renal pelvis and emerge from the hilum before continuing to the bladder.
Within the kidney, the outer border of the renal pelvis divides into two or three major calyces, each of which further subdivide into minor calyces, which are each indented by a renal papilla, the apex of the medullary pyramid, and it is here that the collecting ducts of the renal nephron empty the urine.
Macroscopic Structure of the Kidney. (Image by OpenStax College [CC BY 3.0 , via Wikimedia Commons)
Functions of the Kidney
The kidney is important for the following actions:
- Excretion of waste products and drugs in urine
- Regulation of body fluid and ionic composition
- Regulation of acid-base balance
- Metabolism of certain proteins e.g. insulin, PTH and calcitonin
- Hormone production
- Renin
- Activated vitamin D
- Erythropoietin
- Prostaglandins
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- Biochemistry
- Blood Gases
- Haematology
| Biochemistry | Normal Value |
|---|---|
| Sodium | 135 – 145 mmol/l |
| Potassium | 3.0 – 4.5 mmol/l |
| Urea | 2.5 – 7.5 mmol/l |
| Glucose | 3.5 – 5.0 mmol/l |
| Creatinine | 35 – 135 μmol/l |
| Alanine Aminotransferase (ALT) | 5 – 35 U/l |
| Gamma-glutamyl Transferase (GGT) | < 65 U/l |
| Alkaline Phosphatase (ALP) | 30 – 135 U/l |
| Aspartate Aminotransferase (AST) | < 40 U/l |
| Total Protein | 60 – 80 g/l |
| Albumin | 35 – 50 g/l |
| Globulin | 2.4 – 3.5 g/dl |
| Amylase | < 70 U/l |
| Total Bilirubin | 3 – 17 μmol/l |
| Calcium | 2.1 – 2.5 mmol/l |
| Chloride | 95 – 105 mmol/l |
| Phosphate | 0.8 – 1.4 mmol/l |
| Haematology | Normal Value |
|---|---|
| Haemoglobin | 11.5 – 16.6 g/dl |
| White Blood Cells | 4.0 – 11.0 x 109/l |
| Platelets | 150 – 450 x 109/l |
| MCV | 80 – 96 fl |
| MCHC | 32 – 36 g/dl |
| Neutrophils | 2.0 – 7.5 x 109/l |
| Lymphocytes | 1.5 – 4.0 x 109/l |
| Monocytes | 0.3 – 1.0 x 109/l |
| Eosinophils | 0.1 – 0.5 x 109/l |
| Basophils | < 0.2 x 109/l |
| Reticulocytes | < 2% |
| Haematocrit | 0.35 – 0.49 |
| Red Cell Distribution Width | 11 – 15% |
| Blood Gases | Normal Value |
|---|---|
| pH | 7.35 – 7.45 |
| pO2 | 11 – 14 kPa |
| pCO2 | 4.5 – 6.0 kPa |
| Base Excess | -2 – +2 mmol/l |
| Bicarbonate | 24 – 30 mmol/l |
| Lactate | < 2 mmol/l |
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