Kidney Structure and Function

1. Be able to describe the anatomy of the kidney and the urinary tract.

2. Understand how benign prostatic hyperplasia causes urinary symptoms.  Know the mechanism of action for medical treatments for benign prostatic hyperplasia that we discuss in class.

3. Know that the nephron is the functional unit of the kidney, and be able to identify the different parts of the nephron histologically.  Be able to to relate cellular structure to function for different parts of the nephron.

4. Be able to define polyuria and explain why polyuria might occur in diabetes mellitus.

5. Be able to describe the mechanism of action of SGLT2 inhibitors and their benefit in treating type 2 diabetes mellitus.

6. Know that it is possible to reabsorb water independently of solute to create concentrated urine (urine that has a higher osmolarity than the extracellular fluid).  Be able to outline how water balance is achieved through regulated water reabsorption in the collecting duct.  Know that vasopressin is the hormone that regulates water permeability in the collecting duct.

7. Know that the main factor that regulates secretion of vasopressin is excitatory input from osmoreceptors in the hypothalamus.  Additionally, the osmoreceptors stimulate thirst.  Be able to outline the effect of vasopressin in the kidney.

8. Evaluate the case of Patient C.  Understand the etiology of the urine concentration defect in this patient and the appropriate treatment in this case.  Be able to answer all of the questions in the blue boxes and to define all the purple bold-faced terms.

9. Know that glomerular filtration rate (GFR) is a key measure of kidney health.  Understand why inulin clearance is used to determine GFR.  Know that creatinine is an endogenous marker that is used to monitor kidney function and estimate GFR.

10. If given a set of data, be able to convert units, calculate renal clearance, GFR, filtered load, and the amount secreted or reabsorbed.