ALL ABOUT OUR KIDNEYS

Useful links:Life with a single kidneyandHow to look after your kidneysWe can live quite well with only one kidney and some people live a healthy life even though born with one missing. But while bones can break, muscles can waste away and the brain can sleep without risk to life, if both of your kidneys fail, as happens in end stage kidney failure, bone, muscle or brain can not carry on.How do our kidneys work?Think of your kidneys as an extremely sophisticated, waste disposal system, which sorts non-recyclable waste from recyclable waste, 24 hours a day, 7 days a week, while also cleaning your blood.Much of this waste is produced by the body as it processes the food you eat.KidneyEd TVOur video collections of videos on YouTube, which have been grouped into playlists, to learn more about the kidneys and the urinary system and other related topics. Start with the video belowand later you canview a wide rangeof reviewed kidney health education videos on our profileKidneyHealthAus - on YouTube.Without any kidney function our body dies.Some kidney function is essential for life!Most people are born with two kidneys, each one about the size of an adult fist, arebean-shaped and weigh around 150 grams each.The kidneys are located at both sides of your backbonejust under the rib cage or above the small of your back. They are protected from injury by a large padding of fat, your lower ribs and several muscles.What do your kidneys do?Our kidneys are small biological marvels with a fascinating design. Healthy kidneys act like a filter to make sure the right amount of wastes and fluids are removed. Every hour your blood supply circulates through the kidneys about 12 times. Each day your kidneys process around 200 litres of blood, with around 1 to 2 litres of waste leaving the body as urine. Our kidneys make three important hormones, erythropoietin, renin and active vitamin D. Erythropoietin stimulates the production of red blood cells, renin is involved in the control of blood pressure and active vitamin D controls calcium uptake and helps make strong bones.What is the role of your kidneys in keeping you healthy?For organs so small, your kidneys works hard - they have a number of vital roles to play in the daily functions of our body, as they: act as filters for your body to clean blood of wastes, yet retain essential elements needed by the body they keep the proper balance of salts and acids in the body, and produce hormones and enzymes which help to: control your blood pressure help to keep your internal water balance make red blood cells and help maintain your blood composition and pH levels maintain strong and healthy bones and help to keep mineral balanceYour kidneys are master chemists of the body,intervene inmany processes and balances inthe body and control many vital body functions.The major role of the kidneys is to remove waste from the blood and eliminate it in the urine.To remove this waste and extra water, blood enters the kidney through the renal artery; blood is then cleaned in the kidney as it passes through tiny filters called nephrons.The nephrons are the basic working units of the kidneys, controlling the formation of urine. One kidney contains about one million nephrons, and each nephron contains a filtering apparatus called a glomerulus.Anatomy of the kidneysWe have about a million hairpin-like glomeruli at birth, but lose about 100,000 of these every decade of life. Droplets of filtered blood pass through a number of tubules (tiny tubes) into the medulla, a central collecting region.The glomeruli and tubules together make up nephrons, long and extremely fine tubes which, if connected, would run for 80 kilometres (50 miles).Cleaned blood returns to the body by the renal vein. Waste and extra water removed by the kidney passes through a tube called the ureter to the bladder, where it is stored as urine or wee.When the bladder is full, urine passes out of the body through another tube called the urethra.The process of removing waste and extra water in simple terms is: food and drink enters the stomach and are broken down into nutrients solid waste products are removed and nutrients enter the bloodstream. nutrients are used by the body for energy, growth, repair and maintenance of body functions. this process creates waste which is removed by the kidneys. extra nutrients not immediately needed by the body are also removed by the kidneys. waste products and extra water move from the kidneys to the bladder, then leave the body as urineThe kidneys are designed to last a life-time. They do an amazing job! It is important tocare for them.We recommend these kidney education tools below for a visual introduction to the kidney. Click on either diagram to view animated presentationsonhow our kidneys workandhow dialysis worksto replace the work of healthy kidneys. Diagram of how a healthy kidney worksStructure of the kidneys and bladderKidney Health Australia acknowledges the generosity ofDaVita(USA) for allowing us to use these images and host their excellent teaching resource (flash animation) on our website.

WHAT CAN GO WRONG WITH THE KIDNEYS?Most kidney diseases attack the nephrons. Sometimes kidney failure can happen quickly, caused for example by a sudden loss of large amounts of blood or an accident. A sudden drop in kidney function is called Acute Kidney Failure and is often short lived, but can occasionally lead to lasting kidney damage. More often kidney function worsens over a number of years.This is actually good news, because if kidney disease is found early, medication, dietary and lifestyle changes can increase the life of your kidneys and keep you feeling your best for as long as possible.Kidney disease progression can also be slowed with medicines which help to protect your kidneys.Your GP can prescribe these medicines for your, which are available through your local pharmacist.Take the test atCheck My Kidneysto find out if you are at increased risk of kidney diseaseWhat does Chronic Kidney Disease mean?If you lose over 1/3 of your kidney function for over 3 months, it is calledChronic Kidney Disease or CKD. Sometimes kidney disease leads to kidney failure, which requires dialysis or a kidney transplant to keep you alive. Early detection and treatment can help prevent kidney failure and the need for dialysis or transplant treatment.If you are diagnosed with CKD, this means thatyour kidneys have been damaged and are not working as well as they should normally. Kidney disease is called a silent diseaseas there are often no warnings. It is not uncommon for people to lose up to 90% of their kidney function before getting any symptoms. People can live a near normal life with as little as 20 percent of their total kidney function. Whensymptoms do occur the initial signs may be general, such as feeling tired or generalised itching. As kidney disease progresses, symptoms can include changes in the urine (reduced volume, discolouration, blood or pus), nausea and vomiting and appetite loss. Other symptoms include swollen or numb hands and feet (because of water retention), weakness and lethargy, darkened skin and muscle cramps. About 50 people a day die of a kidney related disease.How do you know if you have CKD?In most cases CKD does not cause any symptoms and is detected because a testhas shown an abnormality. It may be a urine test for blood or protein; an X-ray or scan of the kidneys; or a blood test to measure kidney function. Most cases are discovered by your GP as part of normal care.How common is CKD?1 in 9 Australians over age 25 years have at least one clinical sign of existing CKD, such as reduced kidney function or evidence of kidney damage. It is less common in young adults. In the older person it is more common due to the natural aging of the kidneys. A number of diseases can damage the kidneys such as diabetes, hypertension (high blood pressure) and some inherited conditions. Almost all of these will damage both kidneys at the same time.Go to ourFast Facts on CKDwebpage for more statsUseful links:Kidney Disease: Are you one in three?KHAKidney Health Resourcesincludingsimplified translated versionsKHA webpages:Your heart and CKDandDiabetes and CKDUrinary tract infections(also known as UTIs)A UTI should betreated promptly as akidney infection is serious. It is important to see a doctor if a kidney infection or kidney stones are suspected because lasting damage or even kidney failure can occur if these conditions are left untreated. Infection which has spread from cystitis or pyelonephritis can be life threatening.

WHY DO KIDNEYS FAIL?Inside each kidney there are about one million tiny units called nephrons which filterblood as it passes through each nephron andwater and waste products are removed. Most of the water returns to the blood, the waste products collect in the bladder then leave the body as urine (wee).

'A closer look at kidney disease'Professor Alan CassThe George Institute - Renal and Metabolic Division

What can I do to keep my kidneys healthy?Key recommendations to staying healthy and keeping your kidneys healthy as wellare: keep your blood pressure below 130/90 and maintain healthy levels of cholesterol its important to have your cholesterol levels checked regularly - the recommended level is no higher than 5.5 mmol/litres lead a healthy lifestyle and maintain healthy weight, be active for more than 30 minutes most days eat a balanced healthy diet low in saturated fats become a non smoker if you have diabetes make sure you actively treat your blood glucose levels- normal levels are 4-6 mmol/L before meals and 4-8 mmol/L two-hours after mealsHealthy EatingThe food you eat plays a huge role in the health and well being of your body. As well as providing the body with a variety of nutrients,food choicescan also help in weight reduction and weight control. eat healthy foods -with asmanyfresh ingredients as possible. don't over eat - always leave a meal feeling like you could eat a little bit more. eat breakfast - a good breakfast activates your metabolism first thing in the morning. avoid fad diets - they are hard to maintain over a long period and can create or worsen ill health. check nutrition panelsonall parcelled foods you buy- choose only foodsthat lista low percentage of sugar and salt and are low in saturated fats -find out about food ingredients.To satisfy thirst - drink water instead!Drink plenty of fluids - but choose todrink water instead!Water is the recommended choice, it is also calorie-free, inexpensive and readily available. Sugar drinks have lots of calories, while caffeine and alcohol are both diuretics and can leave the body dehydrated.Research also states that one drink containing sugar each day, has been shown in females to be associated with an 80 % increase in the risk of acquiring diabetes.

Note: Bottled mineral water contains salt which can lead to fluid retention and even increased blood pressure in susceptible people. Check the label and choose low sodium varieties (less than 30mg sodium per 100ml).Losing weight can reduce how hard your kidneys need to workWeight loss can also lead to a decrease in the amount of protein lost via urine. High levels of protein in the urine can make your kidney function worse. Obesity may also cause some people with existing forms of some kidney disease to loose their kidney function more rapidly. There is also evidence to suggest excess weight is also associated with an increased risk of kidney cancer. If you are overweight, you have an increased risk of developingdiabetesandhigh blood pressure- both are major risk factors for kidney disease. Losing as little as 5 kilograms reduces blood pressure in most people who are 10% above a healthy weight.Do at least 30 minutes of physical activity most days of the weekStay fit. The key is to start slowly and gradually increase time and intensity of activities. Physical activity leads to increased strength, stamina and energy. You can break down any activity into 3 x 10 minute bursts, which can be increased as fitness improves.STOP exercisingwithout delay,tell your health care team or go to hospital if you:- have chest pain or pressure- feel dizzy or light headed- have an irregular or fast heart beat that persists when the activity is completed- have excessive shortness of breathUseful weblink:Measure Up and CKDfor tips on a healthy lifeBe or remain a non-smokerIt is well known smoking harms your health and greatly increases your risk of developing many chronic conditions. Smoking causes narrowing of the arteries, including small vessels that are in the filter in sections of your kidney, and reduces the ability of the kidneys to work properly. Smoking has been linked to cancer of the kidneys, the bladder and ureter (the small tubes that run from your kidneys to the bladder). The message is clear: don't smoke. If you do smoke, giving up is one of the best things you can do to keep your kidneys healthier.Order a free QUIT pack - call the QUIT Hotline 137 848Don't drink too much alcoholBe smart about your alcohol intake. While some studies show alcohol causes no harm to the kidneys, it may be dangerous if you already have kidney problems. Alcohol makes your kidney produce more urine than normal, and excessive drinking can have a negative impact on other parts of the body that may contribute to kidney damage, such as the liver. To avoid dehydration caused by more frequent urination, ensure you alternate between alcoholic and non-alcoholic drinks. A glass of water is of course the ideal choice here.There have been studies that have shown that heavy drinking may contribute to high blood pressure and heart disease, which over time may contribute to kidney disease. Alcohol has a high sugar content and therefore may lead to weight gain, another risk factor for kidney disease.

How many alcoholic drinks can you have without it affecting your kidneys?There is evidence to suggest that one standard drink for women and the elderly (e.g.100ml wine; 285ml full strength beer; 30 ml spirit) or two standard drinks for men, three to four times a week, may have a positive health effect.Useful link:Australian guidelines to reduce health risks from drinking alcoholQuick links:Fact Sheets>-Recommended weblinks-Organ Donation

22 June2013 - Disclaimer: Information provided is intended as an introduction to this topic and not meant to substitute for your doctor's or health professional's advice. All care is taken to ensure this information is relevant and applicable to each Australian state. Kidney Health Australia recognises each person's experience is individual and variations do occur in treatment and management due to personal circumstances. Consult a healthcare professional for specific treatment recommendations.If concerned your medication may be affecting your health, refertoABC Health Consumer Guidesorcheck withMedicines Line1300 MEDICINE (1300 633 424) forindependent pharmacist advice on prescriptions, over-the-counter, and complementary (herbal / natural / vitamin / mineral) medicines.

KidneyFrom Wikipedia, the free encyclopediaFor other uses, seeKidney (disambiguation).Kidney

Human kidneys viewed from behind withspineremoved

LatinRen (Greek: nephros)

SystemUrinary systemandendocrine system

ArteryRenal artery

VeinRenal vein

NerveRenal plexus

MeSHKidney

Dorlands/ElsevierKidney

Thekidneysareorgansthat serve several essential regulatory roles in mostanimals, includingvertebratesand someinvertebrates. They are essential in theurinary systemand also servehomeostaticfunctions such as the regulation ofelectrolytes, maintenance ofacidbase balance, and regulation ofblood pressure(via maintaining salt and water balance). They serve the body as a natural filter of theblood, and remove wastes which are diverted to theurinary bladder. In producingurine, the kidneys excrete wastes such asureaandammonium, and they are also responsible for the reabsorption ofwater,glucose, andamino acids. The kidneys also producehormonesincludingcalcitriol,erythropoietin, and the enzymerenin.Located at the rear of theabdominal cavityin theretroperitoneum, the kidneys receive blood from the pairedrenal arteries, and drain into the pairedrenal veins. Each kidney excretes urine into aureter, itself a paired structure that empties into theurinary bladder.Renal physiologyis the study of kidney function, whilenephrologyis the medical specialty concerned withkidney diseases. Diseases of the kidney are diverse, but individuals with kidney disease frequently display characteristic clinical features. Common clinical conditions involving the kidney include thenephriticandnephrotic syndromes,renal cysts,acute kidney injury,chronic kidney disease,urinary tract infection,nephrolithiasis, andurinary tract obstruction.[1]Various cancers of the kidney exist; the most common adult renal cancer isrenal cell carcinoma. Cancers, cysts, and some other renal conditions can be managed with removal of the kidney, ornephrectomy. When renal function, measured byglomerular filtration rate, is persistently poor,dialysisandkidney transplantationmay be treatment options. Although they are not severely harmful,kidney stonescan be painful and a nuisance. The removal of kidney stones involvesultrasoundtreatment to break up the stones into smaller pieces, which are then passed through the urinary tract. One common symptom of kidney stones is a sharp pain in the medial/lateral segments of the lower back.Contents[hide] 1Anatomy 1.1Location 1.2Structure 1.3Blood supply 1.4Histology 1.5Innervation 2Functions 2.1Excretion of wastes 2.2Reabsorption of vital nutrients 2.3Acid-base homeostasis 2.4Osmolality regulation 2.5Blood pressure regulation 2.6Hormone secretion 3Development 4Evolutionary adaptation 5Related terms 6Diseases and disorders 6.1Congenital 6.2Acquired 6.3Diagnosis 6.3.1Clinical 6.3.2Laboratory 6.3.3Imaging studies 6.3.4Renal biopsy 7Calculations 7.1Filtration Fraction 7.2Renal Clearance 8In other animals 9History 10Kidneys as food 11See also 12Additional Images 13References 14External linksAnatomy[edit source|editbeta]Location[edit source|editbeta]

Surface projections of the organs of thetrunk, showing kidneys at the level of T12 to L2.

A CT scan in which the kidneys are shown

In humans the kidneys are located in theabdominal cavity, more specifically in the paravertebral gutter and lie in aretroperitonealposition at a slightly oblique angle. There are two kidneys. One is on each side of the spine.[2]The asymmetry within the abdominal cavity caused by thelivertypically results in the right kidney being slightly lower than the left, and left kidney being located slightly more medial than the right.[3][4]The left kidney is approximately at the vertebral level T12 to L3,[5]and the right slightly lower. The right kidney sits just below thediaphragmand posterior to theliver, the left below the diaphragm and posterior to thespleen. Resting on top of each kidney is anadrenal gland. The upper (cranial) parts of the kidneys are partially protected by the eleventh and twelfthribs, and each whole kidney and adrenal gland are surrounded by two layers of fat (the perirenal and pararenal fat) and therenal fascia. Each adult kidney weighs between 125 and 170grams in males and between 115 and 155grams in females.[6]The left kidney is usually slightly larger than the right kidney.[7]Structure[edit source|editbeta]

1.Renal pyramid 2.Interlobular artery 3.Renal artery 4.Renal vein5.Renal hilum 6.Renal pelvis 7.Ureter 8.Minor calyx 9.Renal capsule 10.Inferior renal capsule 11.Superior renal capsule 12.Interlobular vein 13.Nephron 14.Minor calyx 15.Major calyx 16.Renal papilla17.Renal columnThe kidney has abean-shaped structure; each kidney has aconvexandconcavesurface. The concave surface, therenal hilum, is the point at which therenal arteryenters the organ, and therenal veinandureterleave. The kidney is surrounded by tough fibrous tissue, therenal capsule, which is itself surrounded byperinephric fat,renal fascia(ofGerota) andparanephric fat. The anterior (front) border of these tissues is theperitoneum, while the posterior (rear) border is thetransversalis fascia.The superior border of the right kidney is adjacent to the liver; and thespleen, for the left kidney. Therefore, both move down on inhalation.The kidney is approximately 1114cm in length, 6cm wide and 4cm thick.The substance, orparenchyma, of the kidney is divided into two major structures: superficial is therenal cortexand deep is therenal medulla. Grossly, these structures take the shape of 8 to 18 cone-shapedrenal lobes, each containing renal cortex surrounding a portion of medulla called arenal pyramid(ofMalpighi).[6]Between the renal pyramids are projections of cortex calledrenal columns(ofBertin).Nephrons, the urine-producing functional structures of the kidney, span the cortex and medulla. The initial filtering portion of a nephron is therenal corpuscle, located in the cortex, which is followed by arenal tubulethat passes from the cortex deep into the medullary pyramids. Part of the renal cortex, amedullary rayis a collection of renal tubules that drain into a singlecollecting duct.The tip, orpapilla, of each pyramid empties urine into aminor calyx; minor calyces empty intomajor calyces, and major calyces empty into therenal pelvis, which becomes the ureter. At the hilum, the ureter and renal vein exit the kidney while the renal artery enters. Surrounding these structures is hilar fat and lymphatic tissue with lymph nodes. The hilar fat is contiguous with a fat-filled cavity called therenal sinus. The renal sinus collectively contains the renal pelvis and calyces and separates these structures from the renal medullary tissue.[8]Blood supply[edit source|editbeta]

3D-renderedcomputed tomography, showing renal arteries and veins.The kidneys receive blood from therenal arteries, left and right, which branch directly from theabdominal aorta. Despite their relatively small size, the kidneys receive approximately 20% of thecardiac output.[6]Each renal artery branches into segmental arteries, dividing further intointerlobar arterieswhich penetrate the renal capsule and extend through the renal columns between the renal pyramids. The interlobar arteries then supply blood to thearcuate arteriesthat run through the boundary of the cortex and the medulla. Each arcuate artery supplies severalinterlobulararteries that feed into theafferent arteriolesthat supply theglomeruli.Theinterstitiumis the functional space in the kidney beneath the individual filters (glomeruli) which are rich inblood vessels. The interstitum absorbs fluid recovered fromurine. Various conditions can lead toscarringandcongestionof this area, which can cause kidney dysfunction and failure.After filtration occurs the blood moves through a small network of venules that converge into interlobular veins. As with the arteriole distribution the veins follow the same pattern, the interlobular provide blood to the arcuate veins then back to the interlobar veins which come to form the renal vein exiting the kidney for transfusion for blood.Histology[edit source|editbeta]

Microscopic photograph of therenal medulla

Microscopic photograph of therenal cortexRenalhistologystudies the structure of the kidney as viewed under amicroscope. Various distinctcell typesoccur in the kidney, including: Kidney glomerulus parietal cell Kidney glomerulus podocyte Kidney proximal tubule brush border cell Loop of Henle thin segment cell Thick ascending limbcell Kidney distal tubule cell Kidney collecting duct cell Interstitial kidney cells Renal arteries and their branchesThe renal artery enters into the kidney at the level of first lumbar vertebra just below the superior mesenteric artery. As it enters the kidney it divides into branches: first the segmental artery, which divides into 2 or 3 lobar arteries, then further divides into interlobar arteries, which further divide into the arcuate artery which leads into the interlobular artery, which form afferent arterioles. The afferent arterioles form the glomerulus (network of capillaries closed in Bowman's capsule). From here, efferent arterioles leaves the glomerulus and divide into peritubular capillaries, which drain into the interlobular veins and then into arcuate vein and then into interlobar vein, which runs into lobar vein, which opens into the segmental vein and which drains into the renal vein, and then from it blood moves into the inferior vena cava.Innervation[edit source|editbeta]The kidney andnervous systemcommunicate via therenal plexus, whose fibers course along the renal arteries to reach each kidney.[9]Input from thesympathetic nervous systemtriggersvasoconstrictionin the kidney, thereby reducingrenal blood flow.[9]The kidney also receives input from theparasympathetic nervous system, by way of the renal branches of the vagus nerve (cranial nerve X); the function of this is yet unclear.[9][10]Sensory input from the kidney travels to the T10-11 levels of thespinal cordand is sensed in the correspondingdermatome.[9]Thus, pain in the flank region may be referred from corresponding kidney.[9]Functions[edit source|editbeta]Main article:Renal physiologyThe kidney participates in whole-bodyhomeostasis, regulatingacid-base balance,electrolyteconcentrations,extracellular fluid volume, and regulation ofblood pressure. The kidney accomplishes these homeostatic functions both independently and in concert with other organs, particularly those of theendocrine system. Various endocrine hormones coordinate these endocrine functions; these includerenin,angiotensin II,aldosterone,antidiuretic hormone, andatrial natriuretic peptide, among others.Many of the kidney's functions are accomplished by relatively simple mechanisms of filtration, reabsorption, and secretion, which take place in thenephron. Filtration, which takes place at therenal corpuscle, is the process by which cells and large proteins are filtered from the blood to make an ultrafiltrate that eventually becomes urine. The kidney generates 180 liters of filtrate a day, while reabsorbing a large percentage, allowing for the generation of only approximately 2 liters of urine. Reabsorption is the transport of molecules from this ultrafiltrate and into the blood. Secretion is the reverse process, in which molecules are transported in the opposite direction, from the blood into the urine.Excretion of wastes[edit source|editbeta]The kidneys excrete a variety of waste products produced bymetabolism. These include the nitrogenous wastes called "urea", from proteincatabolism, as well asuric acid, fromnucleic acidmetabolism. Formation of urine is also the function of the kidney. The concentration of nitrogenous wastes, in the urine of mammals and some birds, is dependent on an elaboratecountercurrent multiplicationsystem. This requires several independent nephron characteristics to operate: a tight hair pin configuration of the tubules, water and ion permeability in the descending limb of the loop, water impermeability in the ascending loop and active ion transport out of most of the ascending loop. In addition,countercurrent exchangeby the vessels carrying the blood supply to the nephron is essential for enabling this function.Reabsorption of vital nutrients[edit source|editbeta]Glucose at normal plasma levels is completely reabsorbed in the proximal tubule. The mechanism for this is the Na+/glucose cotransporter. A plasma level of 350mg/dL will fully saturate the transporters and glucose will be lost in the urine. A plasma glucose level of approximately 160 is sufficient to allow glucosuria which is an important clinical clue to diabetes mellitus.Amino acids are reabsorbed by sodium dependent transporters in the proximal tubule.Hartnup's diseaseis a deficiency of the tryptophan amino acid transporter which results inpellagra.[11]Location of ReabsorptionReabsorbed nutrientNotes

Early proximal tubuleGlucose (100%), amino acids (100%), bicarbonate (90%), Na+ (65%), Cl-, phosphate and H2O (65%) PTH will inhibit phosphate excretion AT II stimulates Na+, H2O and HCO3- reabsorption.

Thin descending loop of HenleH2O Reabsorbs via medullary hypertonicity and makes urine hypertonic.

Thick ascending loop of HenleNa+ (10-20%), K+, Cl-; indirectly induces para cellular reabsorption of Mg2+, Ca2+ This region is impermeable to H2O and the urine becomes less concentrated as it ascends.

Early distal convoluted tubuleNa+, Cl- PTH causes Ca2+ reabsorption.

Collecting tubulesNa+(3-5%), H2O Na+ is reabsorbed in exchange for K+ and H+ which is regulated by aldosterone. ADH acts on the V2 receptor and insertsaquaporinson the luminal side

[11]Pregnancy reduces the reabsorption of glucose and amino acids.Acid-base homeostasis[edit source|editbeta]Main article:Acid-base homeostasisTwo organ systems, the kidneys and lungs, maintain acid-base homeostasis, which is the maintenance ofpHaround a relatively stable value. The lungs contribute to acid-base homeostasis by regulatingcarbon dioxide(CO2) concentration. The kidneys have two very important roles in maintaining the acid-base balance: to reabsorb bicarbonate from urine, and to excretehydrogenions into urineOsmolality regulation[edit source|editbeta]Any significant rise inplasma osmolalityis detected by thehypothalamus, which communicates directly with theposterior pituitary gland. An increase in osmolality causes the gland to secreteantidiuretic hormone(ADH), resulting in water reabsorption by the kidney and an increase in urine concentration. The two factors work together to return the plasma osmolality to its normal levels.ADH binds to principal cells in the collecting duct that translocate aquaporins to the membrane, allowing water to leave the normally impermeable membrane and be reabsorbed into the body by the vasa recta, thus increasing the plasma volume of the body.There are two systems that create a hyperosmotic medulla and thus increase the body plasma volume: Urea recycling and the 'single effect.'Urea is usually excreted as a waste product from the kidneys. However, when plasma blood volume is low and ADH is released the aquaporins that are opened are also permeable to urea. This allows urea to leave the collecting duct into the medulla creating a hyperosmotic solution that 'attracts' water. Urea can then re-enter the nephron and be excreted or recycled again depending on whether ADH is still present or not.The 'Single effect' describes the fact that the ascending thick limb of theloop of Henleis not permeable to water but is permeable to NaCl. This allows for acountercurrent exchangesystem whereby the medulla becomes increasingly concentrated, but at the same time setting up an osmotic gradient for water to follow should the aquaporins of the collecting duct be opened by ADH.Blood pressure regulation[edit source|editbeta]Main articles:Blood pressure regulationandRenin-angiotensin systemAlthough the kidney cannot directly sense blood, long-term regulation ofblood pressurepredominantly depends upon the kidney. This primarily occurs through maintenance of theextracellular fluidcompartment, the size of which depends on the plasmasodiumconcentration. Renin is the first in a series of important chemical messengers that make up therenin-angiotensin system. Changes in renin ultimately alter the output of this system, principally the hormonesangiotensin IIandaldosterone. Each hormone acts via multiple mechanisms, but both increase the kidney's absorption ofsodium chloride, thereby expanding the extracellular fluid compartment and raising blood pressure. When renin levels are elevated, the concentrations of angiotensin II and aldosterone increase, leading to increased sodium chloride reabsorption, expansion of the extracellular fluid compartment, and an increase in blood pressure. Conversely, when renin levels are low, angiotensin II and aldosterone levels decrease, contracting the extracellular fluid compartment, and decreasing blood pressure.Hormone secretion[edit source|editbeta]The kidneys secrete a variety ofhormones, includingerythropoietin, and the enzymerenin.Erythropoietinis released in response tohypoxia(low levels of oxygen at tissue level) in the renal circulation. It stimulateserythropoiesis(production of red blood cells) in thebone marrow.Calcitriol, the activated form ofvitamin D, promotes intestinal absorption ofcalciumand the renalreabsorptionofphosphate. Part of therenin-angiotensin-aldosterone system, renin is anenzymeinvolved in the regulation ofaldosteronelevels.Development[edit source|editbeta]Main article:Kidney developmentThe mammalian kidney develops fromintermediate mesoderm.Kidney development, also callednephrogenesis, proceeds through a series of three successive phases, each marked by the development of a more advanced pair of kidneys: the pronephros, mesonephros, and metanephros.[12]Evolutionary adaptation[edit source|editbeta]Kidneys of various animals show evidence of evolutionaryadaptationand have long been studied inecophysiologyandcomparative physiology. Kidney morphology, often indexed as the relative medullary thickness, is associated with habitataridityamong species of mammals.[13]Related terms[edit source|editbeta]Medical terms related to the kidneys commonly use terms such asrenaland the prefixnephro-. Theadjectiverenal, meaning related to the kidney, is from theLatinrns, meaning kidneys; the prefixnephro-is from theAncient Greekword for kidney,nephros ().[14]For example, surgical removal of the kidney is anephrectomy, while a reduction in kidney function is calledrenal dysfunction.Diseases and disorders[edit source|editbeta]Main article:NephropathySee also:Glomerular lipidosisCongenital[edit source|editbeta] Congenitalhydronephrosis Congenital obstruction of urinary tract Duplex kidneys, or double kidneys, occur in approximately 1% of the population. This occurrence normally causes no complications, but can occasionally cause urine infections.[15][16] Duplicated ureteroccurs in approximately one in 100 live births Horseshoe kidneyoccurs in approximately one in 400 live births Polycystic kidney disease Autosomal dominant polycystic kidney diseaseafflicts patients later in life. Approximately one in 1000 people will develop this condition Autosomal recessive polycystic kidney diseaseis far less common, but more severe, than the dominant condition. It is apparentin uteroor at birth. Renal agenesis. Failure of one kidney to form occurs in approximately one in 750 live births. Failure of both kidneys to form is invariably fatal. Renal dysplasia Unilateral small kidney Multicystic dysplastic kidneyoccurs in approximately one in every 2400 live births Ureteropelvic Junction Obstruction or UPJO; although most cases appear congenital, some appear to be an acquired condition[17]Acquired[edit source|editbeta]

Drawing of an enlarged kidney byJohn Hunter. Diabetic nephropathy Glomerulonephritis Glomerular lipidosis Hydronephrosisis the enlargement of one or both of the kidneys caused by obstruction of the flow of urine. Interstitial nephritis Kidney stones(nephrolithiasis) are a relatively common and particularly painful disorder. Kidneytumors Wilms tumor Renal cell carcinoma Lupus nephritis Minimal change disease Innephrotic syndrome, theglomerulushas been damaged so that a large amount ofproteinin the blood enters theurine. Other frequent features of the nephrotic syndrome include swelling, low serum albumin, and high cholesterol. Pyelonephritisis infection of the kidneys and is frequently caused by complication of aurinary tract infection. Renal failure Acute renal failure Stage 5 Chronic Kidney DiseaseKidney FailureMain article:Renal failureGenerally, humans can live normally with just one kidney, as one has more functioning renal tissue than is needed to survive. Only when the amount of functioning kidney tissue is greatly diminished does one developchronic kidney disease.Renal replacement therapy, in the form ofdialysisorkidney transplantation, is indicated when theglomerular filtration ratehas fallen very low or if the renal dysfunction leads to severe symptoms.Diagnosis[edit source|editbeta]Clinical[edit source|editbeta]Many renal diseases are diagnosed on the basis of classical clinical findings. A physician (usually anephrologist) begins by taking a detailed clinical history and performs a physical examination. In addition to medical history and presenting symptoms, a physician will ask about medication history, family history recent infections, toxic/chemical exposures and other historical factors which may indicate an etiology for the patient's renal disease. Often, some diseases are suggested by clinical history and time course alone. For example, in a formerly healthy child with a recent upper respiratory tract infection and facial/lower limb swelling, findings of proteinuria on urinalysis, a diagnosis of minimal change disease is highly suggested. Similarly, a patient with a history of diabetes who presents with decreased urine output is most likely to be suffering from diabetic nephropathy. Often, such cases do not require extensive workup (such as with renal biopsy). A presumptive diagnosis can be made on the basis of history, physical exam and supportive laboratory studies.Laboratory[edit source|editbeta]Laboratory studies are an important adjunct to clinical evaluation for assessment of renal function. An initial workup of a patient may include a complete blood count (CBC); serum electrolytes including sodium, potassium, chloride, bicarbonate, calcium, and phosphorus; blood urea, nitrogen andcreatinine; blood glucose and glycocylated hemoglobin. Glomerular filtration rate (GFR) can be calculated.[18]Urine studies may include urine electrolytes, creatinine, protein, fractional excretion of sodium (FENA) and other studies to assist in evaluation of the etiology of a patient's renal disease.Urinalysisis used to evaluate urine for its pH, protein, glucose, specific gravity and the presence of blood/hemoglobin. Microscopic analysis can be helpful in the identification of casts, red blood cells, white blood cells and crystals.[18]Imaging studies[edit source|editbeta]Imaging studies are important in the evaluation of structural renal disease caused by urinary tract obstruction, renal stones, renal cyst, mass lesions, renal vascular disease, and vesicoureteral reflux.[18]Imaging techniques used most frequently include renal ultrasound and helical CT scan. Patients with suspected vesicoureteral reflux may undergo voiding cystourethrogram (VCUG).Renal biopsy[edit source|editbeta]The role of the renal biopsy is to diagnose renal disease in which the etiology is not clear based upon noninvasive means (clinical history, past medical history, medication history, physical exam, laboratory studies, imaging studies).A detailed description of renal biopsy interpretation is beyond the scope of this article. In general- a renal pathologist will perform a detailed morphological evaluation and integrate the morphologic findings with the clinical history and laboratory data, ultimately arriving at a pathological diagnosis. A renalpathologistis a physician who has undergone general training in anatomic pathology and additional specially training in the interpretation of renal biopsy specimens.Ideally, multiple core sections are obtained and evaluated for adequacy (presence of glomeruli) intraoperatively. A pathologist/pathology assistant divides the specimen(s) for submission for light microscopy, immunofluorescence microscopy and electron microscopy.The pathologist will examine the specimen using light microscopy with multiple staining techniques (hematoxylin and eosin/H&E, PAS, trichrome, silver stain) on multiple level sections. Multiple immunofluorescence stains are performed to evaluate for antibody, protein and complement deposition. Finally, ultra-structural examination is performed with electron microscopy and may reveal the presence of electron-dense deposits or other characteristic abnormalities which may suggest an etiology for the patient's renal disease.Calculations[edit source|editbeta]Calculations of kidney performance are an important part of physiology and can be estimated using the calculations below.Filtration Fraction[edit source|editbeta]The filtration fraction is the amount of plasma which is actually filtered through the kidney. This can be defined using the equation:FF=GFRRPF FF is the filtration fraction GFR is the glomerular filtration rate RPF is the renal plasma flowNormal human FF is 20%.Renal Clearance[edit source|editbeta]Renal clearance is the volume of plasma from which the substance is completely cleared from the blood per unit time.Cx=(Ux)VPx Cxis the clearance of X (normally in units of mL/min. Uxis the urine concentration of X. Pxis the plasma concentration of X. Vis the urine flow rate.More information regarding renal function can be found on theRenal functionWikipedia page.In other animals[edit source|editbeta]

A pig's kidney opened.In the majority of vertebrates, themesonephrospersists into the adult, albeit usually fused with the more advancedmetanephros; only inamniotesis the mesonephros restricted to the embryo. The kidneys offishandamphibiansare typically narrow, elongated organs, occupying a significant portion of the trunk. The collecting ducts from each cluster of nephrons usually drain into anarchinephric duct, which ishomologouswith thevas deferensof amniotes. However, the situation is not always so simple; incartilaginous fishand some amphibians, there is also a shorter duct, similar to the amniote ureter, which drains the posterior (metanephric) parts of the kidney, and joins with the archinephric duct at thebladderorcloaca. Indeed, in many cartilaginous fish, the anterior portion of the kidney may degenerate or cease to function altogether in the adult.[19]In the most primitive vertebrates, thehagfishandlampreys, the kidney is unusually simple: it consists of a row of nephrons, each emptying directly into the archinephric duct. Invertebrates may possess excretory organs that are sometimes referred to as "kidneys", but, even inAmphioxus, these are never homologous with the kidneys of vertebrates, and are more accurately referred to by other names, such asnephridia.[19]The kidneys ofreptilesconsist of a number of lobules arranged in a broadly linear pattern. Each lobule contains a single branch of the ureter in its centre, into which the collecting ducts empty. Reptiles have relatively few nephrons compared with other amniotes of a similar size, possibly because of their lowermetabolic rate.[19]Birdshave relatively large, elongated kidneys, each of which is divided into three or more distinct lobes. The lobes consists of several small, irregularly arranged, lobules, each centred on a branch of the ureter. Birds have small glomeruli, but about twice as many nephrons as similarly sized mammals.[19]The human kidney is fairly typical of that ofmammals. Distinctive features of the mammalian kidney, in comparison with that of other vertebrates, include the presence of the renal pelvis and renal pyramids, and of a clearly distinguishable cortex and medulla. The latter feature is due to the presence of elongatedloops of Henle; these are much shorter in birds, and not truly present in other vertebrates (although the nephron often has a shortintermediate segmentbetween the convoluted tubules). It is only in mammals that the kidney takes on its classical "kidney" shape, although there are some exceptions, such as the multilobedreniculate kidneysofcetaceans.[19]History[edit source|editbeta]The Latin termrenesis related to the English word "reins", a synonym for the kidneys inShakespearean English(e.g.Merry Wives of Windsor3.5), which was also the time theKing James Versionwas translated. Kidneys were once popularly regarded as the seat of theconscienceand reflection,[20][21]and a number of verses in theBible(e.g. Ps. 7:9, Rev. 2:23) state that God searches out and inspects the kidneys, or "reins", of humans. Similarly, theTalmud(Berakhoth61.a) states that one of the two kidneys counsels what is good, and the other evil.Kidneys as food[edit source|editbeta]

Hkarpanna, Swedish pork and kidney stewThe kidneys can becookedand eaten (along with otheroffal).Kidneys are usually grilled or sauted, but in more complex dishes they are stewed with a sauce that will improve their flavor. In many preparations, kidneys are combined with pieces of meat or liver, as inmixed grillormeurav Yerushalmi. Dishes include theBritishsteak and kidney pie, theSwedishhkarpanna(pork and kidney stew), theFrenchrognons de veau sauce moutarde(veal kidneys inmustardsauce) and theSpanishriones al Jerez(kidneys stewed insherrysauce) .[22]See also[edit source|editbeta] Artificial kidney Holonephros Organ donation Organ harvesting Pelvic kidney World Kidney DayAdditional Images[edit source|editbeta] Right Kidney Kidney Right Kidney Kidney Posterior View Anterior relation of Left Kidney Right kidney Left kidney Kidneys Left kidney Kidney Cross SectionReferences[edit source|editbeta]1. ^Cotran, RS S.; Kumar, Vinay; Fausto, Nelson; Robbins, Stanley L.; Abbas, Abul K. (2005).Robbins and Cotran pathologic basis of disease. St. Louis, MO: Elsevier Saunders.ISBN0-7216-0187-1.2. ^"HowStuffWorks How Your Kidney Works".3. ^"Kidneys Location Stock Illustration".4. ^[1][dead link]5. ^Blens ytanatomy (Superficial anatomy of the trunk). Anca Dragomir, Mats Hjortberg and Godfried M. Romans. Section for human anatomy at the Department of medical biology, Uppsala university, Sweden.6. ^abcWalter F., PhD. Boron (2004).Medical Physiology: A Cellular And Molecular Approach. Elsevier/Saunders.ISBN1-4160-2328-3.7. ^Glodny B, Unterholzner V, Taferner B,et al.(2009)."Normal kidney size and its influencing factors - a 64-slice MDCT study of 1.040 asymptomatic patients".BMC Urology9: 19.doi:10.1186/1471-2490-9-19.PMC2813848.PMID20030823.8. ^Clapp, WL. Renal Anatomy. In: Zhou XJ, Laszik Z, Nadasdy T, D'Agati VD, Silva FG, eds. Silva's Diagnostic Renal Pathology. New York, NY: Cambridge University Press; 2009.9. ^abcdeBard, Johnathan; Vize, Peter D.; Woolf, Adrian S. (2003).The kidney: from normal development to congenital disease. Boston: Academic Press. p.154.ISBN0-12-722441-6.10. ^Schrier, Robert W.; Berl, Tomas; Harbottle, Judith A. (1972)."Mechanism of the Antidiuretic Effect Associated with Interruption of Parasympathetic Pathways".Journal Clinical Investigation51(10): 261320.doi:10.1172/JCI107079.PMC332960.PMID5056657.11. ^abLe, Tao. First Aid for the USMLE Step 1 2013. New York: McGraw-Hill Medical, 2013. Print.12. ^Bruce M. Carlson (2004).Human Embryology and Developmental Biology(3rd ed.). Saint Louis: Mosby.ISBN0-323-03649-X.13. ^Al-kahtani, M. A.; C. Zuleta, E. Caviedes-Vidal, and T. Garland, Jr. (2004)."Kidney mass and relative medullary thickness of rodents in relation to habitat, body size, and phylogeny".Physiological and Biochemical Zoology77(3): 346365.doi:10.1086/420941.PMID15286910.14. ^Maton, Anthea; Jean Hopkins, Charles William McLaughlin, Susan Johnson, Maryanna Quon Warner, David LaHart, Jill D. Wright (1993).Human Biology and Health. Englewood Cliffs, New Jersey, USA: Prentice Hall.ISBN0-13-981176-1.15. ^Sample, Ian (2008-02-19)."How many people have four kidneys?".The Guardian(London).16. ^"Girl's Kidneys Fail, But Doctors Find Double Valves, Saving Her Life". Abcnews.go.com. 2010-05-18. Retrieved 2011-01-03.17. ^Stephen Jones, J.; Inderbir S. Gill, Raymond Rackley (2006).Operative Urology at the Cleveland Clinic. Andrew C. Novick, Inderbir S. Gill, Eric A. Klein, Jonathan H. Ross (eds.). Totowa, NJ: Humana Press.ISBN978-1-58829-081-6. Retrieved 2010-10-09.18. ^abcPost TW, Rose BD, auths and Curhan GC, Sheridan AM, eds. Diagnostic Approach to the Patient With Acute Kidney Injury (Acute Renal Failure) or Chronic Kidney Disease. UpToDate.com, Dec. 2012.http://www.uptodate.com.ezproxy2.library.arizona.edu/contents/diagnostic-approach-to-the-patient-with-acute-kidney-injury-acute-renal-failure-or-chronic-kidney-disease?source=preview&anchor=H12&selectedTitle=1~150#H1219. ^abcdeRomer, Alfred Sherwood; Parsons, Thomas S. (1977).The Vertebrate Body. Philadelphia, PA: Holt-Saunders International. pp.367376.ISBN0-03-910284-X.20. ^The Patient as Person: Explorations in Medical Ethicsp. 60 by Paul Ramsey, Margaret Farley, Albert Jonsen, William F. May (2002)21. ^History of Nephrology 2p. 235 by International Association for the History of Nephrology Congress, Garabed Eknoyan, Spyros G. Marketos, Natale G. De Santo - 1997; Reprint ofAmerican Journal of Nephrology; v. 14, no. 4-6, 1994.22. ^Rognons dans les recettes(French)External links[edit source|editbeta]Wikimedia Commons has media related to:Kidneys

The NephCure Foundation offers educational materials on the kidney diseases/conditions Nephrotic Syndrome and FSGS The Kidney Foundation of Canada electron microscopic images of the kidney (Dr. Jastrow's EM-Atlas) European Renal Genome project kidney function tutorial Kidney Foundation of Canada kidney disease information Renal Fellow Network: Structure & Function of Other Animals' Kidneys Kidney Stones Kidney Diseases Kidney Information Animated Presentatin on Kidney Function CAT Scans of various kidney diseases and conditions- CT Cases Kidney Stones; Information and Treatments[show] v t eSystems and organs of theanimal anatomy

[show] v t eAnatomy:urinary system(TA A08,TH H3.06,GA 11.1215)

Categories: Kidney Endocrine system

A List of Kidney Diseases AbderhaldenKaufmannLignac syndrome (Nephropathic Cystinosis) Acute Kidney Failure/Acute Kidney Injury Acute Lobar Nephronia Acute Phosphate Nephropathy Acute Tubular Necrosis Adenine Phosphoribosyltransferase Deficiency Adenovirus Nephritis Alport Syndrome Amyloidosis ANCA Vasculitis Related to Endocarditis and Other Infections Angiomyolipoma Analgesic Nephropathy Anorexia Nervosa and Kidney Disease Angiotensin Antibodies and Focal Segmental Glomerulosclerosis Antiphospholipid Syndrome APOL1 Mutations Apparent Mneralocorticoid Excess Syndrome Aristolochic Acid Nephropathy, Chinese Herbal Nephropathy, Balkan Endemic Nephropathy Bartter Syndrome Beeturia -Thalassemia Renal Disease Bile Cast Nephropathy BK Polyoma Virus Nephropathy in the Native Kidney Bladder Rupture Bladder Sphincter Dyssynergia Bladder Tamponade Border-Crossers' Nephropathy C1q Nephropathy Cardiorenal syndrome CFHR5 nephropathy Cholesterol Emboli ChurgStrauss syndrome Collapsing Glomerulopathy,Collapsing Glomerulopathy Related to CMV Congenital Nephrotic Syndrome Conorenal syndrome (Mainzer-Saldino Syndrome or Saldino-Mainzer Disease) Contrast Nephropathy Copper Sulpfate Intoxication Cortical Necrosis Cryoglobuinemia Crystal-Induced Acute Kidney injury Cystic Kidney Disease, Acquired Cystinuria Dasatinib-Induced Nephrotic-Range Proteinuria Dense Deposit Disease (MPGN Type 2) Dent Disease (X-linked Recessive Nephrolithiasis) Diabetes and Diabetic Kidney Disease Diabetes Insipidus Dietary Supplements and Renal Failure Duplicated Ureter EAST syndrome Ectopic Ureter Edema, Swelling Erdheim-Chester Disease Fabrys Disease Familial Hypocalciuric Hypercalcemia Fanconi Syndrome Fraser syndrome Fibronectin Glomerulopathy Fibrillary Glomerulonephritis and Immunotactoid Glomerulopathy Fraley syndrome Focal Segmental Glomerulosclerosis, Focal Sclerosis, Focal Glomerulosclerosis Galloway Mowat syndrome Giant Cell (Temporal) Arteritis with Kidney Involvement Gestational Hypertension Gitelman Syndrome Glomerular Diseases Glomerular Tubular Reflux Glycosuria Goodpasture Syndrome Hematuria (Blood in Urine) Hemolytic Uremic Syndrome (HUS),Atypical Hemolytic Uremic Syndrome (aHUS) Hemorrhagic Cystitis Hemorrhagic Fever with Renal Syndrome (HFRS, Hantavirus Renal Disease, Korean Hemorrhagic Fever, Epidemic Hemorrhagic Fever, Nephropathis Epidemica) Hemosiderosis related to Paroxysmal Nocturnal Hemoglobinuria and Hemolytic Anemia Hepatic Veno-Occlusive Disease, Sinusoidal Obstruction Syndrome Hepatitis C-Associated Renal Disease Hepatorenal Syndrome High Blood Pressure and Kidney Disease HIV-Associated Nephropathy (HIVAN) Horseshoe Kidney (Renal Fusion) Hunner's Ulcer Hyperaldosteronism Hypercalcemia Hyperkalemia Hypermagnesemia Hypernatremia Hyperoxaluria Hyperphosphatemia Hypocalcemia Hypokalemia,Hypokalemia-induced renal dysfunction Hypomagnesemia Hyponatremia Hypophosphatemia IgA Nephropathy IgG4 Nephropathy Interstitial Cystitis, Painful Bladder Syndrome(Questionnaire) Interstitial Nephritis Ivemark's syndrome Ketamine-Associated Bladder Dysfunction Kidney Stones, Nephrolithiasis Kombucha Tea Toxicity Lead Nephropathy and Lead-Related Nephrotoxicity Leptospirosis Renal Disease Light Chain Deposition Disease, Monoclonal Immunoglobulin Deposition Disease Liddle Syndrome Lightwood-Albright Syndrome Lipoprotein Glomerulopathy Lithium Nephrotoxicity LMX1B Mutations Cause Hereditary FSGS Loin Pain Hematuria Lupus, Systemic Lupus Erythematosis Lupus Kidney Disease, Lupus Nephritis Lyme Disease-Associated Glomerulonephritis Malarial Nephropathy Malignancy-Associated Renal Disease Malignant Hypertension Malakoplakia Meatal Stenosis Medullary Cystic Kidney Disease Medullary Sponge Kidney Megaureter Melamine Toxicity and the Kidney Membranoproliferative Glomerulonephritis Membranous Nephropathy MesoAmerican Nephropathy Metabolic Acidosis Metabolic Alkalosis Microscopic Polyangiitis Milk-alkalai syndrome Minimal Change Disease Multicystic dysplastic kidney Multiple Myeloma Myeloproliferative Neoplasms and Glomerulopathy Nail-patella Syndrome Nephrocalcinosis Nephrogenic Systemic Fibrosis Nephroptosis (Floating Kidney, Renal Ptosis) Nephrotic Syndrome Neurogenic Bladder Nodular Glomerulosclerosis Non-Gonococcal Urethritis - Wikipedia, the free encyclopedia Nutcracker syndrome Orthostatic Hypotension Orthostatic Proteinuria Osmotic Diuresis Page Kidney Papillary Necrosis Papillorenal Syndrome (Renal-Coloboma Syndrome, Isolated Renal Hypoplasia) The Peritoneal-Renal Syndrome Posterior Urethral Valve Post-infectious Glomerulonephritis, Post-streptococcal Glomerulonephritis Polyarteritis Nodosa Polycystic Kidney Disease Posterior Urethral Valves Preeclampsia Propofol infusion syndrome Proteinuria (Protein in Urine) Pseudohyperaldosteronism Pseudohypoparathyroidism Pulmonary-Renal Syndrome Pyelonephritis (Kidney Infection) Pyonephrosis Radiation Nephropathy Reflux Nephropathy Rapidly Progressive Glomerulonephritis Renal Abscess, Peripnephric Abscess Renal Agenesis Renal Artery Aneurysm Renal Artery Stenosis Renal Cell Cancer Renal Cyst Renal Infarction Renal Osteodystrophy Renal Tubular Acidosis Renin Secreting Tumors (Juxtaglomerular Cell Tumor) Reset Osmostat Retroperitoneal Fibrosis Rhabdomyolysis,Rhabdomyolysis related to Bariatric Sugery Rheumatoid Arthritis-Associated Renal Disease Sarcoidosis Renal Disease Salt Wasting, Renal and Cerebral Schistosomiasis and Glomerular Disease Schimke immuno-osseous dysplasia Scleroderma Renal Crisis Serpentine Fibula-Polycystic Kidney Syndrome, Exner Syndrome Silica Exposure and Chronic Kidney Disease Sjgren's Syndrome and Renal Disease Synthetic Cannabinoid Use and Acute Kidney Injury Kidney Disease Following Hematopoietic Cell Transplantation, Kidney Disease Related to Stem Cell Transplantation Thin Basement Membrane Disease, Benign Familial Hematuria Trigonitis Tuberous Sclerosis Tubular Dysgenesis Tumor Lysis Syndrome Uremia Uremic Optic Neuropathy Ureterocele Urethral Caruncle Urethral Stricture Urinary Incontinence Urinary Tract Infection Urinary Tract Obstruction Vesicointestinal Fistula Vesicoureteral Reflux Von Hippel-Lindau Disease Warfarin-Related Nephropathy Wegeners Granulomatosis, Granulomatosis with Polyangiitis West Nile Virus and Chronic Kidney Disease Wunderlich syndrome