Nephron anatomy is fundamental to understanding kidney physiology, disease mechanisms, and targeted therapies. Yet, many trainees learn it through static diagrams and rote memorization, which can feel abstract and disconnected from clinical application. I wanted to design a…
Mythri Shankar, MD, DNBAssistant Professor of NephrologyInstitute of Nephrourology, Bengaluru, India@nephromythri Yuri Gagarin was the first human to leave earth in the year 1961. Since then over 500 astronauts and cosmonauts have visited space. During the initial days,…
To follow up on one of Nate’s posts from 2010, hair grows not only on your skin. He describes a glomerular capillary to be hairy. Glycocalyx, a hairy structure attached to the glomerular endothelium, is a mixture of…
It is well known that hypokalemia does not correct easily if it is accompanied by hypomagnesemia. A medical student I met looked into this topic and found a “Science in Renal Medicine” article. According to this article, one of…
Summer has come to the northern hemisphere and it is time to praise our kidneys for all the hard work of preserving the intravascular volume. Although only 30% of Na reabsorption takes place in the distal nephron, this…
The fractional excretion of sodium (FeNa) is a test that is often used in the setting of acute renal failure to help distinguish between pre-renal and intra-renal causes that has been mentioned in previous blog posts. In general,…
Hypertonicity in kidney medullary interstitium is essential for urinary concentration. Osmolality in the papillary interstitium can reach up to 1200 mOsm/kg. How do cells in the renal medullary interstitium survive this hypertonic stress? Virtually all cells respond to…
As Nate mentioned in a previous post, the urinary anion gap is helpful in differentiating whether a non-gap acidosis is of renal or extra-renal origin. Urinary Anion Gap = Na + K – Cl Because the major cation…
There are two major types of intercalated cell in the collecting duct of the nephron – the alpha and beta intercalated cells. We are probably most familiar with the alpha intercalated cells in terms of acid-base handling by…
This intriguing set of clinical signs was discovered by von Bezold and Hirt in 1867 – they found that injection of a veratrum alkaloid caused bradycardia, hypotension and apnea. In the 1930’s Jarisch and Richter were performing similar…
