Abstract
The kidneys are central to numerous homeostatic mechanisms in the body. Responsible for solute and fluid handling, removal of waste products of nutrients, metabolism, detoxification, and excretion of drugs and metabolites, and regulation of vascular tone, the kidneys also elaborate many metabolites that act in local and distant fashion. The kidneys receive a high proportion of cardiac output per minute and have a high rate of oxygen consumption, evidence of the intensity of regulation that occurs in perpetuity. In this chapter, we will discuss renal physiology using the structure as background, function, and response to illness. Both hemodynamics and filtration will be described in detail. Relevant examples of how commonly encountered disease states affect kidney function will be discussed. Finally, the emerging paradigm of crosstalk between the kidneys and other vital organs will be broached. Critical illness carries dramatic consequence on kidney function and understanding the elements of how the kidneys regulate their own mechanics, and what happens when these compensatory mechanisms are overwhelmed, is essential to practitioners in the pediatric intensive care unit.
Keywords
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Abbreviations
- ACE-I:
-
Angiotensin converting enzyme inh
- ADH:
-
Anti-diuretic hormone
- AE1:
-
Anion exchanger
- ANG-II:
-
Angiotensin 2
- ANP:
-
Atrial natriuretic peptide
- AQP:
-
Aquaporin
- ARB:
-
Angiotensin receptor blockers
- AVP:
-
Arginine vasopressin
- CA:
-
Carbonic anhydrase
- Ca2+ :
-
Calcium
- Ca2+-ATPase:
-
Calcium ATPase
- CD:
-
Collecting duct
- Cl− :
-
Chloride
- DCT:
-
Distal convoluted tubule
- ENaC:
-
Epithelial sodium channel
- GBM:
-
Glomerular basement membrane
- GCP:
-
Glomerular capillary perfusion
- GFR:
-
Glomerular filtration rate
- GLUT:
-
Glucose transporter
- H+-ATPase:
-
Hydrogen ATPase
- HCO3 − :
-
Bicarbonate
- HIF-1:
-
Hypoxia inducible factor
- JGA:
-
Juxtaglomerular apparatus
- K+ :
-
Potassium
- LH:
-
Loop of henle
- MCD:
-
Medullary collecting duct
- MR:
-
Myogenic reflex
- Na+ :
-
Sodium
- Na+-K+-ATPase:
-
Sodium-potassium ATPase
- NaCl:
-
Sodium chloride
- NH3 :
-
Ammonia
- NHE3:
-
Sodium hydrogen exchanger
- NO:
-
Nitric oxide
- NPHS1:
-
Nephrin
- NPHS2:
-
Podocin
- PLCE:
-
Phospholipase C epsilon
- PO4 3− :
-
Phosphate
- PT:
-
Proximal tubule
- PTH:
-
Parathyroid hormone
- RAAS:
-
Renin-angiotensin-aldosterone
- RBF:
-
Renal blood flow
- RPP:
-
Renal perfusion pressure
- RvO2 :
-
Oxygen consumption
- RVR:
-
Renal vascular resistance
- SGLT:
-
Sodium-glucose transporters
- SNGFR:
-
Single nephron GFR
- SSAKI:
-
Severe sepsis associated AKI
- TAL:
-
Thick ascending limb
- TAL:
-
Thick ascending loop of henle
- TGR:
-
Tubuloglomerular feedback
- TPRC6:
-
Transient receptor potential
References
Carew RM, Wang B, Kantharidis P. The role of EMT in renal fibrosis. Cell Tissue Res. 2012;347(1):103–16.
Hatch FE, Johnson JG. Intrarenal blood flow. Annu Rev Med. 1969;20:395–408.
Grunfeld JP, et al. Intrarenal distribution of blood flow. Adv Nephrol Necker Hosp. 1971;1:125–43.
Rosenberger C, Rosen S, Heyman SN. Renal parenchymal oxygenation and hypoxia adaptation in acute kidney injury. Clin Exp Pharmacol Physiol. 2006;33(10):980–8.
Heyman SN, Rosenberger C, Rosen S. Regional alterations in renal haemodynamics and oxygenation: a role in contrast medium-induced nephropathy. Nephrol Dial Transplant. 2005;20 Suppl 1:i6–11.
Graves FT. The arterial anatomy of the kidney: the basis of surgical technique. Bristol: John Wright; 1971. p. xi. 101 p.
McCrory WW. Developmental nephrology. Cambridge: Harvard University Press; 1972. p. xii. 216 p.
Hunley TE, Kon V, Ichikawa I. Glomerular circulation and function. In: Harmon WE, Avner ED, Niaudet P, Yoshikawa N, editors. Pediatric nephrology. Heidelberg: Springer; 2009. p. 31.
Visser MO, et al. Renal blood flow in neonates: quantification with color flow and pulsed Doppler US. Radiology. 1992;183(2):441–4.
Strickland AL, Kotchen TA. A study of the renin-aldosterone system in congenital adrenal hyperplasia. J Pediatr. 1972;81(5):962–9.
Kotchen TA, et al. A study of the renin-angiotensin system in newborn infants. J Pediatr. 1972;80(6):938–46.
Eliot RJ, et al. Plasma catecholamine concentrations in infants at birth and during the first 48 hours of life. J Pediatr. 1980;96(2):311–5.
O’Rourke M. Mechanical principles in arterial disease. Hypertension. 1995;26(1):2–9.
Fretschner M, et al. A narrow segment of the efferent arteriole controls efferent resistance in the hydronephrotic rat kidney. Kidney Int. 1990;37(5):1227–39.
Casellas D, Navar LG. In vitro perfusion of juxtamedullary nephrons in rats. Am J Physiol. 1984;246(3 Pt 2):F349–58.
Imig JD, Roman RJ. Nitric oxide modulates vascular tone in preglomerular arterioles. Hypertension. 1992;19(6 Pt 2):770–4.
Badr KF, Ichikawa I. Prerenal failure: a deleterious shift from renal compensation to decompensation. N Engl J Med. 1988;319(10):623–9.
Helou CM, et al. Angiotensin receptor subtypes in thin and muscular juxtamedullary efferent arterioles of rat kidney. Am J Physiol Renal Physiol. 2003;285(3):F507–14.
Yuan BH, Robinette JB, Conger JD. Effect of angiotensin II and norepinephrine on isolated rat afferent and efferent arterioles. Am J Physiol. 1990;258(3 Pt 2):F741–50.
Denton KM, et al. Morphometric analysis of the actions of angiotensin II on renal arterioles and glomeruli. Am J Physiol. 1992;262(3 Pt 2):F367–72.
Denton KM, et al. Effect of endothelin-1 on regional kidney blood flow and renal arteriole calibre in rabbits. Clin Exp Pharmacol Physiol. 2004;31(8):494–501.
Kimura K, et al. Effects of atrial natriuretic peptide on renal arterioles: morphometric analysis using microvascular casts. Am J Physiol. 1990;259(6 Pt 2):F936–44.
Edwards RM, Trizna W, Kinter LB. Renal microvascular effects of vasopressin and vasopressin antagonists. Am J Physiol. 1989;256(2 Pt 2):F274–8.
Parekh N, et al. Nitric oxide modulates angiotensin II- and norepinephrine-dependent vasoconstriction in rat kidney. Am J Physiol. 1996;270(3 Pt 2):R630–5.
Parekh N, Zou AP. Role of prostaglandins in renal medullary circulation: response to different vasoconstrictors. Am J Physiol. 1996;271(3 Pt 2):F653–8.
Hayashi K, et al. Disparate effects of calcium antagonists on renal microcirculation. Hypertens Res. 1996;19(1):31–6.
Kon V, Fogo A, Ichikawa I. Bradykinin causes selective efferent arteriolar dilation during angiotensin I converting enzyme inhibition. Kidney Int. 1993;44(3):545–50.
Steinhausen M, et al. Responses of in vivo renal microvessels to dopamine. Kidney Int. 1986;30(3):361–70.
Loutzenhiser R, Bidani A, Chilton L. Renal myogenic response: kinetic attributes and physiological role. Circ Res. 2002;90(12):1316–24.
Schnermann J, Briggs JP. Tubuloglomerular feedback: mechanistic insights from gene-manipulated mice. Kidney Int. 2008;74(4):418–26.
DiBona GF, Kopp UC. Neural control of renal function. Physiol Rev. 1997;77(1):75–197.
Dzau VJ, et al. Prostaglandins in severe congestive heart failure. Relation to activation of the renin–angiotensin system and hyponatremia. N Engl J Med. 1984;310(6):347–52.
De Nicola L, Blantz RC, Gabbai FB. Nitric oxide and angiotensin II. Glomerular and tubular interaction in the rat. J Clin Invest. 1992;89(4):1248–56.
Blantz RC. Pathophysiology of pre-renal azotemia. Kidney Int. 1998;53(2):512–23.
Wan L, et al. Pathophysiology of septic acute kidney injury: what do we really know? Crit Care Med. 2008;36(4 Suppl):S198–203.
Boffa JJ, Arendshorst WJ. Maintenance of renal vascular reactivity contributes to acute renal failure during endotoxemic shock. J Am Soc Nephrol. 2005;16(1):117–24.
Gambaro G, Perazella MA. Adverse renal effects of anti-inflammatory agents: evaluation of selective and nonselective cyclooxygenase inhibitors. J Intern Med. 2003;253(6):643–52.
Franklin SS, Smith RD. A comparison of enalapril plus hydrochlorothiazide with standard triple therapy in renovascular hypertension. Nephron. 1986;44 Suppl 1:73–82.
Okuyama H, et al. Effects of synchronous pulsatile extracorporeal membrane oxygenation in an endotoxin-induced shock model: an experimental study. Artif Organs. 1992;16(5):477–84.
Roy BJ, Cornish JD, Clark RH. Venovenous extracorporeal membrane oxygenation affects renal function. Pediatrics. 1995;95(4):573–8.
Drenckhahn D, et al. Ultrastructural organization of contractile proteins in rat glomerular mesangial cells. Am J Pathol. 1990;137(6):1343–51.
Ballermann BJ. Contribution of the endothelium to the glomerular permselectivity barrier in health and disease. Nephron Physiol. 2007;106(2):19–25.
Miner JH, Sanes JR. Collagen IV alpha 3, alpha 4, and alpha 5 chains in rodent basal laminae: sequence, distribution, association with laminins, and developmental switches. J Cell Biol. 1994;127(3):879–91.
Hassell JR, et al. Isolation of a heparan sulfate-containing proteoglycan from basement membrane. Proc Natl Acad Sci U S A. 1980;77(8):4494–8.
Groffen AJ, et al. Agrin is a major heparan sulfate proteoglycan in the human glomerular basement membrane. J Histochem Cytochem. 1998;46(1):19–27.
Caulfield JP, Farquhar MG. Loss of anionic sites from the glomerular basement membrane in aminonucleoside nephrosis. Lab Invest. 1978;39(5):505–12.
Drumond MC, et al. Structural basis for reduced glomerular filtration capacity in nephrotic humans. J Clin Invest. 1994;94(3):1187–95.
Adler S. Integrin receptors in the glomerulus: potential role in glomerular injury. Am J Physiol. 1992;262(5 Pt 2):F697–704.
Regele HM, et al. Glomerular expression of dystroglycans is reduced in minimal change nephrosis but not in focal segmental glomerulosclerosis. J Am Soc Nephrol. 2000;11(3):403–12.
Mundel P, et al. Synaptopodin: an actin-associated protein in telencephalic dendrites and renal podocytes. J Cell Biol. 1997;139(1):193–204.
Huber TB, et al. Bigenic mouse models of focal segmental glomerulosclerosis involving pairwise interaction of CD2AP, Fyn, and synaptopodin. J Clin Invest. 2006;116(5):1337–45.
Patrie KM, et al. The membrane-associated guanylate kinase protein MAGI-1 binds megalin and is present in glomerular podocytes. J Am Soc Nephrol. 2001;12(4):667–77.
Takeda T, et al. Expression of podocalyxin inhibits cell-cell adhesion and modifies junctional properties in Madin-Darby canine kidney cells. Mol Biol Cell. 2000;11(9):3219–32.
Sellin L, et al. NEPH1 defines a novel family of podocin interacting proteins. FASEB J. 2003;17(1):115–7.
Neal CR, et al. Glomerular filtration into the subpodocyte space is highly restricted under physiological perfusion conditions. Am J Physiol Renal Physiol. 2007;293(6):F1787–98.
Deen WM, Lazzara MJ, Myers BD. Structural determinants of glomerular permeability. Am J Physiol Renal Physiol. 2001;281(4):F579–96.
Ohlson M, Sorensson J, Haraldsson B. A gel-membrane model of glomerular charge and size selectivity in series. Am J Physiol Renal Physiol. 2001;280(3):F396–405.
Deen WM, et al. Heteroporous model of glomerular size selectivity: application to normal and nephrotic humans. Am J Physiol. 1985;249(3 Pt 2):F374–89.
Herget-Rosenthal S, Bokenkamp A, Hofmann W. How to estimate GFR-serum creatinine, serum cystatin C or equations? Clin Biochem. 2007;40(3–4):153–61.
Schwartz GJ, et al. New equations to estimate GFR in children with CKD. J Am Soc Nephrol. 2009;20(3):629–37.
Stevens LA, et al. Assessing kidney function–measured and estimated glomerular filtration rate. N Engl J Med. 2006;354(23):2473–83.
Kim KE, et al. Creatinine clearance in renal disease. A reappraisal. Br Med J. 1969;4(5674):11–4.
Schwartz GJ, Work DF. Measurement and estimation of GFR in children and adolescents. Clin J Am Soc Nephrol. 2009;4(11):1832–43.
Peti-Peterdi J, Bell PD. Cytosolic [Ca2+] signaling pathway in macula densa cells. Am J Physiol. 1999;277(3 Pt 2):F472–6.
Briggs JP, Schnermann JB. Whys and wherefores of juxtaglomerular apparatus function. Kidney Int. 1996;49(6):1724–6.
Schnermann J, Briggs J. Role of the renin-angiotensin system in tubuloglomerular feedback. Fed Proc. 1986;45(5):1426–30.
Shemesh O, et al. Effect of colloid volume expansion on glomerular barrier size-selectivity in humans. Kidney Int. 1986;29(4):916–23.
Kestila M, et al. Positionally cloned gene for a novel glomerular protein–nephrin–is mutated in congenital nephrotic syndrome. Mol Cell. 1998;1(4):575–82.
Caridi G, et al. Infantile steroid-resistant nephrotic syndrome associated with double homozygous mutations of podocin. Am J Kidney Dis. 2004;43(4):727–32.
Winn MP, et al. A mutation in the TRPC6 cation channel causes familial focal segmental glomerulosclerosis. Science. 2005;308(5729):1801–4.
Weins A, et al. Mutational and biological analysis of alpha-actinin-4 in focal segmental glomerulosclerosis. J Am Soc Nephrol. 2005;16(12):3694–701.
Hinkes B, et al. Positional cloning uncovers mutations in PLCE1 responsible for a nephrotic syndrome variant that may be reversible. Nat Genet. 2006;38(12):1397–405.
O’Connor PM. Renal oxygen delivery: matching delivery to metabolic demand. Clin Exp Pharmacol Physiol. 2006;33(10):961–7.
Kone BC. Metabolic basis of solute transport. In: Brenner BM, Rector FC, editors. Brenner and Rector’s the kidney, vol. 1. 8th ed. Philadelphia: Saunders Elsevier; 2008. p. 130.
Feraille E, Doucet A. Sodium-potassium-adenosinetriphosphatase-dependent sodium transport in the kidney: hormonal control. Physiol Rev. 2001;81(1):345–418.
Christov M, Alper SL. Tubular transport: core curriculum 2010. Am J Kidney Dis. 2010;56(6):1202–17.
Hughson M, et al. Glomerular number and size in autopsy kidneys: the relationship to birth weight. Kidney Int. 2003;63(6):2113–22.
Wang T, et al. Role of NHE isoforms in mediating bicarbonate reabsorption along the nephron. Am J Physiol Renal Physiol. 2001;281(6):F1117–22.
Preisig PA, et al. Role of the Na+/H + antiporter in rat proximal tubule bicarbonate absorption. J Clin Invest. 1987;80(4):970–8.
Aalkjaer C, et al. Sodium coupled bicarbonate transporters in the kidney, an update. Acta Physiol Scand. 2004;181(4):505–12.
Wang T, et al. Mechanisms of stimulation of proximal tubule chloride transport by formate and oxalate. Am J Physiol. 1996;271(2 Pt 2):F446–50.
Berry CA, Rector Jr FC. Mechanism of proximal NaCl reabsorption in the proximal tubule of the mammalian kidney. Semin Nephrol. 1991;11(2):86–97.
Rector Jr FC. Sodium, bicarbonate, and chloride absorption by the proximal tubule. Am J Physiol. 1983;244(5):F461–71.
Wright EM, Turk E. The sodium/glucose cotransport family SLC5. Pflugers Arch. 2004;447(5):510–8.
Uldry M, Thorens B. The SLC2 family of facilitated hexose and polyol transporters. Pflugers Arch. 2004;447(5):480–9.
Forster IC, et al. Proximal tubular handling of phosphate: a molecular perspective. Kidney Int. 2006;70(9):1548–59.
Biber J, et al. Parathyroid hormone-mediated regulation of renal phosphate reabsorption. Nephrol Dial Transplant. 2000;15 Suppl 6:29–30.
Gonska T, Hirsch JR, Schlatter E. Amino acid transport in the renal proximal tubule. Amino Acids. 2000;19(2):395–407.
Christensen EI, Birn H. Megalin and cubilin: synergistic endocytic receptors in renal proximal tubule. Am J Physiol Renal Physiol. 2001;280(4):F562–73.
Lopez-Nieto CE, et al. Molecular cloning and characterization of NKT, a gene product related to the organic cation transporter family that is almost exclusively expressed in the kidney. J Biol Chem. 1997;272(10):6471–8.
Sekine T, et al. Expression cloning and characterization of a novel multispecific organic anion transporter. J Biol Chem. 1997;272(30):18526–9.
Wright SH, Dantzler WH. Molecular and cellular physiology of renal organic cation and anion transport. Physiol Rev. 2004;84(3):987–1049.
Burckhardt G, Wolff NA. Structure of renal organic anion and cation transporters. Am J Physiol Renal Physiol. 2000;278(6):F853–66.
Enomoto A, Endou H. Roles of organic anion transporters (OATs) and a urate transporter (URAT1) in the pathophysiology of human disease. Clin Exp Nephrol. 2005;9(3):195–205.
DiBona GF. Neural mechanisms in body fluid homeostasis. Fed Proc. 1986;45(13):2871–7.
Baum M, Quigley R. Inhibition of proximal convoluted tubule transport by dopamine. Kidney Int. 1998;54(5):1593–600.
Broer A, et al. The molecular basis of neutral aminoacidurias. Pflugers Arch. 2006;451(4):511–7.
Goodyer P. The molecular basis of cystinuria. Nephron Exp Nephrol. 2004;98(2):e45–9.
Schiavi SC, Moe OW. Phosphatonins: a new class of phosphate-regulating proteins. Curr Opin Nephrol Hypertens. 2002;11(4):423–30.
Gottschalk CW, Mylle M. Micropuncture study of the mammalian urinary concentrating mechanism: evidence for the countercurrent hypothesis. Am J Physiol. 1959;196(4):927–36.
Sands JM, Layton HE. The physiology of urinary concentration: an update. Semin Nephrol. 2009;29(3):178–95.
Bray GA, Preston AS. Effect of urea on urine concentration in the rat. J Clin Invest. 1961;40:1952–60.
Zimmerhackl BL, Robertson CR, Jamison RL. The medullary microcirculation. Kidney Int. 1987;31(2):641–7.
Pannabecker TL, et al. Role of three-dimensional architecture in the urine concentrating mechanism of the rat renal inner medulla. Am J Physiol Renal Physiol. 2008;295(5):F1271–85.
Capasso G, Unwin R, Giebisch G. Role of the loop of Henle in urinary acidification. Kidney Int Suppl. 1991;33:S33–5.
Capasso G, et al. Bicarbonate transport along the loop of Henle. I. Microperfusion studies of load and inhibitor sensitivity. J Clin Invest. 1991;88(2):430–7.
Karim Z, et al. Recent concepts concerning the renal handling of NH3/NH4+. J Nephrol. 2006;19 Suppl 9:S27–32.
Quamme GA, Dirks JH. The physiology of renal magnesium handling. Ren Physiol. 1986;9(5):257–69.
Sutton RA, Domrongkitchaiporn S. Abnormal renal magnesium handling. Miner Electrolyte Metab. 1993;19(4–5):232–40.
Taugner R, et al. Gap junctional coupling between the JGA and the glomerular tuft. Cell Tissue Res. 1978;186(2):279–85.
Schnermann J. Juxtaglomerular cell complex in the regulation of renal salt excretion. Am J Physiol. 1998;274(2 Pt 2):R263–79.
Levens NR, Peach MJ, Carey RM. Role of the intrarenal renin-angiotensin system in the control of renal function. Circ Res. 1981;48(2):157–67.
Good DW. Sodium-dependent bicarbonate absorption by cortical thick ascending limb of rat kidney. Am J Physiol. 1985;248(6 Pt 2):F821–9.
Amirlak I, Dawson KP. Bartter syndrome: an overview. QJM. 2000;93(4):207–15.
de Groot T, Bindels RJ, Hoenderop JG. TRPV5: an ingeniously controlled calcium channel. Kidney Int. 2008;74(10):1241–6.
Reilly RF, Ellison DH. Mammalian distal tubule: physiology, pathophysiology, and molecular anatomy. Physiol Rev. 2000;80(1):277–313.
Wang WH, Schwab A, Giebisch G. Regulation of small-conductance K + channel in apical membrane of rat cortical collecting tubule. Am J Physiol. 1990;259(3 Pt 2):F494–502.
Wade JB, et al. WNK1 kinase isoform switch regulates renal potassium excretion. Proc Natl Acad Sci U S A. 2006;103(22):8558–63.
Liu Z, Wang HR, Huang CL. Regulation of ROMK channel and K + homeostasis by kidney-specific WNK1 kinase. J Biol Chem. 2009;284(18):12198–206.
Lu Z, MacKinnon R. Electrostatic tuning of Mg2+ affinity in an inward-rectifier K + channel. Nature. 1994;371(6494):243–6.
Sands JM, Knepper MA. Urea permeability of mammalian inner medullary collecting duct system and papillary surface epithelium. J Clin Invest. 1987;79(1):138–47.
Nielsen S, et al. Aquaporins in the kidney: from molecules to medicine. Physiol Rev. 2002;82(1):205–44.
Wade JB, Stetson DL, Lewis SA. ADH action: evidence for a membrane shuttle mechanism. Ann N Y Acad Sci. 1981;372:106–17.
Smith CP. Mammalian urea transporters. Exp Physiol. 2009;94(2):180–5.
Teng-umnuay P, et al. Identification of distinct subpopulations of intercalated cells in the mouse collecting duct. J Am Soc Nephrol. 1996;7(2):260–74.
Schwartz GJ, Barasch J, Al-Awqati Q. Plasticity of functional epithelial polarity. Nature. 1985;318(6044):368–71.
Al-Awqati Q. Plasticity in epithelial polarity of renal intercalated cells: targeting of the H(+)-ATPase and band 3. Am J Physiol. 1996;270(6 Pt 1):C1571–80.
Bonegio R, Lieberthal W. Role of apoptosis in the pathogenesis of acute renal failure. Curr Opin Nephrol Hypertens. 2002;11(3):301–8.
Kellenberger S, Gautschi I, Schild L. Mutations in the epithelial Na + channel ENaC outer pore disrupt amiloride block by increasing its dissociation rate. Mol Pharmacol. 2003;64(4):848–56.
Shimkets RA, et al. Liddle’s syndrome: heritable human hypertension caused by mutations in the beta subunit of the epithelial sodium channel. Cell. 1994;79(3):407–14.
Chang SS, et al. Mutations in subunits of the epithelial sodium channel cause salt wasting with hyperkalaemic acidosis, pseudohypoaldosteronism type 1. Nat Genet. 1996;12(3):248–53.
Huang CL, Kuo E. Mechanism of hypokalemia in magnesium deficiency. J Am Soc Nephrol. 2007;18(10):2649–52.
Ko GJ, Rabb H, Hassoun HT. Kidney-lung crosstalk in the critically ill patient. Blood Purif. 2009;28(2):75–83.
Wang GL, et al. Hypoxia-inducible factor 1 is a basic-helix-loop-helix-PAS heterodimer regulated by cellular O2 tension. Proc Natl Acad Sci U S A. 1995;92(12):5510–4.
Arany Z, et al. An essential role for p300/CBP in the cellular response to hypoxia. Proc Natl Acad Sci U S A. 1996;93(23):12969–73.
Grigoryev DN, et al. The local and systemic inflammatory transcriptome after acute kidney injury. J Am Soc Nephrol. 2008;19(3):547–58.
Hoke TS, et al. Acute renal failure after bilateral nephrectomy is associated with cytokine-mediated pulmonary injury. J Am Soc Nephrol. 2007;18(1):155–64.
Li X, et al. Organ crosstalk: the role of the kidney. Curr Opin Crit Care. 2009;15(6):481–7.
Paladino JD, Hotchkiss JR, Rabb H. Acute kidney injury and lung dysfunction: a paradigm for remote organ effects of kidney disease? Microvasc Res. 2009;77(1):8–12.
Liu M, et al. Acute kidney injury leads to inflammation and functional changes in the brain. J Am Soc Nephrol. 2008;19(7):1360–70.
Kelly KJ. Distant effects of experimental renal ischemia/reperfusion injury. J Am Soc Nephrol. 2003;14(6):1549–58.
Shimozawa N, et al. Diagnosis of Zellweger syndrome by rectal biopsy: immunoblot of peroxisomal beta-oxidation enzyme and activity of dihydroxyacetone phosphate acyltransferase in rectal mucosa. Clin Chim Acta. 1988;175(3):345–7.
Price JF, Goldstein SL. Cardiorenal syndrome in children with heart failure. Curr Heart Fail Rep. 2009;6(3):191–8.
Price JF, et al. Worsening renal function in children hospitalized with decompensated heart failure: evidence for a pediatric cardiorenal syndrome? Pediatr Crit Care Med. 2008;9(3):279–84.
Rabb H, et al. Acute renal failure leads to dysregulation of lung salt and water channels. Kidney Int. 2003;63(2):600–6.
Basu RK, Wheeler D. Effects of ischemic acute kidney injury on lung water balance: nephrogenic pulmonary edema? Pulm Med. 2011;2011:414253.
Liu KD. Impact of acute kidney injury on lung injury. Am J Physiol Lung Cell Mol Physiol. 2009;296(1):L1–2.
Singbartl K. Renal-pulmonary crosstalk. Contrib Nephrol. 2011;174:65–70.
Schrier RW, Wang W. Acute renal failure and sepsis. N Engl J Med. 2004;351(2):159–69.
Langenberg C, et al. Renal blood flow in experimental septic acute renal failure. Kidney Int. 2006;69(11):1996–2002.
Guyton AC, Hall JE. Urine formation by the kidneys: I. Glomerular filtration, renal blood flow, and their control. In: Guyton AC, Hall JE, editors. Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Saunders; 2011. p. 307–25.
Guyton AC, Hall JE. Regulation of extracellular fluid osmolarity and sodium concentration. In: Guyton AC, Hall JE, editors. Textbook of medical physiology. 11th ed. Philadelphia: Elsevier Saunders; 2011. p. 348–63.
Weichert J. Urinary system. On-line biological and bio-medical science encyclopedia. New York: McGraw-Hill Publishing; 2012.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag London
About this chapter
Cite this chapter
Samraj, R.S., Basu, R.K. (2014). Applied Renal Physiology in the PICU. In: Wheeler, D., Wong, H., Shanley, T. (eds) Pediatric Critical Care Medicine. Springer, London. https://doi.org/10.1007/978-1-4471-6416-6_12
Download citation
DOI: https://doi.org/10.1007/978-1-4471-6416-6_12
Published:
Publisher Name: Springer, London
Print ISBN: 978-1-4471-6415-9
Online ISBN: 978-1-4471-6416-6
eBook Packages: MedicineMedicine (R0)