Nephron

The nephron is the minute or microscopic structural and functional unit of the kidney. It is composed of a renal corpuscle and a renal tubule. The renal corpuscle consists of a tuft of capillaries called a glomerulus and a cup-shaped structure called Bowman's capsule. The renal tubule extends from the capsule. The capsule and tubule are connected and are composed of epithelial cells with a lumen. A healthy adult has 1 to 1.5 million nephrons in each kidney. Blood is filtered as it passes through three layers: the endothelial cells of the capillary wall, its basement membrane, and between the podocyte foot processes of the lining of the capsule. The tubule has adjacent peritubular capillaries that run between the descending and ascending portions of the tubule. As the fluid from the capsule flows down into the tubule, it is processed by the epithelial cells lining the tubule: water is reabsorbed and substances are exchanged (some are added, others are removed); first with the interstitial fluid outside the tubules, and then into the plasma in the adjacent peritubular capillaries through the endothelial cells lining that capillary. This process regulates the volume of body fluid as well as levels of many body substances. At the end of the tubule, the remaining fluid—urine—exits: it is composed of water, metabolic waste, and toxins.

The interior of Bowman's capsule, called Bowman's space, collects the filtrate from the filtering capillaries of the glomerular tuft, which also contains mesangial cells supporting these capillaries. These components function as the filtration unit and make up the renal corpuscle. The filtering structure (glomerular filtration barrier) has three layers composed of endothelial cells, a basement membrane, and podocyte foot processes. The tubule has five anatomically and functionally different parts: the proximal tubule, which has a convoluted section called the proximal convoluted tubule followed by a straight section (proximal straight tubule); the loop of Henle, which has two parts, the descending loop of Henle ("descending loop") and the ascending loop of Henle ("ascending loop"); the distal convoluted tubule ("distal loop"); the connecting tubule, and the last part of nephron the collecting ducts. Nephrons have two lengths with different urine-concentrating capacities: long juxtamedullary nephrons and short cortical nephrons.

The four mechanisms used to create and process the filtrate (the result of which is to convert blood to urine) are filtration, reabsorption, secretion and excretion. Filtration or ultrafiltration occurs in the glomerulus and is largely passive: it is dependent on the intracapillary blood pressure. About one-fifth of the plasma is filtered as the blood passes through the glomerular capillaries; four-fifths continues into the peritubular capillaries. Normally the only components of the blood that are not filtered into Bowman's capsule are blood proteins, red blood cells, white blood cells and platelets. Over 150 liters of fluid enter the glomeruli of an adult every day: 99% of the water in that filtrate is reabsorbed. Reabsorption occurs in the renal tubules and is either passive, due to diffusion, or active, due to pumping against a concentration gradient. Secretion also occurs in the tubules and collecting duct and is active. Substances reabsorbed include: water, sodium chloride, glucose, amino acids, lactate, magnesium, calcium phosphate, uric acid, and bicarbonate. Substances secreted include urea, creatinine, potassium, hydrogen, and uric acid. Some of the hormones which signal the tubules to alter the reabsorption or secretion rate, and thereby maintain homeostasis, include (along with the substance affected) antidiuretic hormone (water), aldosterone (sodium, potassium), parathyroid hormone (calcium, phosphate), atrial natriuretic peptide (sodium) and brain natriuretic peptide (sodium). A countercurrent system in the renal medulla provides the mechanism for generating a hypertonic interstitium, which allows the recovery of solute-free water from within the nephron and returning it to the venous vasculature when appropriate.

Some diseases of the nephron predominantly affect either the glomeruli or the tubules. Glomerular diseases include diabetic nephropathy, glomerulonephritis and IgA nephropathy; renal tubular diseases include acute tubular necrosis and polycystic kidney disease.

Structure

260px|thumb|right|Fig.1) Schematic diagram of the nephron (yellow), relevant circulation (red/blue), and the four methods of altering the filtrate.

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-

a renal corpuscle, which is the initial filtering component, and
a renal tubule that processes and carries away the filtered fluid.

Renal corpuscle

[[File:Filtration barrier.svg|thumb|260px|Fig.2) Schematic of the glomerular filtration barrier (GFB).

A. The endothelial cells of the glomerulus; 1. endothelial pore (fenestra).<br /> B. Glomerular basement membrane: 1. lamina rara interna 2. lamina densa 3. lamina rara externa <br />

C. Podocytes: 1. enzymatic and structural proteins 2. filtration slit 3. diaphragm]]

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. The arterioles from the renal circulation enter and leave the glomerulus at the vascular pole. The glomerular filtrate leaves the Bowman's capsule at the renal tubule at the urinary pole.

Glomerulus

The glomerulus is the network, known as a tuft, of filtering capillaries located at the vascular pole of the renal corpuscle in Bowman's capsule. Each glomerulus receives its blood supply from an afferent arteriole of the renal circulation. The glomerular blood pressure provides the driving force for water and solutes to be filtered out of the blood plasma, and into the interior of Bowman's capsule, called Bowman's space.

Only about a fifth of the plasma is filtered in the glomerulus. The rest passes into an efferent arteriole. The diameter of the efferent arteriole is smaller than that of the afferent, and this difference increases the hydrostatic pressure in the glomerulus.

Bowman's capsule

The Bowman's capsule, also called the glomerular capsule, surrounds the glomerulus. It is composed of a visceral inner layer formed by specialized cells called podocytes, and a parietal outer layer composed of simple squamous epithelium. Fluids from blood in the glomerulus are ultrafiltered through several layers, resulting in what is known as the filtrate.

The filtrate next moves to the renal tubule, where it is further processed to form urine. The different stages of this fluid are collectively known as the tubular fluid.

===Renal tubule===

The renal tubule is a continuous and long pipe-like structure containing the tubular fluid filtered through the glomerulus. The filtrate passing through the renal tubule ultimately ends at the collecting duct system.

The components of the renal tubule are:

Proximal convoluted tubule: lies in the cortex and is lined by 'simple cuboidal epithelium with brush borders' which greatly increase surface area for absorption.
Loop of Henle: lies in the medulla and is U-shaped (similar to a hair-pin)
Descending limb of loop of Henle: one segment of equal thickness
Ascending limb of loop of Henle: two segments of differing thickness (proximal portion lined by simple squamous epithelium is called the thin ascending limb of loop of Henle, distal portion lined by simple cuboidal epithelium is called the thick ascending limb of loop of Henle).
Distal convoluted tubule: lies in the cortex
Collecting tubule

The epithelial cells that form these nephron segments can be distinguished by the shapes of their actin cytoskeleton visualized by confocal microscopy of fluorescent phalloidin.

Blood from the efferent arteriole, containing everything that was not filtered out in the glomerulus, moves into the peritubular capillaries, tiny blood vessels that surround the loop of Henle and the proximal and distal tubules, where the tubular fluid flows. Substances then reabsorb from the latter back to the blood stream.

The peritubular capillaries then recombine to form an efferent venule, which combines with efferent venules from other nephrons into the renal vein, and rejoins the main bloodstream.

Difference in Length of Nephrons

Cortical nephrons (the majority of nephrons) start high in the cortex and have a short loop of Henle which does not penetrate deeply into the medulla. Cortical nephrons can be subdivided into superficial cortical nephrons and midcortical nephrons.

Juxtamedullary nephrons start low in the cortex near the medulla and have a long loop of Henle which penetrates deeply into the renal medulla: only they have their loop of Henle surrounded by the vasa recta. These long loops of Henle and their associated vasa recta create a hyperosmolar gradient that allows for the generation of concentrated urine. Also the hairpin bend penetrates up to the inner zone of medulla.

Juxtamedullary nephrons are found only in birds and mammals, and have a specific location: medullary refers to the renal medulla, while juxta (Latin: near) refers to the relative position of the renal corpuscle of this nephron - near the medulla, but still in the cortex. In other words, a juxtamedullary nephron is a nephron whose renal corpuscle is near the medulla, and whose proximal convoluted tubule and its associated loop of Henle occur deeper in the medulla than the other type of nephron, the cortical nephron.

The juxtamedullary nephrons comprise only about 15% of the nephrons in the human kidney. Fluid in the filtrate entering the proximal convoluted tubule is reabsorbed into the peritubular capillaries, including 80% of glucose, more than half of the filtered salt, water and all filtered organic solutes (primarily glucose and amino acids).

Though the collecting duct is normally impermeable to water, it becomes permeable in the presence of antidiuretic hormone (ADH). ADH affects the function of aquaporins, resulting in the reabsorption of water molecules as it passes through the collecting duct. Aquaporins are membrane proteins that selectively conduct water molecules while preventing the passage of ions and other solutes. As much as three-quarters of the water from urine can be reabsorbed as it leaves the collecting duct by osmosis. Thus the levels of ADH determine whether urine will be concentrated or diluted. An increase in ADH is an indication of dehydration, while water sufficiency results in a decrease in ADH allowing for diluted urine.

Diseases of the nephron predominantly affect either the glomeruli or the tubules. Glomerular diseases include diabetic nephropathy, glomerulonephritis and IgA nephropathy; renal tubular diseases include acute tubular necrosis, renal tubular acidosis, and polycystic kidney disease.

Additional images

File:Gray1129.png| Distribution of blood vessels in cortex of kidney. (Although the figure labels the efferent vessel as a vein, it is actually an arteriole.)

File:Gray1130.svg|Glomerulus is red; Bowman's capsule is white.

File:Kidney tubules.png|Kidney tissue

File:Glomerular Physiology.png|Glomerulus

File:Kidney Glomerulus Cell Types.png|This image shows the types of cells present in the glomerulus part of a kidney nephron. Podocytes, Endothelial cells, and Glomerular mesangial cell are present.

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