Renal Physiology

Nephrin (protein in slit diaphragm of podocytes) plays an essential role in the

maintenance of normal glomerular permeability because its absence leads to severe
proteinuria.

The Tamm-Horsfall protein (THP aka uromodulin) soluble cleavage product on

the apical membrane of the TAL cells. THP, normally the most abundant protein in the
urine (30-50 mg/day vs. 20 mg for albumin), may play a role in the defense against
pathogenic bacteria like E. Coli in the genitourinary system.

The autonomic innervation to the kidneys is entirely sympathetic; the kidneys lack
parasympathetic nerve fibers.
Sympathetic stim -> vasoconstriction -> inc. Na reabsorption/renin secretion

Clearance = UV / P
Excreted = UV
Filtered = GFR x P
Fraction Excretion (FE) = Excreted / Filtered = UV / GFR x P

Standard GFR = 125 mL/min

Standard RPF = 600 mL/min
Fitration Fraction (FF) = GFR/RPF = 20%
RBF = 1L/min (out of 5L total)
RPF = RBF * (1-Hct)
A high-protein diet increases GFR and RPF by indirectly lowering the sensitivity of
the TGF mechanism (inc. NaCl reabsorption proximal to macula -> macula densa senses
low NaCl -> vasodilation of afferent/inc. GFR)

ANP markedly vasodilates afferent and efferent arterioles. Inhibits aldosterone (dec. Na
reabsorption,

Theproportionalityoffiltrationandproximaltubulereabsorptionismaintained