FUNCTIONS OF THE KIDNEYS Familiar functions of the kidneys: to rid the body of waste materials that are either

ingested or produced by metabolism to control the volume and composition of the body fluids Homeostatic functions: Excretion of metabolic waste products and foreign chemicals Regulation of water and electrolyte balances Regulation of body fluid osmolality and electrolyte concentrations Regulation of arterial pressure Regulation of acid-base balance Secretion, metabolism, and excretion of hormones Gluconeogenesis Excretion of Metabolic Waste Products, Foreign Chemicals, Drugs, and Hormone Metabolites waste products of metabolism are no longer needed by the body like: urea (from the metabolism of amino acids) creatinine (from muscle creatine) uric acid (from nucleic acids) end products of hemoglobin breakdown (such as bilirubin) metabolites of various hormones Elimination of most toxins and other foreign substances that are either produced by the body or ingested: pesticides, drugs, and food additives Regulation of Water and Electrolyte Balances Homeostasis: Intake = excretion of water and electrolytes Regulation of Arterial Pressure Kidneys play a dominant role in the long-term regulation of arterial pressure by excreting variable amounts of sodium and water (Blood volume control) Short-term arterial pressure regulation by secreting hormones and vasoactive factors or substances (e.g., renin) that lead to the formation of vasoactive products (e.g., angiotensin II) Regulation of Acid-Base Balance Kidneys are the only means of eliminating from the body certain types of acids, such as sulfuric acid and phosphoric acid, generated by the metabolism of proteins. Regulation of Erythrocyte Production (Erythropoiesis) The kidneys secrete erythropoietin (90%, remainder is formed in the liver), which stimulates the production of red blood cells by hematopoietic stem cells in the bone marrow. Hypoxia stimulus for erythropoietin secretion Regulation of 1,25-Dihydroxyvitamin D3 Production The kidneys produce the active form of vitamin D, 1,25-dihydroxyvitamin D3 (calcitriol), by hydroxylating this vitamin at the "number 1" position Calcitriol essential for normal calcium deposition in bone and calcium reabsorption by the gastrointestinal tract Glucose Synthesis (Gluconeogenesis) During prolonged fasting, kidneys synthesize glucose from non-carbohydrate sources: amino acids from proteins glycerol from triglycerides

Module: Bloody Urine and Puffy Eyelids Reference: th Guyton and Hall Textbook of Medical Physiology, 12 ed. By: Master Hope Elmer II G. Panduyos Medicine II-B