The first edition of this book appeared in 1982. In the preface to that first edi­ tion, I wrote 'This book is based on the lecture course in renal physiology which I give to medical students at the University of Birmingham. The pur­ pose of the book is primarily to set out the principles of renal physiology for preclinical medical students, and it is therefore concerned mainly with normal renal function. However, diseases or abnormalities in other body systems may lead to adaptations or modifications of renal function, so that a good knowl­ edge of renal physiology is essential to the understanding of many disease states, for example the oedema of heart failure or liver disease, or the conse­ quences of haemorrhage and shock. ' The new edition is still based on the lec­ tures which I continue to give at Birmingham University, but over the years the course has gradually changed, to being a system based course covering all aspects of the kidney - the anatomy, physiology, pharmacology and pathology. The new edition of the book, which has been extensively revised and rewritten, reflects this. However, it continues to offer a concise, easily readable format, primarily intended for undergraduate medical and medical science students.

Inhalt

1 The body fluids.- 1.1 Introduction.- 1.2 Body water.- 1.3 Body fluid osmolality.- 1.4 Distribution of ions across biological membranes.- 1.5 Fluid exchanges between body compartments.- 1.6 Fluid exchanges between the body and the external environment.- 1.7 Ionic composition of the body fluids.- 1.8 Ion exchanges between the body and the external environment.- 1.9 Body fluid compartments: methods of measurement.- Further reading.- Problems.- 2 Essential anatomy of the kidney.- 2.1 Introduction.- 2.2 General morphology and cellular organization.- 2.3 Blood supply and vascular structure within the kidney.- 2.4 Renal lymphatic drainage.- 2.5 Juxtaglomerular apparatus.- Further reading.- 3 Glomerular filtration.- 3.1 The filter.- 3.2 Glomerular filtration process.- 3.3 Composition of the glomerular filtrate.- 3.4 Filtration fraction.- 3.5 Tubulo-glomerular feedback.- Further reading.- Problems.- 4 Tubular transport.- 4.1 Introduction.- 4.2 Primary and secondary active transport.- 4.3 Ion channels, uniporters and facilitated diffusion.- 4.4 Paracellular movement.- 4.5 Water absorption.- 4.6 Fractional excretion and fractional reabsorption.- Further reading.- 5 The proximal tubule.- 5.1 Morphology of proximal tubule cells.- 5.2 Proximal tubular handling of sodium.- 5.3 Uptake of NaCl and water into peritubular capillaries.- 5.4 Relationship of proximal tubular reabsorption to glomerular filtration rate.- 5.5 Proximal tubular reabsorption of other solutes.- 5.6 Secretory processes in the proximal tubule.- Further reading.- Problem.- 6 The loop of Henle, distal tubule and collecting duct.- 6.1 The loop of Henle.- 6.2 Collecting tubules.- 6.3 Importance of urea in countercurrent multiplication.- 6.4 Further requirements of the countercurrent multiplication mechanism: the vasa recta.- 6.5 Long and short loops of Henle.- 6.6 Regulation of urine concentration.- 6.7 Other hormones affecting distal nephron transport processes.- Further reading.- 7 Renal blood flow and glomerular filtration rate.- 7.1 Measurement of renal blood flow and glomerular filtration rate.- 7.2 Regulation of renal blood flow and glomerular filtration rate.- Further reading.- Problem.- 8 Regulation of body fluid osmolality.- 8.1 Introduction.- 8.2 Osmoreceptors.- 8.3 Regulation of water excretion and water reabsorption.- Further reading.- 9 Regulation of body fluid volume.- 9.1 Introduction.- 9.2 Aldosterone.- 9.3 Renin and angiotensin, and their relationship to aldosterone.- 9.4 Starling forces and proximal tubular sodium reabsorption.- 9.5 Renal nerves.- 9.6 Prostaglandins and other arachidonate metabolites.- 9.7 Atrial natriuretic peptide and urodilatin.- 9.8 Other factors which may be involved in regulating sodium excretion.- 9.9 ADH and the relationship between osmotic regulation and volume regulation.- 9.10 Overall scheme of body fluid volume regulation.- Further reading tc.- 10 Renal regulation of body fluid pH.- 10.1 Introduction.- 10.2 Physiological buffers.- 10.3 Renal regulation of plasma bicarbonate concentration.- 10.4 Regulation of H+ secretion according to acid-base balance requirements.- Further reading.- Problem.- 11 Renal control of body fluid potassium content.- 11.1 Importance of K+ in the body.- 11.2 Regulation of body K+.- 11.3 Hypokalaemia.- 11.4 Hyperkalemia.- Further reading.- 12 Renal regulation of body calcium, magnesium and phosphate.- 12.1 Introduction.- 12.2 Calcium.- 12.3 Phosphate.- 12.4 Calcium and phosphate homeostasis.- 12.5 Magnesium.- Further reading.- 13 Summary of the principal reabsorptive and secretory processes in the nephron segments.- 13.1 Introduction.- 13.2 Sodium.- 13.3 Water.- 13.4 Potassium.- 13.5 Hydrogen ions and HCO-3.- 13.6 Phosphate.- 13.7 Calcium.- 13.8 Glucose.- 13.9 Urea and other nitrogenous waste products.- 14 Disease conditions which alter renal sodium and water reabsorption.- 14.1 Introduction.- 14.2 Oedema.- 14.3 Congestive heart failure.- 14.4 Hypovolaemia and shock.- 14.5 Hypertension.- 14.6 Liver disease.- 14.7 Nephrotic syndrome.- Further reading.- 15 Use of diuretics.- 15.1 Introduction.- 15.2 Osmotic diuretics.- 15.3 Loop diuretics.- 15.4 Thiazides.- 15.5 Aldosterone antagonists.- 15.6 Na channel blockers.- 15.7 Carbonic anhydrase inhibitors.- 15.8 Clinical use of diuretics.- Further reading.- Answers to problems.