basic medial science of the kidney: the scientific basis of clinical disease, marc imhotep cray,...

7/21/2019 Basic Medial Science of the Kidney: The Scientific Basis of Clinical Disease, Marc Imhotep Cray, M.D.

1/150

Ycd Rbkdltkfkb M`sks gf Bnklkb`n Iksd`sd

KVAR| M`skb Adikb`n Rbkdlbdgf tcd Hkildy

R M`skb Adbik`n Rbkdlbd gf tcd Hkildy, Ycd Rbkdltkfkb M`sks gf Bnklkb`n Iksd`sd

Bgapkndi my A`rb Kacgtdp Br`y, A.I.(0=-02-v0)

Fgr Kacgtdp Vkrtu`n Adikb`n Rbcggn TRAND Rtdp 0 `li Rtdp = rdvkdw prdp`r`tkgl prgjr`as.

Vkskt gur wdmsktd5 cttp5//www.kacgtdpvkrtu`nadisbc.bga/
http://www.imhotepvirtualmedsch.com/


2/150

Bgltdlts

@rtkbnds

Hkildy 0

]dl`n fulbtkgl 02

]dl`n bgrpusbnd ==

Ldpcrgl =9

Jngadrunus =;

Mgwa`l's b`psund 22

]dl`n pcyskgngjy 26

]dl`n jnubgsd rd`msgrptkgl 90

]dl`n sgikua rd`msgrptkgl 9=

]dl`n bcngrkid rd`msgrptkgl 99

]dl`n prgtdkl rd`msgrptkgl 94

]dl`n tumun`r `bkigsks 96

_rgxka`n rdl`n tumun`r `bkigsks 9;

Ikst`n rdl`n tumun`r `bkigsks 40

]dl`n urd` c`linklj 42

@aaglk` 49

Trkld :9

Bnd`r`lbd (adikbkld) 30

Mnggi prdssurd 34

Drytcrgpgkdtkl 0??

B`nbkua adt`mgnksa 0?;

Fnuki m`n`lbd 002

V`sgprdsskl 00:

@nigstdrgld 0=3

Bgultdrburrdlt auntkpnkb`tkgl 029

Gsagrdjun`tkgl 024

Nggp gf Cdlnd 02;

Z`tdr-dndbtrgnytd kam`n`lbd 09=

Cypgl`trdak` 092

Cypdrl`trdak` 09;

@bkim`sd cgadgst`sks 040

@bkigsks 049

@nh`ngsks 04:

Jngadrungldpcrktks 04;



3/150

Kltdrstktk`n ldpcrktks 069

Ik`mdtkb ldpcrgp`tcy 066

@butd hkildy kleury 0:0

@butd tumun`r ldbrgsks 0:6

Bcrglkb hkildy iksd`sd 0:3

Ik`nysks 034

Hkildy tr`lspn`lt`tkgl 0;?

]dfdrdlbds

@rtkbnd Rgurbds `li Bgltrkmutgrs 0;;

Ka`jd Rgurbds, Nkbdlsds li Bgltrkmutgrs =?9

@rtkbnd NkbdlsdsNkbdlsd =?:



4/150

Hkildy 0

Hkildy

Hkildy

Cua`l hkildys vkdwdi frga mdckli wktc spkld rdagvdi

N`tkl ]dl (Jrddh5 ldpcrgs)

Rystda Trkl`ry systda `li dligbrkld systda@rtdry ]dl`n rtdry

Vdkl ]dl`n vdkl

Ldrvd ]dl`n pndxus

AdRC HkildyX0Q

Igrn`lis/DnsdvkdrHkildy

X=Q

Ycd hkildys `rd grj`ls tc`t sdrvd sdvdr`n dssdltk`n rdjun`tgry rgnds kl vdrtdmr`td `lka`ns. Ycdy `rd dssdltk`n kl tcd

urkl`ry systda `li `nsg sdrvd cgadgst`tkb fulbtkgls subc `s tcd rdjun`tkgl gf dndbtrgnytds, a`kltdl`lbd gf `bkim`sd

m`n`lbd, `li rdjun`tkgl gf mnggi prdssurd (vk` a`klt`klklj s`nt `li w`tdr m`n`lbd). Ycdy sdrvd tcd mgiy `s ` l`tur`nfkntdr gf tcd mnggi, `li rdagvd w`stds, wckbc `rd ikvdrtdi tg tcd urkl`ry mnìidr. Kl prgiubklj urkld, tcd hkildys

dxbrdtd w`stds subc `s urd` `li àaglkua, `li tcdy `rd `nsg rdspglskmnd fgr tcd rd`msgrptkgl gf w`tdr, jnubgsd, `li

àklg `bkis. Ycd hkildys `nsg prgiubd cgraglds klbnuiklj b`nbktrkgn, drytcrgpgkdtkl, `li tcd dlzyad rdlkl.

Ngb`tdi `t tcd rd`r gf tcd `migakl`n b`vkty kl tcd rdtrgpdrktgldua, tcd hkildys rdbdkvd mnggi frga tcd p`krdi rdl`n

`rtdrkds, `li ir`kl kltg tcd p`krdi rdl`n vdkls. D`bc hkildy dxbrdtds urkld kltg ` urdtdr, ktsdnf ` p`krdi strubturd tc`t

daptkds kltg tcd urkl`ry mnìidr.

]dl`n pcyskgngjy ks tcd stuiy gf hkildy fulbtkgl, wcknd ldpcrgngjy ks tcd adikb`n spdbk`nty bglbdrldi wktc hkildy

iksd`sds. Iksd`sds gf tcd hkildy `rd ikvdrsd, mut klikvkiu`ns wktc hkildy iksd`sd frdqudltny ikspn`y bc`r`btdrkstkb

bnklkb`n fd`turds. Bgaagl bnklkb`n bgliktkgls klvgnvklj tcd hkildy klbnuid tcd ldpcrktkb `li ldpcrgtkb sylirgads,rdl`n bysts, `butd hkildy kleury, bcrglkb hkildy iksd`sd, urkl`ry tr`bt klfdbtkgl, ldpcrgnktck`sks, `li urkl`ry tr`bt

gmstrubtkgl. V`rkgus b`lbdrs gf tcd hkildy dxkst8 tcd agst bgaagl ìunt rdl`n b`lbdr ks rdl`n bdnn b`rbklga`.

B`lbdrs, bysts, `li sgad gtcdr rdl`n bgliktkgls b`l md a`l`jdi wktc rdagv`n gf tcd hkildy, gr ldpcrdbtgay. Zcdl

rdl`n fulbtkgl, ad`surdi my jngadrun`r fkntr`tkgl r`td, ks pdrskstdltny pggr, ik`nysks `li hkildy tr`lspn`lt`tkgl a`y

md trd`tadlt gptkgls. @ntcgujc tcdy `rd lgt lgra`nny c`rafun, hkildy stglds b`l md p`klfun `li rdpd`tdi, bcrglkb

fgra`tkgl gf stglds b`l sb`r tcd hkildys. Ycd rdagv`n gf hkildy stglds klvgnvds untr`sguli trd`tadlt tg mrd`h up tcd

stglds kltg sa`nndr pkdbds, wckbc `rd tcdl p`ssdi tcrgujc tcd urkl`ry tr`bt. Gld bgaagl syaptga gf hkildy stglds

ks ` sc`rp tg iks`mnklj p`kl kl tcd adik`n/n`tdr`n sdjadlts gf tcd ngwdr m`bh gr jrgkl.

https://en.wikipedia.org/w/index.php?title=Ultrasoundhttps://en.wikipedia.org/w/index.php?title=Ultrasoundhttps://en.wikipedia.org/w/index.php?title=Kidney_stonehttps://en.wikipedia.org/w/index.php?title=Glomerular_filtration_ratehttps://en.wikipedia.org/w/index.php?title=Nephrectomyhttps://en.wikipedia.org/w/index.php?title=Renal_cell_carcinomahttps://en.wikipedia.org/w/index.php?title=Urinary_tract_obstructionhttps://en.wikipedia.org/w/index.php?title=Urinary_tract_obstructionhttps://en.wikipedia.org/w/index.php?title=Nephrolithiasishttps://en.wikipedia.org/w/index.php?title=Urinary_tract_infectionhttps://en.wikipedia.org/w/index.php?title=Renal_cysthttps://en.wikipedia.org/w/index.php?title=Nephrotic_syndromehttps://en.wikipedia.org/w/index.php?title=Nephritic_syndromehttps://en.wikipedia.org/w/index.php?title=Kidney_diseasehttps://en.wikipedia.org/w/index.php?title=Kidney_diseasehttps://en.wikipedia.org/w/index.php?title=Nephrologyhttps://en.wikipedia.org/w/index.php?title=Urinary_bladderhttps://en.wikipedia.org/w/index.php?title=Ureterhttps://en.wikipedia.org/w/index.php?title=Renal_veinhttps://en.wikipedia.org/w/index.php?title=Renal_arteryhttps://en.wikipedia.org/w/index.php?title=Renal_arteryhttps://en.wikipedia.org/w/index.php?title=Retroperitoneumhttps://en.wikipedia.org/w/index.php?title=Abdominal_cavityhttps://en.wikipedia.org/w/index.php?title=Reninhttps://en.wikipedia.org/w/index.php?title=Calcitriolhttps://en.wikipedia.org/w/index.php?title=Hormonehttps://en.wikipedia.org/w/index.php?title=Amino_acidhttps://en.wikipedia.org/w/index.php?title=Glucosehttps://en.wikipedia.org/w/index.php?title=Waterhttps://en.wikipedia.org/w/index.php?title=Ammoniumhttps://en.wikipedia.org/w/index.php?title=Ureahttps://en.wikipedia.org/w/index.php?title=Urinary_bladderhttps://en.wikipedia.org/w/index.php?title=Bloodhttps://en.wikipedia.org/w/index.php?title=Electrolytehttps://en.wikipedia.org/w/index.php?title=Homeostasishttps://en.wikipedia.org/w/index.php?title=Urinary_systemhttps://en.wikipedia.org/w/index.php?title=Animalhttps://en.wikipedia.org/w/index.php?title=Vertebratehttps://en.wikipedia.org/w/index.php?title=Organ_%28anatomy%29http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/five/000056330.htmhttps://en.wikipedia.org/w/index.php?title=Elsevierhttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Kidneyhttps://en.wikipedia.org/w/index.php?title=Medical_Subject_Headingshttps://en.wikipedia.org/w/index.php?title=Renal_plexushttps://en.wikipedia.org/w/index.php?title=Nervehttps://en.wikipedia.org/w/index.php?title=Renal_veinhttps://en.wikipedia.org/w/index.php?title=Veinhttps://en.wikipedia.org/w/index.php?title=Renal_arteryhttps://en.wikipedia.org/w/index.php?title=Arteryhttps://en.wikipedia.org/w/index.php?title=Endocrine_systemhttps://en.wikipedia.org/w/index.php?title=Urinary_systemhttps://en.wikipedia.org/w/index.php?title=Organ_systemhttps://en.wikipedia.org/w/index.php?title=Greek_languagehttps://en.wikipedia.org/w/index.php?title=Latinhttps://en.wikipedia.org/w/index.php?title=Human_vertebral_columnhttps://en.wikipedia.org/w/index.php?title=File:Gray1123.png


5/150

Hkildy =

@l`tgay

Ngb`tkgl

Rurf`bd prgedbtkgls gf tcd grj`ls gf tcd trulh, scgwklj hkildys

`t tcd ndvdn gf Y0= tg N=.

@ BY sb`l kl wckbc tcd hkildys `rd scgwl

Kl cua`ls tcd hkildys `rd ngb`tdi kl

tcd `migakl`n b`vkty, agrd spdbkfkb`nny

kl tcd p`r`vdrtdmr`n juttdr `li nkd kl `rdtrgpdrktgld`n pgsktkgl `t ` snkjctny

gmnkqud `ljnd. Ycdrd `rd twg hkildys.

Gld ks gl d`bc skid gf tcd spkld. Ycd

`syaadtry wktckl tcd `migakl`n

b`vkty bùsdi my tcd nkvdr typkb`nny

rdsunts kl tcd rkjct hkildy mdklj

snkjctny ngwdr tc`l tcd ndft, `li ndft

hkildy mdklj ngb`tdi snkjctny agrd

adik`n tc`l tcd rkjct. Ycd ndft hkildy

ks `pprgxka`tdny `t tcd vdrtdmr`n ndvdnY0= tg N2,X2Q `li tcd rkjct snkjctny

ngwdr. Ycd rkjct hkildy skts eust mdngw

tcd ik`pcr`ja `li pgstdrkgr tg tcd

nkvdr, tcd ndft mdngw tcd ik`pcr`ja `li

pgstdrkgr tg tcd spnddl. ]dstklj gl tgp

gf d`bc hkildy ks `l ìrdl`n jn`li. Ycd

uppdr (br`lk`n) p`rts gf tcd hkildys `rd

p`rtk`nny prgtdbtdi my tcd dndvdltc `li

twdnftc rkms, `li d`bc wcgnd hkildy

`li ìrdl`n jn`li `rd surrgulidi my

twg n`ydrs gf f`t (tcd pdrkrdl`n `li

p`r`rdl`n f`t) `li tcd rdl`n f`sbk`.

D`bc ìunt hkildy wdkjcs mdtwddl 0=4

`li 0:? jràs kl a`nds `li mdtwddl

004 `li 044 jràs kl fda`nds. Ycd ndft

hkildy ks usu`nny snkjctny n`rjdr tc`l

tcd rkjct hkildy.

https://en.wikipedia.org/w/index.php?title=Renal_fasciahttps://en.wikipedia.org/w/index.php?title=Ribhttps://en.wikipedia.org/w/index.php?title=Adrenal_glandhttps://en.wikipedia.org/w/index.php?title=Spleenhttps://en.wikipedia.org/w/index.php?title=Liverhttps://en.wikipedia.org/w/index.php?title=Diaphragm_%28anatomy%29https://en.wikipedia.org/w/index.php?title=Liverhttps://en.wikipedia.org/w/index.php?title=Retroperitonealhttps://en.wikipedia.org/w/index.php?title=Abdominal_cavityhttps://en.wikipedia.org/w/index.php?title=File%3ACTscankidney.jpghttps://en.wikipedia.org/w/index.php?title=File%3ASurface_projections_of_the_organs_of_the_trunk.pnghttps://en.wikipedia.org/w/index.php?title=Trunk_%28anatomy%29


6/150

Hkildy 2

Rtrubturd

0. ]dl`n pyràki =. Kltdrngmun`r `rtdry 2. ]dl`n `rtdry 9. ]dl`nvdkl 4. ]dl`n cknua 6. ]dl`n pdnvks :. Trdtdr 3. Aklgr b`nyx ;. ]dl`n b`psund 0?. Klfdrkgr rdl`n b`psund 00. Rupdrkgr rdl`nb`psund 0=. Kltdrngmun`r vdkl 02. Ldpcrgl 09. Aklgr b`nyx

04. Aègr b`nyx 06. ]dl`n p`pknn` 0:. ]dl`n bgnual

Ycd hkildy c`s ` md`l-sc`pdi strubturd8 d`bc hkildy

c`s ` bglvdx `li bglb`vd surf`bd. Ycd bglb`vd

surf`bd, tcd rdl`n cknua, ks tcd pgklt `t wckbc tcd rdl`n

`rtdry dltdrs tcd grj`l, `li tcd rdl`n vdkl `li urdtdr

nd`vd. Ycd hkildy ks surrgulidi my tgujc fkmrgustkssud, tcd rdl`n b`psund, wckbc ks ktsdnf surrgulidi my

pdrkldpcrkb f`t, rdl`n f`sbk` (gf Jdrgt`) `li p`r`ldpcrkb

f`t. Ycd `ltdrkgr (frglt) mgridr gf tcdsd tkssuds ks tcd

pdrktgldua, wcknd tcd pgstdrkgr (rd`r) mgridr ks tcd

tr`lsvdrs`nks f`sbk`.

Ycd supdrkgr mgridr gf tcd rkjct hkildy ks ìe`bdlt tg

tcd nkvdr8 `li tcd spnddl, fgr tcd ndft hkildy. Ycdrdfgrd,

mgtc agvd igwl gl klc`n`tkgl.

Ycd hkildy ks `pprgxka`tdny 0009 ba kl ndljtc, 6 bawkid `li 9 ba tckbh.

Ycd sumst`lbd, gr p`rdlbcya`, gf tcd hkildy ks ikvkidi

kltg twg aègr strubturds5 supdrfkbk`n ks tcd rdl`n bgrtdx

`li iddp ks tcd rdl`n adiunn`. Jrgssny, tcdsd strubturds

t`hd tcd sc`pd gf 3 tg 03 bgld-sc`pdi rdl`n ngmds, d`bc

bglt`klklj rdl`n bgrtdx surrguliklj ` pgrtkgl gf

adiunn` b`nndi ` rdl`n pyràki (gf A`npkjck). Mdtwddl tcd rdl`n pyràkis `rd prgedbtkgls gf bgrtdx b`nndi rdl`n

bgnuals (gf Mdrtkl). Ldpcrgls, tcd urkld-prgiubklj fulbtkgl`n strubturds gf tcd hkildy, sp`l tcd bgrtdx `li adiunn`.

Ycd klktk`n fkntdrklj pgrtkgl gf ` ldpcrgl ks tcd rdl`n bgrpusbnd, ngb`tdi kl tcd bgrtdx, wckbc ks fgnngwdi my ` rdl`n

tumund tc`t p`ssds frga tcd bgrtdx iddp kltg tcd adiunn`ry pyràkis. _`rt gf tcd rdl`n bgrtdx, ` adiunn`ry r`y ks `

bgnndbtkgl gf rdl`n tumunds tc`t ir`kl kltg ` skljnd bgnndbtklj iubt.

Ycd tkp, gr p`pknn`, gf d`bc pyràki daptkds urkld kltg ` aklgr b`nyx8 aklgr b`nybds dapty kltg aègr b`nybds, `li

aègr b`nybds dapty kltg tcd rdl`n pdnvks, wckbc mdbgads tcd urdtdr. @t tcd cknua, tcd urdtdr `li rdl`n vdkl dxkt tcd

hkildy wcknd tcd rdl`n `rtdry dltdrs. Rurrguliklj tcdsd strubturds ks ckn`r f`t `li nyapc`tkb tkssud wktc nyapc lgids.

Ycd ckn`r f`t ks bgltkjugus wktc ` f`t-fknndi b`vkty b`nndi tcd rdl`n sklus. Ycd rdl`n sklus bgnndbtkvdny bglt`kls tcd

rdl`n pdnvks `li b`nybds `li sdp`r`tds tcdsd strubturds frga tcd rdl`n adiunn`ry tkssud. X9Q

Mnggi suppny

2I-rdlidrdi bgaputdi tgagjr`pcy, scgwklj

rdl`n `rtdrkds `li vdkls.

Ycd hkildys rdbdkvd mnggi frga tcd rdl`n `rtdrkds, ndft `li rkjct, wckbc

mr`lbc ikrdbtny frga tcd `migakl`n `grt`. Idspktd tcdkr rdn`tkvdny sa`nn

skzd, tcd hkildys rdbdkvd `pprgxka`tdny =?% gf tcd b`rik`b gutput.

D`bc rdl`n `rtdry mr`lbcds kltg sdjadlt`n `rtdrkds, ikvkiklj furtcdr kltg

kltdrngm`r `rtdrkds, wckbc pdldtr`td tcd rdl`n b`psund `li dxtdli

tcrgujc tcd rdl`n bgnuals mdtwddl tcd rdl`n pyràkis. Ycd kltdrngm`r

`rtdrkds tcdl suppny mnggi tg tcd `rbu`td `rtdrkds tc`t rul tcrgujc tcd

mguli`ry gf tcd bgrtdx `li tcd adiunn`. D`bc `rbu`td `rtdry suppnkds

sdvdr`n kltdrngmun`r `rtdrkds tc`t fddi kltg tcd `ffdrdlt `rtdrkgnds tc`t

suppny tcd jngadrunk.

https://en.wikipedia.org/w/index.php?title=Afferent_arteriolehttps://en.wikipedia.org/w/index.php?title=Interlobularhttps://en.wikipedia.org/w/index.php?title=Arcuate_arterieshttps://en.wikipedia.org/w/index.php?title=Interlobar_arterieshttps://en.wikipedia.org/w/index.php?title=Cardiac_outputhttps://en.wikipedia.org/w/index.php?title=Abdominal_aortahttps://en.wikipedia.org/w/index.php?title=Renal_arteryhttps://en.wikipedia.org/w/index.php?title=File%3A3D_rendered_CT_of_abdominal_aortic_branches_and_kidneys.svghttps://en.wikipedia.org/w/index.php?title=X-ray_computed_tomographyhttps://en.wikipedia.org/w/index.php?title=Renal_sinushttps://en.wikipedia.org/w/index.php?title=Renal_pelvishttps://en.wikipedia.org/w/index.php?title=Major_calyceshttps://en.wikipedia.org/w/index.php?title=Minor_calyxhttps://en.wikipedia.org/w/index.php?title=Renal_papillahttps://en.wikipedia.org/w/index.php?title=Collecting_ducthttps://en.wikipedia.org/w/index.php?title=Medullary_ray_%28anatomy%29https://en.wikipedia.org/w/index.php?title=Renal_tubulehttps://en.wikipedia.org/w/index.php?title=Renal_tubulehttps://en.wikipedia.org/w/index.php?title=Exupere_Joseph_Bertinhttps://en.wikipedia.org/w/index.php?title=Renal_columnhttps://en.wikipedia.org/w/index.php?title=Renal_columnhttps://en.wikipedia.org/w/index.php?title=Marcello_Malpighihttps://en.wikipedia.org/w/index.php?title=Renal_pyramidhttps://en.wikipedia.org/w/index.php?title=Renal_lobehttps://en.wikipedia.org/w/index.php?title=Renal_medullahttps://en.wikipedia.org/w/index.php?title=Renal_cortexhttps://en.wikipedia.org/w/index.php?title=Parenchymahttps://en.wikipedia.org/w/index.php?title=Spleenhttps://en.wikipedia.org/w/index.php?title=Transversalis_fasciahttps://en.wikipedia.org/w/index.php?title=Peritoneumhttps://en.wikipedia.org/w/index.php?title=Paranephric_fathttps://en.wikipedia.org/w/index.php?title=Paranephric_fathttps://en.wikipedia.org/w/index.php?title=Dimitrie_Gerotahttps://en.wikipedia.org/w/index.php?title=Renal_fasciahttps://en.wikipedia.org/w/index.php?title=Perinephric_fathttps://en.wikipedia.org/w/index.php?title=Renal_capsulehttps://en.wikipedia.org/w/index.php?title=Ureterhttps://en.wikipedia.org/w/index.php?title=Renal_veinhttps://en.wikipedia.org/w/index.php?title=Renal_arteryhttps://en.wikipedia.org/w/index.php?title=Renal_arteryhttps://en.wikipedia.org/w/index.php?title=Renal_hilumhttps://en.wiktionary.org/wiki/concavehttps://en.wiktionary.org/wiki/convexhttps://en.wikipedia.org/w/index.php?title=Beanhttps://en.wikipedia.org/w/index.php?title=File%3AKidneyStructures_PioM.svg


7/150

Hkildy 9

Ycd kltdrstktkua ks tcd fulbtkgl`n sp`bd kl tcd hkildy mdld`tc tcd klikvkiu`n fkntdrs (jngadrunk), wckbc `rd rkbc kl

mnggi vdssdns. Ycd kltdrstktua `msgrms fnuki rdbgvdrdi frga urkld. V`rkgus bgliktkgls b`l ndì tg sb`rrklj `li

bgljdstkgl gf tcks `rd`, wckbc b`l bùsd hkildy iysfulbtkgl `li f`knurd.

@ftdr fkntr`tkgl gbburs tcd mnggi agvds tcrgujc ` sa`nn ldtwgrh gf vdlunds tc`t bglvdrjd kltg kltdrngmun`r vdkls. @s

wktc tcd `rtdrkgnd ikstrkmutkgl tcd vdkls fgnngw tcd sàd p`ttdrl, tcd kltdrngmun`r prgvkid mnggi tg tcd `rbu`td vdkls

tcdl m`bh tg tcd kltdrngm`r vdkls, wckbc bgad tg fgra tcd rdl`n vdkl dxktklj tcd hkildy fgr tr`lsfuskgl fgr mnggi.

Ckstgngjy

Akbrgsbgpkb pcgtgjr`pc gf tcd rdl`n adiunn`

Akbrgsbgpkb pcgtgjr`pc gf tcd rdl`n bgrtdx

]dl`n ckstgngjy stuikds tcd strubturd gf tcd hkildy `s vkdwdi ulidr `

akbrgsbgpd. V`rkgus ikstklbt bdnn typds gbbur kl tcd hkildy, klbnuiklj5

Hkildy jngadrunus p`rkdt n bdnn

Hkildy jngadrunus pgigbytd

Hkildy prgxka n tumund mrusc mgridr bdnn

Nggp gf Cdlnd tckl sdjadlt bdnn

Yckbh sbdliklj nkam bdnn Hkildy ikst n tumund bdnn

Hkildy bgnndbtklj iubt bdnn

Kltdrstktk`n hkildy bdnns

]dl`n `rtdrkds `li tcdkr mr`lbcds

Ycd rdl`n `rtdry dltdrs kltg tcd hkildy `t tcd ndvdn gf fkrst nuam`r

vdrtdmr` eust mdngw tcd supdrkgr adsdltdrkb `rtdry. @s kt dltdrs tcd

hkildy kt ikvkids kltg mr`lbcds5 fkrst tcd sdjadlt`n `rtdry, wckbc

ikvkids kltg = gr 2 ngm`r `rtdrkds, tcdl furtcdr ikvkids kltg kltdrngm`r

`rtdrkds, wckbc furtcdr ikvkid kltg tcd `rbu`td `rtdry, wckbc ndìs kltg

tcd kltdrngmun`r `rtdry, wckbc fgra `ffdrdlt `rtdrkgnds. Ycd `ffdrdlt`rtdrkgnds fgra tcd jngadrunus (ldtwgrh gf b`pknn`rkds bngsdi kl

Mgwa`l's b`psund). Frga cdrd, dffdrdlt `rtdrkgnds nd`vds tcd

jngadrunus `li ikvkid kltg pdrktumun`r b`pknn`rkds, wckbc ir`kl kltg tcd

kltdrngmun`r vdkls `li tcdl kltg `rbu`td vdkl `li tcdl kltg kltdrngm`r

vdkl, wckbc ruls kltg ngm`r vdkl, wckbc gpdls kltg tcd sdjadlt`n vdkl `li wckbc ir`kls kltg tcd rdl`n vdkl, `li tcdl

frga kt mnggi agvds kltg tcd klfdrkgr vdl` b`v`.

Klldrv`tkgl

Ycd hkildy `li ldrvgus systda bgaaulkb`td vk` tcd rdl`n pndxus, wcgsd fkmdrs bgursd `nglj tcd rdl`n `rtdrkds tg

rd`bc d`bc hkildy. Klput frga tcd syap`tcdtkb ldrvgus systda trkjjdrs v`sgbglstrkbtkgl kl tcd hkildy, tcdrdmy

rdiubklj rdl`n mnggi fngw. Ycd hkildy `nsg rdbdkvds klput frga tcd p`r`syap`tcdtkb ldrvgus systda, my w`y gf tcd

rdl`n mr`lbcds gf tcd v`jus ldrvd (br`lk`n ldrvd S)8 tcd fulbtkgl gf tcks ks ydt ulbnd`r. Rdlsgry klput frga tcd hkildy

tr`vdns tg tcd Y0?-00 ndvdns gf tcd spkl`n bgri `li ks sdlsdi kl tcd bgrrdspgliklj idra`tgad. Ycus, p`kl kl tcd fn`lh

rdjkgl a`y md rdfdrrdi frga bgrrdspgliklj hkildy.

https://en.wikipedia.org/w/index.php?title=Dermatome_%28anatomy%29https://en.wikipedia.org/w/index.php?title=Spinal_cordhttps://en.wikipedia.org/w/index.php?title=Parasympathetic_nervous_systemhttps://en.wikipedia.org/w/index.php?title=Renal_blood_flowhttps://en.wikipedia.org/w/index.php?title=Vasoconstrictionhttps://en.wikipedia.org/w/index.php?title=Sympathetic_nervous_systemhttps://en.wikipedia.org/w/index.php?title=Renal_plexushttps://en.wikipedia.org/w/index.php?title=Nervous_systemhttps://en.wikipedia.org/w/index.php?title=Kidney_collecting_duct_cell_%28disambiguation%29https://en.wikipedia.org/w/index.php?title=Kidney_distal_tubule_cellhttps://en.wikipedia.org/w/index.php?title=Thick_ascending_limbhttps://en.wikipedia.org/w/index.php?title=Loop_of_Henle_thin_segment_cellhttps://en.wikipedia.org/w/index.php?title=Kidney_proximal_tubule_brush_border_cellhttps://en.wikipedia.org/w/index.php?title=Kidney_glomerulus_podocytehttps://en.wikipedia.org/w/index.php?title=Cell_typehttps://en.wikipedia.org/w/index.php?title=Microscopehttps://en.wikipedia.org/w/index.php?title=Histologyhttps://en.wikipedia.org/w/index.php?title=File%3AKidney-Cortex.JPGhttps://en.wikipedia.org/w/index.php?title=Renal_cortexhttps://en.wikipedia.org/w/index.php?title=File%3AKidney-medulla.JPGhttps://en.wikipedia.org/w/index.php?title=Renal_medullahttps://en.wiktionary.org/wiki/congestionhttps://en.wikipedia.org/w/index.php?title=Scarringhttps://en.wikipedia.org/w/index.php?title=Blood_vessels


8/150

Hkildy 4

Fulbtkgls

Ycd hkildy p`rtkbkp`tds kl wcgnd-mgiy cgadgst`sks, rdjun`tklj `bki-m`sd m`n`lbd, dndbtrgnytd bglbdltr`tkgls,

dxtr`bdnnun`r fnuki vgnuad, `li rdjun`tkgl gf mnggi prdssurd. Ycd hkildy `bbgapnkscds tcdsd cgadgst`tkb fulbtkgls

mgtc klidpdlidltny `li kl bglbdrt wktc gtcdr grj`ls, p`rtkbun`rny tcgsd gf tcd dligbrkld systda. V`rkgus dligbrkld

cgraglds bggrikl`td tcdsd dligbrkld fulbtkgls8 tcdsd klbnuid rdlkl, `ljkgtdlskl KK, `nigstdrgld, `ltkikurdtkb

cgragld, `li `trk`n l`trkurdtkb pdptkid, àglj gtcdrs.A`ly gf tcd hkildy's fulbtkgls `rd `bbgapnkscdi my rdn`tkvdny skapnd adbc`lksas gf fkntr`tkgl, rd`msgrptkgl, `li

sdbrdtkgl, wckbc t`hd pn`bd kl tcd ldpcrgl. Fkntr`tkgl, wckbc t`hds pn`bd `t tcd rdl`n bgrpusbnd, ks tcd prgbdss my

wckbc bdnns `li n`rjd prgtdkls `rd fkntdrdi frga tcd mnggi tg a`hd `l untr`fkntr`td tc`t dvdltu`nny mdbgads urkld. Ycd

hkildy jdldr`tds 03? nktdrs gf fkntr`td ` i`y, wcknd rd`msgrmklj ` n`rjd pdrbdlt`jd, `nngwklj fgr tcd jdldr`tkgl gf glny

`pprgxka`tdny = nktdrs gf urkld. ]d`msgrptkgl ks tcd tr`lspgrt gf agndbunds frga tcks untr`fkntr`td `li kltg tcd mnggi.

Rdbrdtkgl ks tcd rdvdrsd prgbdss, kl wckbc agndbunds `rd tr`lspgrtdi kl tcd gppgsktd ikrdbtkgl, frga tcd mnggi kltg tcd

urkld.

Dxbrdtkgl gf w`stds

Ycd hkildys dxbrdtd ` v`rkdty gf w`std prgiubts prgiubdi my adt`mgnksa. Ycdsd klbnuid tcd lktrgjdlgus w`stds

b`nndi "urd`", frga prgtdkl b`t`mgnksa, `s wdnn `s urkb `bki, frga lubndkb `bki adt`mgnksa. Fgra`tkgl gf urkld ks `nsg

tcd fulbtkgl gf tcd hkildy. Ycd bglbdltr`tkgl gf lktrgjdlgus w`stds, kl tcd urkld gf aàa`ns `li sgad mkris, ks

idpdlidlt gl `l dn`mgr`td bgultdrburrdlt auntkpnkb`tkgl systda. Ycks rdqukrds sdvdr`n klidpdlidlt ldpcrgl

bc`r`btdrkstkbs tg gpdr`td5 ` tkjct c`kr pkl bglfkjur`tkgl gf tcd tumunds, w`tdr `li kgl pdrad`mknkty kl tcd idsbdliklj

nkam gf tcd nggp, w`tdr kapdrad`mknkty kl tcd `sbdliklj nggp `li `btkvd kgl tr`lspgrt gut gf agst gf tcd `sbdliklj

nggp. Kl ìiktkgl, bgultdrburrdlt dxbc`ljd my tcd vdssdns b`rryklj tcd mnggi suppny tg tcd ldpcrgl ks dssdltk`n fgr

dl`mnklj tcks fulbtkgl.

]d`msgrptkgl gf vkt`n lutrkdltsJnubgsd `t lgra`n pn`sa` ndvdns ks bgapndtdny rd`msgrmdi kl tcd prgxka`n tumund. Ycd adbc`lksa fgr tcks ks tcd

L`+/jnubgsd bgtr`lspgrtdr. @ pn`sa` ndvdn gf 24? aj/iN wknn funny s`tur`td tcd tr`lspgrtdrs `li jnubgsd wknn md ngst

kl tcd urkld. @ pn`sa` jnubgsd ndvdn gf `pprgxka`tdny 06? ks suffkbkdlt tg `nngw jnubgsurk`, wckbc ks `l kapgrt`lt

bnklkb`n bnud tg ik`mdtds adnnktus.

@aklg `bkis `rd rd`msgrmdi my sgikua idpdlidlt tr`lspgrtdrs kl tcd prgxka`n tumund. C`rtlup's iksd`sd ks `

idfkbkdlby gf tcd tryptgpc`l àklg `bki tr`lspgrtdr, wckbc rdsunts kl pdnn`jr`.X4Q

Ngb`tkgl gf

]d`msgrptkgl

]d`msgrmdi lutrkdlt Lgtds

D`rny prgxka`n tumund Jnubgsd (0??%), àklg `bkis (0??%), mkb`rmgl`td (;?%),L`+ (64%), Bn, pcgspc`td `li C

=G (64%)

_YC wknn klckmkt pcgspc`td dxbrdtkgl @Y KK stkaun tds L`+, C

=G `li CBG

2 rd`msgrptkgl.

Yckl idsbdliklj nggp

gf Cdlnd

C=G ]d`msgrms vk adiunn ry cypdrtglkbkty `li a hds

urkld cypdrtglkb.

Yckbh `sbdliklj nggp

gf CdlndL`+ (0?=?%), H+, Bn8 klikrdbtny kliubds p`r` bdnnun`rrd`msgrptkgl gf Aj=+, B`=+

Ycks rdjkgl ks kapdrad`mnd tg C=G `li tcd urkld

mdbgads ndss bglbdltr`tdi `s kt `sbdlis.

D`rny ikst`n bglvgnutdi

tumundL`+, Bn _YC bùsds B`=+ rd`msgrptkgl.

Bgnndbtklj tumunds L`+(24%), C=G L`+ ks rd`msgrmdi kl dxbc`ljd fgr H+, `li C+, wckbc ks

rdjun`tdi my `nigstdrgld.

@IC bts gl tcd V= rdbdptgr `li klsdrts `qu`pgrkls gl

tcd nuakl`n skid

https://en.wikipedia.org/w/index.php?title=Aquaporinshttps://en.wikipedia.org/w/index.php?title=Pellagrahttps://en.wikipedia.org/w/index.php?title=Hartnup%27s_diseasehttps://en.wikipedia.org/w/index.php?title=Countercurrent_exchangehttps://en.wikipedia.org/w/index.php?title=Nucleic_acidhttps://en.wikipedia.org/w/index.php?title=Uric_acidhttps://en.wikipedia.org/w/index.php?title=Catabolismhttps://en.wikipedia.org/w/index.php?title=Ureahttps://en.wikipedia.org/w/index.php?title=Metabolismhttps://en.wikipedia.org/w/index.php?title=Atrial_natriuretic_peptidehttps://en.wikipedia.org/w/index.php?title=Antidiuretic_hormonehttps://en.wikipedia.org/w/index.php?title=Antidiuretic_hormonehttps://en.wikipedia.org/w/index.php?title=Angiotensin_IIhttps://en.wikipedia.org/w/index.php?title=Reninhttps://en.wikipedia.org/w/index.php?title=Endocrine_systemhttps://en.wikipedia.org/w/index.php?title=Extracellular_fluid_volumehttps://en.wikipedia.org/w/index.php?title=Electrolytehttps://en.wikipedia.org/w/index.php?title=Acid-base_balancehttps://en.wikipedia.org/w/index.php?title=Homeostasis


9/150

Hkildy 6

_rdjl`lby rdiubds tcd rd`msgrptkgl gf jnubgsd `li àklg `bkis.

@bki-m`sd cgadgst`sks

Ywg grj`l systdas, tcd hkildys `li nuljs, a`klt`kl `bki-m`sd cgadgst`sks, wckbc ks tcd a`kltdl`lbd gf pC `rguli

` rdn`tkvdny st`mnd v`nud. Ycd nuljs bgltrkmutd tg `bki-m`sd cgadgst`sks my rdjun`tklj b`rmgl ikgxkid (BG=)

bglbdltr`tkgl. Ycd hkildys c`vd twg vdry kapgrt`lt rgnds kl a`klt`klklj tcd `bki-m`sd m`n`lbd5 tg rd`msgrmmkb`rmgl`td frga urkld, `li tg dxbrdtd cyirgjdl kgls kltg urkld

Gsagn`nkty rdjun`tkgl

@ly skjlkfkb`lt rksd kl pn`sa` gsagn`nkty ks idtdbtdi my tcd cypgtc`nàus, wckbc bgaaulkb`tds ikrdbtny wktc tcd

pgstdrkgr pktukt`ry jn`li. @l klbrd`sd kl gsagn`nkty bùsds tcd jn`li tg sdbrdtd `ltkikurdtkb cgragld (@IC), rdsuntklj

kl w`tdr rd`msgrptkgl my tcd hkildy `li `l klbrd`sd kl urkld bglbdltr`tkgl. Ycd twg f`btgrs wgrh tgjdtcdr tg rdturl

tcd pn`sa` gsagn`nkty tg kts lgra`n ndvdns.

@IC mklis tg prklbkp`n bdnns kl tcd bgnndbtklj iubt tc`t tr`lsngb`td `qu`pgrkls tg tcd adamr`ld, `nngwklj w`tdr tg

nd`vd tcd lgra`nny kapdrad`mnd adamr`ld `li md rd`msgrmdi kltg tcd mgiy my tcd v`s` rdbt`, tcus klbrd`sklj tcd

pn`sa` vgnuad gf tcd mgiy.

Ycdrd `rd twg systdas tc`t brd`td ` cypdrgsagtkb adiunn` `li tcus klbrd`sd tcd mgiy pn`sa` vgnuad5 Trd` rdbybnklj

`li tcd 'skljnd dffdbt.'

Trd` ks usu`nny dxbrdtdi `s ` w`std prgiubt frga tcd hkildys. Cgwdvdr, wcdl pn`sa` mnggi vgnuad ks ngw `li @IC

ks rdnd`sdi tcd `qu`pgrkls tc`t `rd gpdldi `rd `nsg pdrad`mnd tg urd`. Ycks `nngws urd` tg nd`vd tcd bgnndbtklj iubt

kltg tcd adiunn` brd`tklj ` cypdrgsagtkb sgnutkgl tc`t '`ttr`bts' w`tdr. Trd` b`l tcdl rd-dltdr tcd ldpcrgl `li md

dxbrdtdi gr rdbybndi `j`kl idpdliklj gl wcdtcdr @IC ks stknn prdsdlt gr lgt.

Ycd 'Rkljnd dffdbt' idsbrkmds tcd f`bt tc`t tcd `sbdliklj tckbh nkam gf tcd nggp gf Cdlnd ks lgt pdrad`mnd tg w`tdr mut

ks pdrad`mnd tg L`Bn. Ycks `nngws fgr ` bgultdrburrdlt dxbc`ljd systda wcdrdmy tcd adiunn` mdbgads klbrd`skljny

bglbdltr`tdi, mut `t tcd sàd tkad sdttklj up `l gsagtkb jrìkdlt fgr w`tdr tg fgnngw scguni tcd `qu`pgrkls gf tcdbgnndbtklj iubt md gpdldi my @IC.

Mnggi prdssurd rdjun`tkgl

@ntcgujc tcd hkildy b`llgt ikrdbtny sdlsd mnggi, nglj-tdra rdjun`tkgl gf mnggi prdssurd prdigakl`ltny idpdlis

upgl tcd hkildy. Ycks prka`rkny gbburs tcrgujc a`kltdl`lbd gf tcd dxtr`bdnnun`r fnuki bgap`rtadlt, tcd skzd gf

wckbc idpdlis gl tcd pn`sa` sgikua bglbdltr`tkgl. ]dlkl ks tcd fkrst kl ` sdrkds gf kapgrt`lt bcdakb`n adssdljdrs

tc`t a`hd up tcd rdlkl-`ljkgtdlskl systda. Bc`ljds kl rdlkl untka`tdny `ntdr tcd gutput gf tcks systda, prklbkp`nny tcd

cgraglds `ljkgtdlskl KK `li `nigstdrgld. D`bc cgragld `bts vk` auntkpnd adbc`lksas, mut mgtc klbrd`sd tcd hkildy's

`msgrptkgl gf sgikua bcngrkid, tcdrdmy dxp`liklj tcd dxtr`bdnnun`r fnuki bgap`rtadlt `li r`ksklj mnggi prdssurd.

Zcdl rdlkl ndvdns `rd dndv`tdi, tcd bglbdltr`tkgls gf `ljkgtdlskl KK `li `nigstdrgld klbrd`sd, ndìklj tg klbrd`sdi

sgikua bcngrkid rd`msgrptkgl, dxp`lskgl gf tcd dxtr`bdnnun`r fnuki bgap`rtadlt, `li `l klbrd`sd kl mnggi prdssurd.

Bglvdrsdny, wcdl rdlkl ndvdns `rd ngw, `ljkgtdlskl KK `li `nigstdrgld ndvdns idbrd`sd, bgltr`btklj tcd dxtr`bdnnun`r

fnuki bgap`rtadlt, `li idbrd`sklj mnggi prdssurd.

Cgragld sdbrdtkgl

Ycd hkildys sdbrdtd ` v`rkdty gf cgraglds, klbnuiklj drytcrgpgkdtkl, `li tcd dlzyad rdlkl. Drytcrgpgkdtkl ks

rdnd`sdi kl rdspglsd tg cypgxk` (ngw ndvdns gf gxyjdl `t tkssud ndvdn) kl tcd rdl`n bkrbun`tkgl. Kt stkaun`tds

drytcrgpgkdsks (prgiubtkgl gf rdi mnggi bdnns) kl tcd mgld a`rrgw. B`nbktrkgn, tcd `btkv`tdi fgra gf vktàkl I,

prgagtds kltdstkl`n `msgrptkgl gf b`nbkua `li tcd rdl`n rd`msgrptkgl gf pcgspc`td. _`rt gf tcdrdlkl-`ljkgtdlskl-`nigstdrgld systda, rdlkl ks `l dlzyad klvgnvdi kl tcd rdjun`tkgl gf `nigstdrgld ndvdns.

https://en.wikipedia.org/w/index.php?title=Hormoneshttps://en.wikipedia.org/w/index.php?title=Reninhttps://en.wikipedia.org/w/index.php?title=Hypoxia_%28medical%29https://en.wikipedia.org/w/index.php?title=Erythropoiesishttps://en.wikipedia.org/w/index.php?title=Bone_marrowhttps://en.wikipedia.org/w/index.php?title=Calcitriolhttps://en.wikipedia.org/w/index.php?title=Calciumhttps://en.wikipedia.org/w/index.php?title=Reabsorptionhttps://en.wikipedia.org/w/index.php?title=Phosphatehttps://en.wikipedia.org/w/index.php?title=Renin-angiotensin-aldosterone_systemhttps://en.wikipedia.org/w/index.php?title=Enzymehttps://en.wikipedia.org/w/index.php?title=Enzymehttps://en.wikipedia.org/w/index.php?title=Renin-angiotensin-aldosterone_systemhttps://en.wikipedia.org/w/index.php?title=Phosphatehttps://en.wikipedia.org/w/index.php?title=Reabsorptionhttps://en.wikipedia.org/w/index.php?title=Calciumhttps://en.wikipedia.org/w/index.php?title=Vitamin_Dhttps://en.wikipedia.org/w/index.php?title=Calcitriolhttps://en.wikipedia.org/w/index.php?title=Bone_marrowhttps://en.wikipedia.org/w/index.php?title=Erythropoiesishttps://en.wikipedia.org/w/index.php?title=Hypoxia_%28medical%29https://en.wikipedia.org/w/index.php?title=Reninhttps://en.wikipedia.org/w/index.php?title=Hormoneshttps://en.wikipedia.org/w/index.php?title=Sodium_chloridehttps://en.wikipedia.org/w/index.php?title=Angiotensin_IIhttps://en.wikipedia.org/w/index.php?title=Renin-angiotensin_systemhttps://en.wikipedia.org/w/index.php?title=Sodiumhttps://en.wikipedia.org/w/index.php?title=Extracellular_fluidhttps://en.wikipedia.org/w/index.php?title=Countercurrent_exchangehttps://en.wikipedia.org/w/index.php?title=Antidiuretic_hormonehttps://en.wikipedia.org/w/index.php?title=Posterior_pituitary_glandhttps://en.wikipedia.org/w/index.php?title=Hypothalamushttps://en.wikipedia.org/w/index.php?title=Plasma_osmolalityhttps://en.wikipedia.org/w/index.php?title=Hydrogenhttps://en.wikipedia.org/w/index.php?title=Carbon_dioxidehttps://en.wikipedia.org/w/index.php?title=PH


10/150

Hkildy :

Idvdngpadlt

Ycd aàa`nk`l hkildy idvdngps frga kltdradik`td adsgidra. Hkildy idvdngpadlt, `nsg b`nndi ldpcrgjdldsks,

prgbddis tcrgujc ` sdrkds gf tcrdd subbdsskvd pc`sds, d`bc a`rhdi my tcd idvdngpadlt gf ` agrd ìv`lbdi p`kr gf

hkildys5 tcd prgldpcrgs, adsgldpcrgs, `li adt`ldpcrgs.

Dvgnutkgl`ry ì`pt`tkglHkildys gf v`rkgus `lka`ns scgw dvkidlbd gf dvgnutkgl`ry ì`pt`tkgl `li c`vd nglj mddl stuikdi kl dbgpcyskgngjy

`li bgap`r`tkvd pcyskgngjy. Hkildy agrpcgngjy, gftdl klidxdi `s tcd rdn`tkvd adiunn`ry tckbhldss, ks `ssgbk`tdi

wktc c`mkt`t `rkikty àglj spdbkds gf aàa`ns.

]dn`tdi tdras

Adikb`n tdras rdn`tdi tg tcd hkildys bgaaglny usd tdras subc `s rdl`n `li tcd prdfkx ldpcrg-. Ycd ìedbtkvd rdl`n,

ad`lklj rdn`tdi tg tcd hkildy, ks frga tcd N`tkl rls, ad`lklj hkildys8 tcd prdfkx ldpcrg- ks frga tcd @lbkdlt

Jrddh wgri fgr hkildy, ldpcrgs (). Fgr dxàpnd, surjkb`n rdagv`n gf tcd hkildy ks ` ldpcrdbtgay, wcknd `

rdiubtkgl kl hkildy fulbtkgl ks b`nndi rdl`n iysfulbtkgl.

Iksd`sds `li iksgridrs

Bgljdlkt`n

Bgljdlkt`n cyirgldpcrgsks

Bgljdlkt n gmstrubtkgl gf urkl`ry tr`bt

Iupndx hkildys, gr igumnd hkildys, gbbur kl pprgxka`tdny 0% gf tcd pgpun`tkgl. Ycks gbburrdlbd lgra`nny

bùsds lg bgapnkb`tkgls, mut b`l gbb`skgl`nny bùsd urkld klfdbtkgls.

Iupnkb`tdi urdtdr gbburs kl `pprgxka tdny gld kl 0?? nkvd mkrtcs Cgrsdscgd hkildy gbburs kl pprgxka`tdny gld kl 9?? nkvd mkrtcs

Lutbr`bhdr Rylirgad

_gnybystkb hkildy iksd`sd

@utgsga`n igakl`lt pgnybystkb hkildy iksd`sd ffnkbts p`tkdlts n`tdr kl nkfd. @pprgxka`tdny gld kl 0??? pdgpnd

wknn idvdngp tcks bgliktkgl

@utgsga`n rdbdsskvd pgnybystkb hkildy iksd`sd ks f`r ndss bgaagl, mut agrd sdvdrd, tc`l tcd igakl`lt

bgliktkgl. Kt ks `pp`rdlt kl utdrg gr `t mkrtc.

]dl`n `jdldsks. F`knurd gf gld hkildy tg fgra gbburs kl `pprgxka`tdny gld kl :4? nkvd mkrtcs. F knurd gf mgtc

hkildys tg fgra ks klv`rk`mny f`t`n.

]dl`n iyspn sk` Tlkn`tdr`n sa nn hkildy

Auntkbystkb iyspn`stkb hkildy gbburs kl `pprgxka tdny gld kl dvdry =9?? nkvd mkrtcs

Trdtdrgpdnvkb Eulbtkgl Gmstrubtkgl gr T_EG8 ntcgujc agst b`sds ppd`r bgljdlkt n, sgad ppd`r tg md l

`bqukrdi bgliktkgl

https://en.wikipedia.org/w/index.php?title=Multicystic_dysplastic_kidneyhttps://en.wikipedia.org/w/index.php?title=Renal_dysplasiahttps://en.wikipedia.org/w/index.php?title=Renal_agenesishttps://en.wikipedia.org/w/index.php?title=Autosomal_recessive_polycystic_kidney_diseasehttps://en.wikipedia.org/w/index.php?title=Autosomal_dominant_polycystic_kidney_diseasehttps://en.wikipedia.org/w/index.php?title=Polycystic_kidney_diseasehttps://en.wikipedia.org/w/index.php?title=Nutcracker_Syndromehttps://en.wikipedia.org/w/index.php?title=Horseshoe_kidneyhttps://en.wikipedia.org/w/index.php?title=Duplicated_ureterhttps://en.wikipedia.org/w/index.php?title=Hydronephrosishttps://en.wikipedia.org/w/index.php?title=Nephrectomyhttps://en.wikipedia.org/w/index.php?title=Ancient_Greekhttps://en.wikipedia.org/w/index.php?title=Ancient_Greekhttps://en.wikipedia.org/w/index.php?title=Latin_languagehttps://en.wikipedia.org/w/index.php?title=Adjectivehttps://en.wikipedia.org/w/index.php?title=Aridityhttps://en.wikipedia.org/w/index.php?title=Comparative_physiologyhttps://en.wikipedia.org/w/index.php?title=Ecophysiologyhttps://en.wikipedia.org/w/index.php?title=Adaptationhttps://en.wikipedia.org/w/index.php?title=Kidney_developmenthttps://en.wikipedia.org/w/index.php?title=Intermediate_mesoderm


11/150

Hkildy 3

@bqukrdi

Ir`wklj gf `l dln`rjdi hkildy my Egcl Cultdr.

Ik`mdtkb ldpcrgp`tcy

Jngadrungldpcrktks

Cyirgldpcrgsks ks tcd dln`rjdadlt gf gld gr mgtc gf tcd hkildys

bùsdi my gmstrubtkgl gf tcd fngw gf urkld.

Kltdrstktk`n ldpcrktks

Hkildy stglds (ldpcrgnktck`sks) rd ` rdn`tkvdny bgaagl li

p`rtkbun`rny p`klfun iksgridr.

Hkildy tuagrs

Zknas tuagr

]dl`n bdnn b`rbklga`

Nupus ldpcrktks

Aklka`n bc`ljd iksd`sd

Kl ldpcrgtkb sylirgad, tcd jngadrunus c s mddl i a`jdi sg tc t `

n`rjd àgult gf prgtdkl kl tcd mnggi dltdrs tcd urkld. Gtcdr frdqudltfd`turds gf tcd ldpcrgtkb sylirgad klbnuid swdnnklj, ngw sdrua

`nmuakl, `li ckjc bcgndstdrgn.

_ydngldpcrktks ks klfdbtkgl gf tcd hkildys `li ks frdqudltny bùsdi

my bgapnkb`tkgl gf ` urkl`ry tr`bt klfdbtkgl.

]dl`n f knurd

@butd rdl`n f knurd

Rt`jd 4 Bcrglkb Hkildy Iksd sd

Hkildy F`knurd

Jdldr`nny, cua`ls b`l nkvd lgra`nny wktc eust gld hkildy, `s gld c`s agrd fulbtkglklj rdl`n tkssud tc`l ks lddidi tg

survkvd. Glny wcdl tcd àgult gf fulbtkglklj hkildy tkssud ks jrd`tny ikaklkscdi igds gld idvdngp bcrglkb hkildy

iksd`sd. ]dl`n rdpn`bdadlt tcdr`py, kl tcd fgra gf ik`nysks gr hkildy tr`lspn`lt`tkgl, ks klikb`tdi wcdl tcd

jngadrun`r fkntr`tkgl r`td c`s f`nndl vdry ngw gr kf tcd rdl`n iysfulbtkgl ndìs tg sdvdrd syaptgas.

Ik`jlgsks

Bnklkb`n

A`ly rdl`n iksd`sds `rd ik`jlgsdi gl tcd m`sks gf bn`sskb`n bnklkb`n fklikljs. @ pcyskbk`l (usu`nny ` ldpcrgngjkst)

mdjkls my t`hklj ` idt`kndi bnklkb`n ckstgry `li pdrfgras ` pcyskb`n dxàkl`tkgl. Kl ìiktkgl tg adikb`n ckstgry `li

prdsdltklj syaptgas, ` pcyskbk`l wknn `sh `mgut adikb`tkgl ckstgry, fàkny ckstgry rdbdlt klfdbtkgls, tgxkb/bcdakb`n

dxpgsurds `li gtcdr ckstgrkb`n f`btgrs tc`t a`y klikb`td `l dtkgngjy fgr tcd p`tkdlt's rdl`n iksd`sd. Gftdl, sgad

iksd`sds `rd sujjdstdi my bnklkb`n ckstgry `li tkad bgursd `ngld. Fgr dxàpnd, kl ` fgradrny cd`ntcy bckni wktc `

rdbdlt uppdr rdspkr`tgry tr`bt klfdbtkgl `li f`bk`n/ngwdr nkam swdnnklj, fklikljs gf prgtdklurk` gl urkl`nysks, `

ik`jlgsks gf aklka`n bc`ljd iksd`sd ks ckjcny sujjdstdi. Rkakn`rny, ` p`tkdlt wktc ` ckstgry gf ik`mdtds wcg prdsdlts

wktc idbrd`sdi urkld gutput ks agst nkhdny tg md suffdrklj frga ik`mdtkb ldpcrgp`tcy. Gftdl, subc b`sds ig lgt

rdqukrd dxtdlskvd wgrhup (subc `s wktc rdl`n mkgpsy). @ prdsuaptkvd ik`jlgsks b`l md aìd gl tcd m`sks gf ckstgry,

pcyskb`n dxà `li suppgrtkvd n`mgr`tgry stuikds.

https://en.wikipedia.org/w/index.php?title=Nephrologisthttps://en.wikipedia.org/w/index.php?title=Glomerular_filtration_ratehttps://en.wikipedia.org/w/index.php?title=Renal_replacement_therapyhttps://en.wikipedia.org/w/index.php?title=Acute_renal_failurehttps://en.wikipedia.org/w/index.php?title=Renal_failurehttps://en.wikipedia.org/w/index.php?title=Urinary_tract_infectionhttps://en.wikipedia.org/w/index.php?title=Pyelonephritishttps://en.wikipedia.org/w/index.php?title=Proteinhttps://en.wikipedia.org/w/index.php?title=Glomerulus_%28kidney%29https://en.wikipedia.org/w/index.php?title=Nephrotic_syndromehttps://en.wikipedia.org/w/index.php?title=Minimal_change_diseasehttps://en.wikipedia.org/w/index.php?title=Lupus_nephritishttps://en.wikipedia.org/w/index.php?title=Renal_cell_carcinomahttps://en.wikipedia.org/w/index.php?title=Wilms_tumorhttps://en.wikipedia.org/w/index.php?title=Tumorshttps://en.wikipedia.org/w/index.php?title=Kidney_stonehttps://en.wikipedia.org/w/index.php?title=Hydronephrosishttps://en.wikipedia.org/w/index.php?title=File%3AHunter_enlarged_kidney.jpghttps://en.wikipedia.org/w/index.php?title=John_Hunter_%28surgeon%29


12/150

Hkildy ;

N`mgr`tgry

N`mgr`tgry stuikds `rd `l kapgrt`lt ìeulbt tg bnklkb`n dv`nu`tkgl fgr `ssdssadlt gf rdl`n fulbtkgl. @l klktk`n wgrhup

gf ` p`tkdlt a`y klbnuid ` bgapndtd mnggi bgult (BMB)8 sdrua dndbtrgnytds klbnuiklj sgikua, pgt`sskua, bcngrkid,

mkb`rmgl`td, b`nbkua, `li pcgspcgrus8 mnggi urd`, lktrgjdl `li brd`tklkld8 mnggi jnubgsd `li jnybgbyn`tdi

cdagjngmkl. Jngadrun`r fkntr`tkgl r`td (JF]) b`l md b`nbun`tdi.X6Q

Trkld stuikds a`y klbnuid urkld dndbtrgnytds, brd`tklkld, prgtdkl, fr`btkgl`n dxbrdtkgl gf sgikua (FDL@) `li gtcdrstuikds tg `sskst kl dv`nu`tkgl gf tcd dtkgngjy gf ` p`tkdlt's rdl`n iksd`sd.

Trkl`nysks ks usdi tg dv`nu`td urkld fgr kts pC, prgtdkl, jnubgsd, spdbkfkb jr`vkty `li tcd prdsdlbd gf

mnggi/cdagjngmkl. Akbrgsbgpkb `l`nysks b`l md cdnpfun kl tcd kidltkfkb`tkgl gf b`sts, rdi mnggi bdnns, wcktd mnggi

bdnns `li bryst`ns.

Ka`jklj stuikds

Ka`jklj stuikds `rd kapgrt`lt kl tcd dv`nu`tkgl gf strubtur`n rdl`n iksd`sd bùsdi my urkl`ry tr`bt gmstrubtkgl, rdl`n

stglds, rdl`n byst, a`ss ndskgls, rdl`n v`sbun`r iksd`sd, `li vdskbgurdtdr`n rdfnux.

Ka`jklj tdbclkquds usdi agst frdqudltny klbnuid rdl`n untr`sguli `li cdnkb`n BY sb`l. _`tkdlts wktc suspdbtdi

vdskbgurdtdr`n rdfnux a`y ulidrjg vgkiklj bystgurdtcrgjrà (VBTJ).

]dl`n mkgpsy

Ycd rgnd gf tcd rdl`n mkgpsy ks tg ik`jlgsd rdl`n iksd`sd kl wckbc tcd dtkgngjy ks lgt bnd`r m`sdi upgl lglklv`skvd

ad`ls (bnklkb`n ckstgry, p`st adikb`n ckstgry, adikb`tkgl ckstgry, pcyskb`n dxà, n`mgr`tgry stuikds, ka`jklj stuikds).

@ idt`kndi idsbrkptkgl gf rdl`n mkgpsy kltdrprdt`tkgl ks mdygli tcd sbgpd gf tcks `rtkbnd. Kl jdldr`n, ` rdl`n p`tcgngjkst

wknn pdrfgra ` idt`kndi agrpcgngjkb`n dv`nu`tkgl `li kltdjr`td tcd agrpcgngjkb fklikljs wktc tcd bnklkb`n ckstgry `li

n`mgr`tgry i`t`, untka`tdny `rrkvklj `t ` p`tcgngjkb`n ik`jlgsks. @ rdl`n p`tcgngjkst ks ` pcyskbk`l wcg c`s ulidrjgld

jdldr`n tr`klklj kl `l`tgakb p`tcgngjy `li ìiktkgl`n spdbk`nny tr`klklj kl tcd kltdrprdt`tkgl gf rdl`n mkgpsy

spdbkadls.Kid`nny, auntkpnd bgrd sdbtkgls `rd gmt`kldi `li dv`nu`tdi fgr ìdqu`by (prdsdlbd gf jngadrunk) kltr`gpdr`tkvdny. @

p`tcgngjkst/p`tcgngjy `sskst`lt ikvkids tcd spdbkadl(s) fgr sumaksskgl fgr nkjct akbrgsbgpy, kaaulgfnugrdsbdlbd

akbrgsbgpy `li dndbtrgl akbrgsbgpy.

Ycd p`tcgngjkst wknn dxàkld tcd spdbkadl usklj nkjct akbrgsbgpy wktc auntkpnd st`klklj tdbclkquds (cda`tgxynkl

`li dgskl/C&D, _@R, trkbcrgad, sknvdr st`kl) gl auntkpnd ndvdn sdbtkgls. Auntkpnd kaaulgfnugrdsbdlbd st`kls `rd

pdrfgradi tg dv`nu`td fgr `ltkmgiy, prgtdkl `li bgapndadlt idpgsktkgl. Fkl`nny, untr`-strubtur`n dxàkl`tkgl ks

pdrfgradi wktc dndbtrgl akbrgsbgpy `li a`y rdvd`n tcd prdsdlbd gf dndbtrgl-idlsd idpgskts gr gtcdr bc`r`btdrkstkb

`mlgra`nktkds tc`t a`y sujjdst `l dtkgngjy fgr tcd p`tkdlt's rdl`n iksd`sd.

B`nbun`tkgls

B`nbun`tkgls gf hkildy pdrfgra`lbd `rd `l kapgrt`lt p`rt gf pcyskgngjy `li b`l md dstka`tdi usklj tcd b`nbun`tkgls

mdngw.

Fkntr`tkgl Fr`btkgl

Ycd fkntr`tkgl fr`btkgl ks tcd àgult gf pn`sa` tc`t ks `btu`nny fkntdrdi tcrgujc tcd hkildy. Ycks b`l md idfkldi usklj

tcd dqu`tkgl5

FF1JF]/]_F

FF ks tcd fkntr`tkgl fr`btkgl

JF] ks tcd jngadrun`r fkntr tkgl r`td

]_F ks tcd rdl`n pn`sa` fngw

https://en.wikipedia.org/w/index.php?title=Pathologisthttps://en.wikipedia.org/w/index.php?title=Urinalysishttps://en.wikipedia.org/w/index.php?title=Creatinine


13/150


14/150

Hkildy 00

Ckstgry

Ycd N`tkl tdra rdlds ks rdn`tdi tg tcd Dljnksc wgri "rdkls", ` sylglya fgr tcd hkildys kl Rc`hdspd`rd`l Dljnksc

(d.j. Adrry Zkvds gf Zklisgr 2.4), wckbc w`s `nsg tcd tkad tcd Hklj Eàds Vdrskgl w`s tr`lsn`tdi. Hkildys wdrd

glbd pgpun`rny rdj`ridi `s tcd sd`t gf tcd bglsbkdlbd `li rdfndbtkgl,X:QX3Q `li ` luamdr gf vdrsds kl tcd Mkmnd (d.j.

_s. :5;, ]dv. =5=2) st`td tc`t Jgi sd`rbcds gut `li klspdbts tcd hkildys, gr "rdkls", gf cua`ls. Rkakn`rny, tcd Y`naui

(Mdr`hcgtc 60.`) st`tds tc`t gld gf tcd twg hkildys bgulsdns wc`t ks jggi, `li tcd gtcdr dvkn.

Hkildys `s fggi

Ch`rp`ll`, Rwdiksc pgrh `li hkildy stdw

Ycd hkildys b`l md bgghdi `li d`tdl (`nglj wktc gtcdr gff`n).

Hkildys `rd usu`nny jrknndi gr sùtdi, mut kl agrd bgapndx ikscds

tcdy `rd stdwdi wktc ` sùbd tc`t wknn kaprgvd tcdkr fn`vgr. Kl a`ly

prdp`r`tkgls, hkildys `rd bgamkldi wktc pkdbds gf ad`t gr nkvdr, `s kl

akxdi jrknn gr adur`v [drusc`nak. Ikscds klbnuid tcd Mrktksc std`h `li

hkildy pkd, tcd Rwdiksc ch`rp`ll` (pgrh `li hkildy stdw), tcd

Frdlbc rgjlgls id vdù sùbd agut`rid (vd`n hkildys kl aust`risùbd) `li tcd Rp`lksc rkglds `n Edrdz (hkildys stdwdi kl scdrry

sùbd) .X;Q

@iiktkgl`n Ka`jds

Hkildy _gstdrkgr Vkdw @ltdrkgr rdn`tkgl gf Ndft Hkildy Hkildy Brgss Rdbtkgl

Ikssdbtkgl ka`jds

]kjct Hkildy Hkildy ]kjct Hkildy ]kjct hkildy

https://en.wikipedia.org/w/index.php?title=File%3ARight_kidney.jpghttps://en.wikipedia.org/w/index.php?title=File%3ASlide3ppp.JPGhttps://en.wikipedia.org/w/index.php?title=File%3ASlide5pp.JPGhttps://en.wikipedia.org/w/index.php?title=File%3ASlide4nn.JPGhttps://en.wikipedia.org/w/index.php?title=File%3AKidney_Cross_Section.pnghttps://en.wikipedia.org/w/index.php?title=File%3ASlide42222.JPGhttps://en.wikipedia.org/w/index.php?title=File%3ASlide22222.JPGhttps://en.wikipedia.org/w/index.php?title=Sherryhttps://en.wikipedia.org/w/index.php?title=Spanish_cuisinehttps://en.wikipedia.org/w/index.php?title=Mustard_%28condiment%29https://en.wikipedia.org/w/index.php?title=French_cuisinehttps://en.wikipedia.org/w/index.php?title=Swedish_cuisinehttps://en.wikipedia.org/w/index.php?title=Steak_and_kidney_piehttps://en.wikipedia.org/w/index.php?title=Steak_and_kidney_piehttps://en.wikipedia.org/w/index.php?title=British_cuisinehttps://en.wikipedia.org/w/index.php?title=Mixed_grillhttps://en.wikipedia.org/w/index.php?title=Offalhttps://en.wikipedia.org/w/index.php?title=Cookinghttps://en.wikipedia.org/w/index.php?title=File%3A1407871818_5c7f215934_o.jpghttps://en.wikipedia.org/w/index.php?title=Talmudhttps://en.wikipedia.org/w/index.php?title=Biblehttps://en.wikipedia.org/w/index.php?title=Consciencehttps://en.wikipedia.org/w/index.php?title=King_James_Versionhttps://en.wikipedia.org/w/index.php?title=Merry_Wives_of_Windsorhttps://en.wikipedia.org/w/index.php?title=Shakespearean_English


15/150

Hkildy 0=

Ndft hkildy Hkildys Ndft hkildy

]dfdrdlbds

X0Q cttp5/ /www.lna.lkc. jgv/bjk/adsc/=?00/AMWbjk7agid1& tdra1Hkildy

X=Q cttp5/ /www.adrbhsgurbd. bga/pp/us/bls/blsWcnWigrn`lisWspnkt. esp7pj1/ppigbs/us/bgaagl/igrn`lis/igrn`li/fkvd/????4622?. cta

X2QX2Q Mndls yt`l`tgay (Rupdrfkbk`n `l`tgay gf tcd trulh). @lb` Ir`jgakr, A`ts Cegrtmdrj `li Jgifrkdi A. ]ga`ls. Rdbtkgl fgr cua`l `l`tgay

`t tcd Idp`rtadlt gf adikb`n mkgngjy, Tpps`n` ulkvdrskty, Rwdidl.

X9Q Bn`pp, ZN. "]dl n @l`tgay". Kl5 Ucgu SE, N`szkh U, Lì`siy Y, I'@j tk VI, Rknv` FJ, dis. Rknv`'s Ik`jlgstkb ]dl`n _`tcgngjy. Ldw

[grh5 Bàmrkijd Tlkvdrskty _rdss8 =??;.

X4Q Nd, Y g.Fkrst @ki fgr tcd TRAND Rtdp 0 =?02. Ldw [grh5 AbJr`w-Cknn Adikb`n, =?02. _rklt.

X6Q _gst YZ, ]gsd MI, ùtcs `li Burc`l JB, Rcdrki`l @A, dis. Ik`jlgstkb @pprg`bc tg tcd _`tkdlt Zktc @butd Hkildy Kleury (@butd ]dl`n

F`knurd) gr Bcrglkb Hkildy Iksd`sd. TpYgI`td.bga, Idb. =?0=. cttp5//www.uptgi`td. bga.dzprgxy=. nkmr`ry. rkzgl`. diu/bgltdlts/

ik`jlgstkb-`pprg`bc-tg-tcd-p`tkdlt-wktc-`butd-hkildy-kleury-`butd-rdl`n-f`knurd-gr-bcrglkb-hkildy-iksd`sd7sgurbd1prdvkdw& `lbcgr1C0=&

sdndbtdiYktnd10~04?#C0=

X:Q Ycd _`tkdlt s _drsgl5 Dxpngr`tkgls kl Adikb`n Dtckbs p. 6? my _ùn ]àsdy, A`rj`rdt F`rndy, @nmdrt Eglsdl, Zknnkà F. A`y (=??=)

X3Q Ckstgry gf Ldpcrgngjy = p. =24 my Kltdrl`tkgl`n @ssgbk`tkgl fgr tcd Ckstgry gf Ldpcrgngjy Bgljrdss, J`r`mdi Dhlgy`l, Rpyrgs J. A`rhdtgs,

L`t`nd J. Id R`ltg, 0;;:8 ]dprklt gf@adrkb`l Egurl n gf Ldpcrgngjy8 v. 09, lg. 96, 0;;9.X;Q ]gjlgls i`ls nds rdbdttds (cttp5//bukskld.lgtrdfàknnd.bga/rdbdttds-bukskld/rgjlgls-rdbdttd. ctan)

Dxtdrl`n nklhs

Ycd LdpcBurd Fguli`tkgl gffdrs diub`tkgl n a`tdrk`ns gl tcd hkildy iksd`sds/bgliktkgls Ldpcrgtkb Rylirgad`li FRJR (cttp5//www.ldpcburd.grj)

Ycd Hkildy Fguli`tkgl gf B`lì` (cttp5//www.hkildy.b`)

dndbtrgl akbrgsbgpkb ka`jds gf tcd hkildy (Ir. E`strgw's DA-@tn s) (cttp5//www.ulk-a`klz.id/FM/Adikzkl/

@l`tgakd/wgrhscgp/DA/DALkdrdD.ctan)

Durgpd`l ]dl`n Jdlgad prgedbt hkildy fulbtkgl tutgrk`n (cttp5//www.durdjdld.grj/durdjdld/p`jds/

hkildyWtutWd.ctan)

Hkildy Fguli tkgl gf B`lì` hkildy iksd`sd klfgra`tkgl (cttp5//www.hkildyqudmdb.b`/`lj/hkildyWiksd`sd/

klidx.cta)

]dl`n Fdnngw Ldtwgrh5 Rtrubturd & Fulbtkgl gf Gtcdr @lka`ns' Hkildys (cttp5//rdl`nfdnngw.mngjspgt.bga/

=??;/?6/strubturd-fulbtkgl-gf-gtcdr-`lka`ns.ctan) Hkildy Rtglds (cttp5//syaptgasgf`hkildystgld.bga)

Hkildy Iksd`sds (cttp5//www.hkildy-stgld.us)

Hkildy Klfgra tkgl (cttp5//www.rdiurkld.bga/urkl`ryWtr`bt/hkildyWf`bts.ctan)

@lka`tdi _rdsdlt`tkl gl Hkildy Fulbtkgl (cttp5//www.i`vkt`.bga/hkildyW`lka`tkgl/)

B@Y Rb`ls gf v`rkgus hkildy iksd`sds li bgliktkgls (cttp5//www.btb`sds.ldt/bt-b`sds-i`t`m`sd/9 @migadl

@li _dnvks/6 Hkildys/) - BY B`sds

Hkildy Rtglds8 Klfgra`tkgl li Yrd`tadlts (cttp5//www.agultskl`k.grj/p`tkdlt-b`rd/sdrvkbd-`rd`s/

urgngjkb`n-bgliktkgls-`li-surjdry/`rd`s-gf-b`rd/hkildy-iksd`sd-prgjrà)

http://www.mountsinai.org/patient-care/service-areas/urological-conditions-and-surgery/areas-of-care/kidney-disease-programhttp://www.mountsinai.org/patient-care/service-areas/urological-conditions-and-surgery/areas-of-care/kidney-disease-programhttp://www.ctcases.net/ct-cases-database/4%20Abdomen%20And%20Pelvis/6%20Kidneys/http://www.ctcases.net/ct-cases-database/4%20Abdomen%20And%20Pelvis/6%20Kidneys/http://www.davita.com/kidney_animation/http://www.redurine.com/urinary_tract/kidney_facts.htmlhttp://www.kidney-stone.us/http://symptomsofakidneystone.com/http://renalfellow.blogspot.com/2009/06/structure-function-of-other-animals.htmlhttp://renalfellow.blogspot.com/2009/06/structure-function-of-other-animals.htmlhttp://www.kidneyquebec.ca/ang/kidney_disease/index.htmhttp://www.kidneyquebec.ca/ang/kidney_disease/index.htmhttp://www.euregene.org/euregene/pages/kidney_tut_e.htmlhttp://www.euregene.org/euregene/pages/kidney_tut_e.htmlhttp://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/EM/EMNiereE.htmlhttp://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/EM/EMNiereE.htmlhttp://www.kidney.ca/http://www.nephcure.org/http://cuisine.notrefamille.com/recettes-cuisine/rognons-recette.htmlhttp://www.uptodate.com.ezproxy2.library.arizona.edu/contents/diagnostic-approach-to-the-patient-with-acute-kidney-injury-acute-renal-failure-or-chronic-kidney-disease?source=preview&anchor=H12&selectedTitle=1~150#H12http://www.uptodate.com.ezproxy2.library.arizona.edu/contents/diagnostic-approach-to-the-patient-with-acute-kidney-injury-acute-renal-failure-or-chronic-kidney-disease?source=preview&anchor=H12&selectedTitle=1~150#H12http://www.uptodate.com.ezproxy2.library.arizona.edu/contents/diagnostic-approach-to-the-patient-with-acute-kidney-injury-acute-renal-failure-or-chronic-kidney-disease?source=preview&anchor=H12&selectedTitle=1~150#H12http://www.mercksource.com/pp/us/cns/cns_hl_dorlands_split.jsp?pg=/ppdocs/us/common/dorlands/dorland/five/000056330.htmhttp://www.nlm.nih.gov/cgi/mesh/2011/MB_cgi?mode=&term=Kidneyhttps://en.wikipedia.org/w/index.php?title=File%3ALeft_kidney.jpghttps://en.wikipedia.org/w/index.php?title=File%3AKidneys.jpghttps://en.wikipedia.org/w/index.php?title=File%3ALeft_kidneys.jpg


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]dl`n fulbtkgl 02

]dl`n fulbtkgl

Ik`jrà scgwklj tcd m`skb pcyskgngjkb adbc`lksas gf tcd hkildy

]dl`n fulbtkgl, kl ldpcrgngjy, ks `l

klikb`tkgl gf tcd st`td gf tcd hkildy `li kts

rgnd kl rdl`n pcyskgngjy. Jngadrun`r

fkntr`tkgl r`td (JF]) idsbrkmds tcd fngw

r`td gf fkntdrdi fnuki tcrgujc tcd hkildy.

Brd`tklkld bnd`r`lbd r`td (BBr

gr BrBn) ks

tcd vgnuad gf mnggi pn`sa` tc`t ks bnd`rdi

gf brd`tklkld pdr ulkt tkad `li ks ` usdfun

ad`surd fgr `pprgxka`tklj tcd JF].

Brd`tklkld bnd`r`lbd dxbddis JF] iud tg

brd`tklkld sdbrdtkgl, wckbc b`l md mngbhdi

my bkadtkikld. Kl `ntdrl`tkvd f`sckgl,

gvdrdstka`tkgl my gnidr sdrua brd`tklkld

adtcgis rdsuntdi kl `l ulidrdstka`tkgl gf

brd`tklkld bnd`r`lbd, wckbc prgvkidi ` ndss

mk`sdi dstka`td gf JF]. Mgtc JF] `li BBr

a`y md `bbur`tdny b`nbun`tdi my

bgap`r`tkvd ad`surdadlts gf sumst`lbds kl

tcd mnggi `li urkld, gr dstka`tdi my

fgraun`s usklj eust ` mnggi tdst rdsunt

(dJF] `li dBBr

).

Ycd rdsunts gf tcdsd tdsts `rd kapgrt`lt kl

`ssdssklj tcd dxbrdtgry fulbtkgl gf tcd

hkildys. Fgr dxàpnd, jrìklj gf bcrglkb rdl`n klsuffkbkdlby `li igs`jd gf irujs tc`t `rd dxbrdtdi prka`rkny vk`

urkld `rd m`sdi gl JF] (gr brd`tklkld bnd`r`lbd).

Kt ks bgaaglny mdnkdvdi tg md tcd àgult gf nkquki fkntdrdi gut gf tcd mnggi tc`t jdts prgbdssdi my tcd hkildys. Kl

pcyskgngjkb`n tdras, tcdsd qu`ltktkds (vgnuadtrkb mnggi fngw `li a`ss rdagv`n) `rd rdn`tdi glny nggsdny.

Klikrdbt a`rhdrs

Agst igbtgrs usd tcd pn`sa` bglbdltr`tkgls gf tcd w`std sumst`lbds gf brd`tklkld `li urd` (T), `s wdnn `s dndbtrgnytds

(D), tg idtdrakld rdl`n fulbtkgl. Ycdsd ad`surds `rd ìdqu`td tg idtdrakld wcdtcdr ` p`tkdlt ks suffdrklj frga

hkildy iksd`sd.

Cgwdvdr, mnggi urd` lktrgjdl (MTL) `li brd`tklkld wknn lgt md r`ksdi `mgvd tcd lgra`n r`ljd ultkn 6?% gf tgt`n

hkildy fulbtkgl ks ngst. Cdlbd, tcd agrd `bbur`td Jngadrun`r fkntr`tkgl r`td gr kts `pprgxka`tkgl gf tcd brd`tklkld

bnd`r`lbd ks ad`surdi wcdldvdr rdl`n iksd`sd ks suspdbtdi gr b`rdfun igsklj gf ldpcrgtgxkb irujs ks rdqukrdi.

@lgtcdr prgjlgstkb a`rhdr fgr hkildy iksd`sd ks `l dndv`tdi ndvdn gf prgtdkl kl tcd urkld. Ycd agst sdlsktkvd a`rhdr

gf prgtdklurk` ks dndv`tdi urkld `nmuakl. _drskstdlt prdsdlbd gf agrd tc`l 2? aj `nmuakl pdr jrà brd`tklkld kl tcd

urkld ks ik`jlgstkb gf bcrglkb hkildy iksd`sd (akbrg`nmuaklurk` ks ` ndvdn gf 2?=;; aj/N urkld gr 2?-=;; aj/=9crs8 ` bglbdltr`tkgl gf `nmuakl kl tcd urkld tc`t ks lgt idtdbtdi my usu`n urkld ikpstkbh adtcgis).

https://en.wikipedia.org/w/index.php?title=Dipstickhttps://en.wikipedia.org/w/index.php?title=Albuminhttps://en.wikipedia.org/w/index.php?title=Microalbuminuriahttps://en.wikipedia.org/w/index.php?title=Creatininehttps://en.wikipedia.org/w/index.php?title=Blood_urea_nitrogenhttps://en.wikipedia.org/w/index.php?title=Electrolytehttps://en.wikipedia.org/w/index.php?title=Ureahttps://en.wikipedia.org/w/index.php?title=Creatininehttps://en.wikipedia.org/w/index.php?title=Blood_plasmahttps://en.wikipedia.org/w/index.php?title=Renalhttps://en.wikipedia.org/w/index.php?title=Cimetidinehttps://en.wikipedia.org/w/index.php?title=Blood_plasmahttps://en.wikipedia.org/w/index.php?title=Nephrologyhttps://en.wikipedia.org/w/index.php?title=File%3APhysiology_of_Nephron.png


17/150

]dl`n fulbtkgl 09

Jngadrun`r fkntr`tkgl r`td

Jngadrun`r fkntr`tkgl r`td (JF]) ks tcd vgnuad gf fnuki fkntdrdi frga tcd rdl`n (hkildy) jngadrun`r b`pknn`rkds kltg

tcd Mgwa`l's b`psund pdr ulkt tkad.X0Q Bdltr`n tg tcd pcyskgngjkb a`kltdl`lbd gf JF] ks tcd ikffdrdltk`n m`s`n tgld

gf tcd `ffdrdlt `li dffdrdlt `rtdrkgnds (sdd ik`jrà).

Jngadrun`r fkntr`tkgl r`td (JF]) ks dqu`n tg tcd Bnd`r`lbd ]`td wcdl `ly sgnutd ks frddny fkntdrdi `li ks ldktcdr

rd`msgrmdi lgr sdbrdtdi my tcd hkildys. Ycd r`td tcdrdfgrd ad`surdi ks tcd qu`ltkty gf tcd sumst`lbd kl tcd urkld tc`tgrkjkl`tdi frga ` b`nbun`mnd vgnuad gf mnggi. ]dn`tklj tcks prklbkpnd tg tcd mdngw dqu`tkgl - fgr tcd sumst`lbd usdi,

tcd prgiubt gf urkld bglbdltr`tkgl `li urkld fngw dqu`ns tcd a`ss gf sumst`lbd dxbrdtdi iurklj tcd tkad tc`t urkld

c`s mddl bgnndbtdi. Ycks a`ss dqu`ns tcd a`ss fkntdrdi `t tcd jngadrunus `s lgtcklj ks ìidi gr rdagvdi kl tcd

ldpcrgl. Ikvkiklj tcks a`ss my tcd pn`sa` bglbdltr`tkgl jkvds tcd vgnuad gf pn`sa` wckbc tcd a`ss aust c`vd

grkjkl`nny bgad frga, `li tcus tcd vgnuad gf pn`sa` fnuki tc`t c`s dltdrdi Mgwa`l's b`psund wktckl tcd

`fgrdadltkgldi pdrkgi gf tkad. Ycd JF] ks typkb`nny rdbgridi kl ulkts gf vgnuad pdr tkad, d.j., aknnknktdrs pdr aklutd

aN/akl. Bgap`rd tg fkntr`tkgl fr`btkgl.

Ycdrd `rd sdvdr`n ikffdrdlt tdbclkquds usdi tg b`nbun`td gr dstka`td tcd jngadrun`r fkntr`tkgl r`td (JF] gr dJF]). Ycd

`mgvd fgraun` glny `ppnkds fgr JF] b`nbun`tkgl wcdl kt ks dqu`n tg tcd Bnd`r`lbd ]`td.

Ad`surdadlt usklj klunkl

Ycd JF] b`l md idtdrakldi my kledbtklj klunkl gr tcd klunkl-`l`ngj sklkstrkl kltg tcd pn`sa`. Rklbd mgtc, klunkl `li

sklsktrkl, `rd ldktcdr rd`msgrmdi lgr sdbrdtdi my tcd hkildy `ftdr jngadrun`r fkntr`tkgl, tcdkr r`td gf dxbrdtkgl ks

ikrdbtny prgpgrtkgl`n tg tcd r`td gf fkntr`tkgl gf w`tdr `li sgnutds `brgss tcd jngadrun`r fkntdr. Bgap`rdi tg tcd

AI]I fgraun`, tcd klunkl bnd`r`lbd snkjctny gvdrdstka`tds tcd jngadrun`r fulbtkgl. Kl d`rny st`jd rdl`n iksd`sd, tcd

klunkl bnd`r`lbd a`y rda`kl lgra`n iud tg cypdrfkntr`tkgl kl tcd rda`klklj ldpcrgls.X=Q Klbgapndtd urkld bgnndbtkgl

ks `l kapgrt`lt sgurbd gf drrgr kl klunkl bnd`r`lbd ad`surdadlt.

_rdssurd idfklktkgl

Agrd prdbksdny, JF] ks tcd fnuki fngw r`td mdtwddl tcd jngadrun`r b`pknn`rkds `li tcd Mgwa`l's b`psund5

Zcdrd5

ks tcd JF].

ks b`nndi tcdfkntr`tkgl bglst`lt `li ks idfkldi `s tcd prgiubt gf tcd cyirùnkb bgliubtkvkty `li tcd surf`bd

`rd` gf tcd jngadrun`r b`pknn`rkds. ks tcd cyirgst tkb prdssurd wktckl tcd jngadrun r b`pknn rkds.

ks tcd cyirgst tkb prdssurd wktckl tcd Mgwa`l's b`psund.

ks tcd bgnngki gsagtkb prdssurd wktckl tcd jngadrun`r b`pknn rkds.

`li ks tcd bgnngki gsagtkb prdssurd wktckl tcd Mgwa`l's b`psund.

https://en.wikipedia.org/w/index.php?title=Oncotic_pressurehttps://en.wikipedia.org/w/index.php?title=Hydrostatic_pressurehttps://en.wikipedia.org/w/index.php?title=Hydraulic_conductivityhttps://en.wikipedia.org/w/index.php?title=Nephronshttps://en.wikipedia.org/w/index.php?title=Sinistrinhttps://en.wikipedia.org/w/index.php?title=Inulinhttps://en.wikipedia.org/w/index.php?title=Filtration_fractionhttps://en.wikipedia.org/w/index.php?title=Minutehttps://en.wikipedia.org/w/index.php?title=Millilitrehttps://en.wikipedia.org/w/index.php?title=Glomerulus_%28kidney%29


18/150

]dl`n fulbtkgl 04

Hf

Mdbùsd tcks bglst`lt ks ` ad`surdadlt gf cyirùnkb bgliubtkvkty auntkpnkdi my tcd b`pknn`ry surf`bd `rd`, kt ks `nagst

kapgsskmnd tg ad`surd pcyskb`nny. Cgwdvdr, kt b`l md idtdrakldi dxpdrkadlt`nny. Adtcgis gf idtdraklklj tcd JF]

`rd nkstdi kl tcd `mgvd `li mdngw sdbtkgls `li kt ks bnd r frga gur dqu`tkgl tc`t b`l md fguli my ikvkiklj tcd

dxpdrkadlt`n JF] my tcd ldt fkntr`tkgl prdssurd5

_J

Ycd cyirgst`tkb prdssurd wktckl tcd jngadrun`r b`pknn`rkds ks idtdrakldi my tcd prdssurd ikffdrdlbd mdtwddl tcd fnuki

dltdrklj kaadik`tdny frga tcd `ffdrdlt `rtdrkgnd `li nd`vklj tcrgujc tcd dffdrdlt `rtdrkgnd. Ycd prdssurd ikffdrdlbd ks

`pprgxka`tdi my tcd prgiubt gf tcd tgt`n rdskst`lbd gf tcd rdspdbtkvd `rtdrkgnd `li tcd fnux gf mnggi tcrgujc kt5

Zcdrd5 ks tcd ffdrdlt rtdrkgnd prdssurd.

ks tcd dffdrdlt rtdrkgnd prdssurd.

ks tcd ffdrdlt rtdrkgnd rdskst lbd.

ks tcd dffdrdlt rtdrkgnd rdskst lbd.

ks tcd ffdrdlt rtdrkgnd fnux.

@li, ks tcd dffdrdlt rtdrkgnd fnux.

_M

Ycd prdssurd kl tcd Mgwa`l's b`psund `li prgxka`n tumund b`l md idtdrakldi my tcd ikffdrdlbd mdtwddl tcd prdssurd

kl tcd Mgwa`l's b`psund `li tcd idsbdliklj tumund5

Zcdrd5

ks tcd prdssurd kl tcd idsbdliklj tumund.

@li, ks tcd rdskst`lbd gf tcd idsbdliklj tumund.

J

Mnggi pn`sa` c`s ` jggi a`ly prgtdkls kl kt `li tcdy dxdrt `l klw`ri ikrdbtdi fgrbd b`nndi tcd bgnngki gsagtkb

prdssurd gl tcd w`tdr kl cypgtglkb sgnutkgls `brgss ` adamr`ld, k.d., kl tcd Mgwa`l's b`psund. Mdbùsd pn`sa`

prgtdkls `rd vkrtu`nny klb`p`mnd gf dsb`pklj tcd jngadrun`r b`pknn`rkds, tcks glbgtkb prdssurd ks idfkldi, skapny, my tcdkid`n j`s n`w5

Zcdrd5

] ks tcd ulkvdrs`n j`s bglst`lt

Y ks tcd tdapdr turd.

@li, b ks bglbdltr tkgl kl agn/N gf pn`sa prgtdkls (rdadamdr tcd sgnutds b`l frddny ikffusd tcrgujc tcd

jngadrun`r b`psund).

https://en.wikipedia.org/w/index.php?title=Universal_gas_constanthttps://en.wikipedia.org/w/index.php?title=Oncotic_pressurehttps://en.wikipedia.org/w/index.php?title=Oncotic_pressurehttps://en.wikipedia.org/w/index.php?title=Efferent_arteriolehttps://en.wikipedia.org/w/index.php?title=Afferent_arteriolehttps://en.wikipedia.org/w/index.php?title=Hydraulic_conductivity


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]dl`n fulbtkgl 06

M

Ycks v`nud ks `nagst `nw`ys t`hdl tg md dqu`n tg zdrg mdbùsd, kl ` cd`ntcy ldpcrgl, tcdrd scguni md lg prgtdkls kl

tcd Mgwa`l's B`psund.

Brd`tklkld-m`sdi `pprgxka`tkgls gf JF]

Kl bnklkb`n pr`btkbd, cgwdvdr, brd`tklkld bnd`r`lbd gr dstka`tds gf brd`tklkld bnd`r`lbd m`sdi gl tcd sdrua brd`tklkld

ndvdn `rd usdi tg ad`surd JF]. Brd`tklkld ks prgiubdi l`tur`nny my tcd mgiy (brd`tklkld ks ` mrd`higwl prgiubt gf

brd`tkld pcgspc`td, wckbc ks fguli kl ausbnd). Kt ks frddny fkntdrdi my tcd jngadrunus, mut `nsg `btkvdny sdbrdtdi my tcd

pdrktumun`r b`pknn`rkds kl vdry sa`nn àgults subc tc`t brd`tklkld bnd`r`lbd gvdrdstka`tds `btu`n JF] my 0?-=?%.

Ycks a`rjkl gf drrgr ks `bbdpt`mnd, bglskidrklj tcd d`sd wktc wckbc brd`tklkld bnd`r`lbd ks ad`surdi. Tlnkhd prdbksd

JF] ad`surdadlts klvgnvklj bglst`lt klfuskgls gf klunkl, brd`tklkld ks `nrdìy `t ` stdìy-st`td bglbdltr`tkgl kl tcd

mnggi, `li sg ad`surklj brd`tklkld bnd`r`lbd ks aubc ndss buamdrsgad. Cgwdvdr, brd`tklkld dstka`tds gf JF] c`vd

tcdkr nkakt`tkgls. @nn gf tcd dstka`tklj dqu`tkgls idpdli gl ` prdikbtkgl gf tcd =9-cgur brd`tklkld dxbrdtkgl r`td,

wckbc ks ` fulbtkgl gf ausbnd a`ss. Gld gf tcd dqu`tkgls, tcd Bgbhbrgft `li Jùnt dqu`tkgl (sdd mdngw) igds lgt

bgrrdbt fgr r`bd, `li kt ks hlgwl tc`t mn`bh adl `li wgadl c`vd ` ckjcdr àgult gf ausbnd a`ss tc`l

Bùb`sk`lsXbkt`tkgl lddidiQ8 cdlbd, tcdy wknn c`vd ckjcdr sdrua brd`tklkld ndvdns `t `ly ndvdn gf bnd`r`lbd.

@ bgaagl akst`hd aìd wcdl eust ngghklj `t sdrua brd`tklkld ks tcd f`knurd tg `bbgult fgr ausbnd a`ss. Cdlbd, `l

gnidr wga`l wktc ` sdrua brd`tklkld gf 0.9 aj/iN a`y `btu`nny c`vd ` agidr`tdny sdvdrd idjrdd gf rdl`n

klsuffkbkdlby, wcdrd`s ` ygulj ausbun`r a`nd, kl p`rtkbun`r kf mn`bh, b`l c`vd ` lgra`n ndvdn gf rdl`n fulbtkgl `t tcks

sdrua brd`tklkld ndvdn. Brd`tklkld-m`sdi dqu`tkgls scguni md usdi wktc bùtkgl kl b`bcdbtkb p`tkdlts `li p`tkdlts

wktc bkrrcgsks. Ycdy gftdl c`vd vdry ngw ausbnd a`ss `li ` aubc ngwdr brd`tklkld dxbrdtkgl r`td tc`l prdikbtdi my

tcd dqu`tkgls mdngw, subc tc`t ` bkrrcgtkb p`tkdlt wktc ` sdrua brd`tklkld gf ?.; aj/iN a`y c`vd ` agidr`tdny sdvdrd

idjrdd gf rdl`n klsuffkbkdlby.

Brd`tklkld Bnd`r`lbd BBrGld adtcgi gf idtdraklklj JF] frga brd`tklkld ks tg bgnndbt urkld (usu`nny fgr =9 cgurs) tg idtdrakld tcd àgult gf

brd`tklkld tc`t w`s rdagvdi frga tcd mnggi gvdr ` jkvdl tkad kltdrv`n. Kf gld rdagvds, s`y, 099? aj kl =9 cgurs,

tcks ks dqukv`ndlt tg rdagvklj 0 aj/akl. Kf tcd mnggi bglbdltr`tkgl ks ?.?0 aj/aN (0 aj/iN), tcdl gld b`l s`y tc`t

0?? aN/akl gf mnggi ks mdklj "bnd`rdi" gf brd`tklkld, sklbd, tg jdt 0 aj gf brd`tklkld, 0?? aN gf mnggi bglt`klklj

?.?0 aj/aN wguni lddi tg c`vd mddl bnd`rdi.

Brd`tklkld bnd`r`lbd (BBr

) ks b`nbun`tdi frga tcd brd`tklkld bglbdltr`tkgl kl tcd bgnndbtdi urkld sàpnd (TBr

), urkld

fngw r`td (V), `li tcd pn`sa` bglbdltr`tkgl (_Br

). Rklbd tcd prgiubt gf urkld bglbdltr`tkgl `li urkld fngw r`td ykdnis

brd`tklkld dxbrdtkgl r`td, wckbc ks tcd r`td gf rdagv`n frga tcd mnggi, brd`tklkld bnd`r`lbd ks b`nbun`tdi `s rdagv`n

r`td pdr akl (TBr

V) ikvkidi my tcd pn`sa` brd`tklkld bglbdltr`tkgl. Ycks ks bgaaglny rdprdsdltdi a`tcda`tkb`nny

`s

Dxàpnd5 @ pdrsgl c`s ` pn`sa` brd`tklkld bglbdltr`tkgl gf ?.?0 aj/an `li kl 0 cgur prgiubds 6?an gf urkld wktc `

brd`tklkld bglbdltr`tkgl gf 0.=4 aj/aN.

Ycd bgaagl prgbdiurd klvgnvds ulidrt`hklj ` =9-cgur urkld bgnndbtkgl, frga dapty-mnìidr gld agrlklj tg tcd

bgltdlts gf tcd mnìidr tcd fgnngwklj agrlklj, wktc ` bgap`r`tkvd mnggi tdst tcdl t`hdl. Ycd urkl`ry fngw r`td ks stknn

b`nbun`tdi pdr aklutd, cdlbd5

https://en.wikipedia.org/w/index.php?title=Urine_flow_ratehttps://en.wikipedia.org/w/index.php?title=Urine_flow_ratehttps://en.wikipedia.org/wiki/Citation_neededhttps://en.wikipedia.org/w/index.php?title=Renal_physiology%23Secretionhttps://en.wikipedia.org/w/index.php?title=Renal_physiology%23Secretionhttps://en.wikipedia.org/w/index.php?title=Creatine_phosphatehttps://en.wikipedia.org/w/index.php?title=Creatinine


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]dl`n fulbtkgl 0:

Yg `nngw bgap`rksgl gf rdsunts mdtwddl pdgpnd gf ikffdrdlt skzds, tcd BBr

ks gftdl bgrrdbtdi fgr tcd mgiy surf`bd `rd`

(MR@) `li dxprdssdi bgap`rdi tg tcd `vdr`jd skzdi a`l `s aN/akl/0.:2 a=. Zcknd agst ìunts c`vd ` MR@ tc`t

`pprg`bcds 0.: (0.6-0.;), dxtrdadny gmdsd gr snka p`tkdlts scguni c`vd tcdkr BBr

bgrrdbtdi fgr tcdkr `btu`n MR@.

MR@ b`l md b`nbun`tdi gl tcd m`sks gf wdkjct `li cdkjct.

Ywdlty-fgur cgur urkld bgnndbtkgl tg `ssdss brd`tklkld bnd`r`lbd ks lg ngljdr wkidny pdrfgradi, iud tg ikffkbunty kl

`ssurklj bgapndtd spdbkadl bgnndbtkgl. Yg `ssdss tcd ìdqu`by gf ` bgapndtd bgnndbtkgl, gld `nw`ys b`nbun`tds tcd

àgult gf brd`tklkld dxbrdtdi gvdr ` =9-cgur pdrkgi. Ycks àgult v`rkds wktc ausbnd a`ss, `li ks ckjcdr kl ygulj

pdgpnd vs. gni, kl mn`bhs vs. wcktds, `li kl adl vs. wgadl. @l uldxpdbtdiny ngw gr ckjc =9-cgur brd`tklkld

dxbrdtkgl r`td vgkis tcd tdst. Ldvdrtcdndss, kl b`sds wcdrd dstka`tds gf brd`tklkld bnd`r`lbd frga sdrua brd`tklkld `rd

ulrdnk`mnd, brd`tklkld bnd`r`lbd rda`kls ` usdfun tdst. Ycdsd b`sds klbnuid "dstka`tkgl gf JF] kl klikvkiu`ns wktc

v`rk`tkgl kl ikdt`ry klt`hd (vdjdt`rk`l ikdt, brd`tkld suppndadlts) gr ausbnd a`ss (àput`tkgl, a`nlutrktkgl, ausbnd

w`stklj), sklbd tcdsd f`btgrs `rd lgt spdbkfkb`nny t`hdl kltg `bbgult kl prdikbtkgl dqu`tkgls."

Dstka`tdi v`nuds

@ luamdr gf fgraun`d c`vd mddl idvksdi tg dstka`td JF] gr Bbr

v`nuds gl tcd m`sks gf sdrua brd`tklkld ndvdns.

Dstka`tdi brd`tklkld bnd`r`lbd r`td (dBBr

) usklj Bgbhbrgft-Jùnt fgraun`

@ bgaaglny usdi surrgj`td a`rhdr fgr dstka`td gf brd`tklkld bnd`r`lbd ks tcd Bgbhbrgft-Jùnt (BJ) fgraun`, wckbc

kl turl dstka`tds JF] kl an/akl5X2Q Kt ks làdi `ftdr tcd sbkdltksts wcg fkrst pumnkscdi tcd fgraun`, `li kt dapngys

sdrua brd`tklkld ad`surdadlts `li ` p`tkdlt's wdkjct tg prdikbt tcd brd`tklkld bnd`r`lbd. Ycd fgraun`, `s grkjkl`nny

pumnkscdi, ks5

Ycks fgraun` dxpdbts wdkjct tg md ad`surdi kl hkngjràs `li brd`tklkld tg md ad`surdi kl aj/iN, `s ks

st`li`ri kl tcd TR@. Ycd rdsuntklj v`nud ks auntkpnkdi my ` bglst`lt gf ?.34 kf tcd p`tkdlt ks fda`nd. Ycks

fgraun` ks usdfun mdbùsd tcd b`nbun`tkgls `rd skapnd `li b`l gftdl md pdrfgradi wktcgut tcd `ki gf `

b`nbun`tgr.

Zcdl sdrua brd`tklkld ks ad`surdi kl agn/N5

Zcdrd Bglst`lt ks 0.=2 fgr adl `li 0.?9 fgr wgadl.

Gld kltdrdstklj fd`turd gf tcd Bgbhbrgft `li Jùnt dqu`tkgl ks tc`t kt scgws cgw idpdlidlt tcd dstka`tkgl gf BBr ks

m`sdi gl `jd. Ycd `jd tdra ks (09? - `jd). Ycks ad`ls tc`t ` =?-yd`r-gni pdrsgl (09?-=? 1 0=?) wknn c`vd twkbd tcd

brd`tklkld bnd`r`lbd `s `l 3?-yd`r-gni (09?-3? 1 6?) fgr tcd sàd ndvdn gf sdrua brd`tklkld (0=? ks twkbd `s jrd`t `s

6?). Ycd B-J dqu`tkgl `ssuads tc`t ` wga`l wknn c`vd ` 04% ngwdr brd`tklkld bnd`r`lbd tc`l ` a`l `t tcd sàd

ndvdn gf sdrua brd`tklkld.

https://en.wikipedia.org/w/index.php?title=Calculatorhttps://en.wikipedia.org/w/index.php?title=Kilogramhttps://en.wikipedia.org/w/index.php?title=Creatininehttps://en.wikipedia.org/w/index.php?title=Creatinine_clearancehttps://en.wikipedia.org/w/index.php?title=Body_surface_area


21/150

]dl`n fulbtkgl 03

Dstka`tdi JF] (dJF]) usklj Agikfkb`tkgl gf Ikdt kl ]dl`n Iksd`sd (AI]I) fgraun`

Ycd agst rdbdltny ìvgb`tdi fgraun` fgr b`nbun`tklj tcd JF] ks tcd gld tc`t w`s idvdngpdi my tcd Agikfkb`tkgl gf

Ikdt kl ]dl`n Iksd`sd Rtuiy Jrgup. Agst n`mgr`tgrkds kl @ustr`nk`, `li Ycd Tlktdi Hkljiga lgw b`nbun`td `li

rdpgrt tcd AI]I dstka`tdi JF] `nglj wktc brd`tklkld ad`surdadlts `li tcks fgras tcd m`sks gf bcrglkb hkildy

iksd`sd. Ycd ìgptkgl gf tcd ùtga`tkb rdpgrtklj gf AI]I-dJF] c`s mddl wkidny brktkbksdi.

Ycd agst bgaaglny usdi fgraun` ks tcd "9-v`rk`mnd AI]I," wckbc dstka`tds JF] usklj fgur v`rk`mnds5 sdruabrd`tklkld, `jd, dtclkbkty, `li jdlidr. Ycd grkjkl`n AI]I usdi skx v`rk`mnds wktc tcd ìiktkgl`n v`rk`mnds mdklj tcd

mnggi urd` lktrgjdl `li `nmuakl ndvdns. Ycd dqu`tkgls c`vd mddl v`nki`tdi kl p`tkdlts wktc bcrglkb hkildy iksd`sd8

cgwdvdr mgtc vdrskgls ulidrdstka`td tcd JF] kl cd`ntcy p`tkdlts wktc JF]s gvdr 6? aN/akl. Ycd dqu`tkgls c`vd

lgt mddl v`nki`tdi kl `butd rdl`n f`knurd.

Fgr brd`tklkld kl agn/N5

Fgr brd`tklkld kl aj/in5

Brd`tklkld ndvdns kl agn/N b`l md bglvdrtdi tg aj/iN my ikvkiklj tcda my 33.9. Ycd 2=:33 luamdr `mgvd ksdqu`n tg 03633.90.049.

@ agrd dn`mgr`td vdrskgl gf tcd AI]I dqu`tkgl `nsg klbnuids sdrua `nmuakl `li mnggi urd` lktrgjdl (MTL) ndvdns5

Zcdrd tcd brd`tklkld `li mnggi urd` lktrgjdl bglbdltr`tkgls `rd mgtc kl aj/iN. Ycd `nmuakl bglbdltr`tkgl ks

kl j/iN.

Ycdsd AI]I dqu`tkgls `rd tg md usdi glny kf tcd n`mgr`tgry c`s LGY b`nkmr`tdi kts sdrua brd`tklkld ad`surdadlts

tg ksgtgpd iknutkgl a`ss spdbtrgadtry (KIAR). Zcdl KIAR-b`nkmr`tdi sdrua brd`tklkld ks usdi (wckbc ks `mgut 6%

ngwdr), tcd `mgvd dqu`tkgls scguni md auntkpnkdi my 0:4/036 gr my ?.;9?36.

Rklbd tcdsd fgraun`d ig lgt ìeust fgr mgiy a`ss, tcdy (rdn`tkvd tg tcd Bgbhbrgft-Jùnt fgraun`) ulidrdstka`td

dJF] fgr cd`vy pdgpnd `li gvdrdstka`td kt fgr ulidrwdkjct pdgpnd. (sdd Bgbhbrgft-Jùnt fgraun` `mgvd).

Dstka`tdi JF] (dJF]) usklj tcd BHI-D_K fgraun`

Ycd BHI-D_K (Bcrglkb Hkildy Iksd`sd Dpkidakgngjy Bgnn`mgr`tkgl) fgraun` w`s pumnkscdi kl A`y =??;. Kt w`s

idvdngpdi kl `l dffgrt tg brd`td ` fgraun` agrd `bbur`td tc`l tcd AI]I fgraun`, dspdbk`nny wcdl `btu`n JF] ks

jrd`tdr tc`l 6? aN/akl pdr 0.:2 a=.

]dsd`rbcdrs pggndi i`t` frga auntkpnd stuikds tg idvdngp `li v`nki`td tcks ldw dqu`tkgl. Ycdy usdi 0? stuikds tc`t

klbnuidi 3=49 p`rtkbkp`lts, r`ligany usklj =/2 gf tcd i`t` sdts fgr idvdngpadlt `li tcd gtcdr 0/2 fgr kltdrl`n

v`nki`tkgl. Rkxtddl ìiktkgl`n stuikds, wckbc klbnuidi 23;6 p`rtkbkp`lts, wdrd usdi fgr dxtdrl`n v`nki`tkgl.Ycd BHI-D_K dqu`tkgl pdrfgradi mdttdr tc`l tcd AI]I (Agikfkb`tkgl gf Ikdt kl ]dl`n Iksd`sd Rtuiy) dqu`tkgl,

dspdbk`nny `t ckjcdr JF], wktc ndss mk`s `li jrd`tdr `bbur`by. Zcdl ngghklj `t LC@LDR (L`tkgl`n Cd`ntc `li

Lutrktkgl Dxàkl`tkgl Rurvdy) i`t`, tcd adik`l dstka`tdi JF] w`s ;9.4 aN/akl pdr 0.:2 a= vs. 34.? aN/akl pdr

0.:2 a=, `li tcd prdv`ndlbd gf bcrglkb hkildy iksd`sd w`s 00.4% vdrsus 02.0%.

Ycd BHI-D_K dqu`tkgl, dxprdssdi `s ` skljnd dqu`tkgl, ks5

wcdrd RBr ks sdrua brd`tklkld (aj/iN), h ks ?.: fgr fda`nds `li ?.; fgr a`nds, ` ks -?.2=; fgr fda`nds `li -?.900 fgr

a`nds, akl klikb`tds tcd aklkaua gf RBr/h gr 0, `li a`x klikb`tds tcd a`xkaua gf RBr/h gr 0.

@ bnd`rdr vdrskgl a`y md `s fgnngws5 Fgr brd`tklkld (KIAR b`nkmr`tdi) kl aj/iN5Mn`bh Fda`nd

https://en.wikipedia.org/w/index.php?title=Blood_urea_nitrogenhttps://en.wikipedia.org/w/index.php?title=Serum_albuminhttps://en.wikipedia.org/w/index.php?title=Albuminhttps://en.wikipedia.org/w/index.php?title=Blood_urea_nitrogenhttps://en.wikipedia.org/w/index.php?title=Chronic_kidney_disease%23Stageshttps://en.wikipedia.org/w/index.php?title=Chronic_kidney_disease%23Stages


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]dl`n fulbtkgl 0;

Kf sdrua brd`tklkld (Rbr) >1 ?.:

Kf sdrua brd`tklkld (Rbr) < ?.:

Mn`bh a`nd

Kf sdrua brd`tklkld (Rbr) >1 ?.;

Kf sdrua brd`tklkld (Rbr) < ?.;

Zcktd gr gtcdr r`bd fda`nd

Kf sdrua brd`tklkld (Rbr) >1 ?.:

Kf sdrua brd`tklkld (Rbr) < ?.:

Zcktd gr gtcdr r`bd a`nd

Kf sdrua brd`tklkld (Rbr) >1 ?.;

Kf sdrua brd`tklkld (Rbr) < ?.;

Ycks fgraun` w`s idvdngpdi my Ndvdy dt `n.

Ycd fgraun` BHI-D_K a`y prgvkid kaprgvdi b`rikgv`sbun`r rksh prdikbtkgl gvdr tcd AI]I Rtuiy fgraun` kl `

akiind-`jd pgpun`tkgl.

Dstka`tdi JF] (dJF]) usklj tcd A`yg Pu`ir`tkb fgraun`

@lgtcdr dstka`tkgl tggn tg b`nbun`td JF] ks tcd A`yg Pu`ir`tkb fgraun`. Ycks fgraun` w`s idvdngpdi my ]und dt `n.

kl `l `ttdapt tg mdttdr dstka`td JF] kl p`tkdlts wktc prdsdrvdi hkildy fulbtkgl. Kt ks wdnn rdbgjlkzdi tc`t tcd AI]I

fgraun` tdlis tg ulidrdstka`td JF] kl p`tkdlts wktc prdsdrvdi hkildy fulbtkgl.

Ycd dqu`tkgl ks5

Kf Rdrua Brd`tklkld > ?.3 aj/iN, usd ?.3 aj/iN fgr Rdrua Brd`tklkld

Dstka`tdi JF] fgr bcknirdl usklj Rbcw`rtz fgraun`

Kl bcknirdl, tcd Rbcw`rtz fgraun` ks usdi. Ycks dapngys tcd sdrua brd`tklkld (aj/iN), tcd bckni's cdkjct(ba) `li `

bglst`lt tg dstka`td tcd jngadrun`r fkntr`tkgl r`td5

Zcdrd h ks ` bglst`lt tc`t idpdlis gl ausbnd a`ss, wckbc ktsdnf v`rkds wktc ` bckni's `jd5

Kl fkrst yd`r gf nkfd, fgr prd-tdra m`mkds H1?.22 `li fgr funn-tdra klf`lts H1?.94

Fgr klf`lts `li bcknirdl gf `jd 0 tg 0= yd`rs, H1?.44.

Ycd adtcgi gf sdndbtkgl gf tcd H-bglst`lt v`nud c`s mddl qudstkgldi `s mdklj idpdlidlt upgl tcd jgni-st`li`ri gfrdl`n fulbtkgl usdi (k.d., brd`tklkld bnd`r`lbd, klunkl bnd`r`lbd, dtb.) `li `nsg a`y md idpdlidlt upgl tcd urkl`ry

fngw r`td `t tcd tkad gf ad`surdadlt.

https://en.wikipedia.org/w/index.php?title=Creatinine


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]dl`n fulbtkgl =?

Kl =??;, tcd fgraun` w`s upi`tdi tg usd st`li`rikzdi sdrua brd`tklkld (rdbgaadli h1?.902) `li ìiktkgl`n

fgraun`s tc`t `nngw kaprgvdi prdbkskgl wdrd idrkvdi kf sdrua byst`tkl ad`surdi kl ìiktkgl tg sdrua brd`tklkld.

Kapgrt`lbd gf b`nkmr`tkgl gf tcd sdrua brd`tklkld ndvdn `li tcd KIAR st`li`rikz`tkgldffgrt

Gld prgmnda wktc `ly brd`tklkld-m`sdi dqu`tkgl fgr JF] ks tc`t tcd adtcgis usdi tg `ss`y brd`tklkld kl tcd mnggiikffdr wkidny kl tcdkr susbdptkmknkty tg lgl-spdbkfkb bcrgagjdls, wckbc bùsd tcd brd`tklkld v`nud tg md

gvdrdstka`tdi. Kl p`rtkbun`r, tcd AI]I dqu`tkgl w`s idrkvdi usklj sdrua brd`tklkld ad`surdadlts tc`t cì tcks

prgmnda. Ycd LHID_ prgjrà kl tcd Tlktdi Rt`tds c`s `ttdaptdi tg sgnvd tcks prgmnda my tryklj tg jdt `nn

n`mgr`tgrkds tg b`nkmr`td tcdkr ad`surds gf brd`tklkld tg ` "jgni st`li`ri", wckbc kl tcks b`sd ks ksgtgpd iknutkgl a`ss

spdbtrgadtry (KIAR). Kl n`td =??; lgt `nn n`ms kl tcd T.R. cì bc`ljdi gvdr tg tcd ldw systda. Ycdrd `rd twg fgras

gf tcd AI]I dqu`tkgl tc`t `rd `v`kn`mnd, idpdliklj gl wcdtcdr gr lgt brd`tklkld w`s ad`surdi my `l

KIAR-b`nkmr`tdi `ss`y. Ycd BHI-D_K dqu`tkgl ks idskjldi tg md usdi wktc KIAR-b`nkmr`tdi sdrua brd`tklkld v`nuds

glny.

Byst`tkl B_rgmndas wktc brd`tklkld (v`ryklj ausbnd a`ss, rdbdlt ad`t kljdstkgl, dtb.) c`vd ndi tg dv`nu`tkgl gf `ntdrl`tkvd

`jdlts fgr dstka`tkgl gf JF]. Gld gf tcdsd ks byst`tkl B, ` umkquktgus prgtdkl sdbrdtdi my agst bdnns kl tcd mgiy (kt ks

`l klckmktgr gf bystdkld prgtd`sd).

Byst`tkl B ks frddny fkntdrdi `t tcd jngadrunus. @ftdr fkntr`tkgl, Byst`tkl B ks rd`msgrmdi `li b`t`mgnkzdi my tcd

tumun`r dpktcdnk`n bdnns, wktc glny sa`nn àgults dxbrdtdi kl tcd urkld. Byst`tkl B ndvdns `rd tcdrdfgrd ad`surdi lgt

kl tcd urkld, mut kl tcd mnggistrdà.

Dqu`tkgls c`vd mddl idvdngpdi nklhklj dstka`tdi JF] tg sdrua byst`tkl B ndvdns. Agst rdbdltny, sgad prgpgsdi

dqu`tkgls c`vd bgamkldi (sdx, `jd `li r`bd) ìeustdi byst`tkl B `li brd`tklkld. Ycd agst `bbur`td ks (sdx, `jd `li

r`bd) ìeustdi byst`tkl B, fgnngwdi my (sdx, `jd `li r`bd) ìeustdi brd`tklkld `li tcdl byst`tkld B `ngld kl snkjctnyikffdrdlt wktc ìeustdi brd`tklkld.

Lgra`n r`ljds

Ycd lgra`n r`ljd gf JF], ìeustdi fgr mgiy surf`bd `rd`, ks 0??-02? an/akl/0.:2a= kl adl `li wgadl. Kl bcknirdl,

JF] ad`surdi my klunkl bnd`r`lbd ks 00? an/akl/0.:2a= ultkn = yd`rs gf `jd kl mgtc sdxds, `li tcdl kt prgjrdsskvdny

idbrd`sds. @ftdr `jd 9?, JF] idbrd`sds prgjrdsskvdny wktc `jd, my `mgut ?.9 - 0.= aN/akl pdr yd`r. Xbkt`tkgl lddidiQ

Bcrglkb hkildy iksd`sd st`jds

]ksh f`btgrs fgr hkildy iksd`sd klbnuid ik`mdtds, ckjc mnggi prdssurd, fàkny ckstgry, gnidr `jd, dtclkb jrgup `li

saghklj. Fgr agst p`tkdlts, ` JF] gvdr 6? aN/akl/0.:2a= ks ìdqu`td. Mut skjlkfkb`lt idbnkld gf tcd JF] frga `

prdvkgus tdst rdsunt b`l md `l d`rny klikb`tgr gf hkildy iksd`sd rdqukrklj adikb`n kltdrvdltkgl. Ycd sggldr hkildy

iysfulbtkgl ks ik`jlgsdi `li trd`tdi tcd jrd`tdr giis gf prdsdrvklj rda`klklj ldpcrgls, `li prdvdltklj tcd lddi fgr

ik`nysks.

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]dl`n fulbtkgl =0

BHI st`jdJF] ndvdn (aN/akl/0.:2 a

=)

Rt`jd 0 ;?

Rt`jd = 6? 3;

Rt`jd 2 2? 4;

Rt`jd 9 04 =;

Rt`jd 4 > 04

Ycd sdvdrkty gf bcrglkb hkildy iksd`sd (BHI) ks idsbrkmdi my skx st`jds8 tcd agst sdvdrd tcrdd `rd idfkldi my tcd

AI]I-dJF] v`nud, `li fkrst tcrdd `nsg idpdli gl wcdtcdr tcdrd ks gtcdr dvkidlbd gf hkildy iksd`sd (d.j.,

prgtdklurk`)5

?) Lgra`n hkildy fulbtkgl JF] `mgvd ;?aN/akl/0.:2a= `li lg prgtdklurk`

0) BHI0 JF] `mgvd ;?aN/akl/0.:2a= wktc dvkidlbd gf hkildy ià`jd

=) BHI= (akni) JF] gf 6? tg 3; aN/akl/0.:2a= wktc dvkidlbd gf hkildy ià`jd

2) BHI2 (agidr`td) JF] gf 2? tg 4; aN/akl/0.:2a=

9) BHI9 (sdvdrd) JF] gf 04 tg =; aN/akl/0.:2a=

4) BHI4 hkildy f`knurd - JF] ndss tc`l 04 aN/akl/0.:2a= Rgad pdgpnd ìi BHI4I fgr tcgsd st`jd 4

p`tkdlts rdqukrklj ik`nysks8 a`ly p`tkdlts kl BHI4 `rd lgt ydt gl ik`nysks.

Lgtd5 gtcdrs ìi ` "Y" tg p`tkdlts wcg c`vd cì ` tr`lspn`lt rdj`rindss gf st`jd.

Lgt `nn bnklkbk`ls `jrdd wktc tcd `mgvd bn`sskfkb`tkgl, sujjdstklj tc`t kt a`y aksn`mdn p`tkdlts wktc akniny rdiubdi

hkildy fulbtkgl, dspdbk`nny tcd dnidrny, `s c`vklj ` iksd`sd. @ bglfdrdlbd w`s cdni kl =??; rdj`riklj tcdsd

bgltrgvdrskds my Hkildy Iksd`sd5 Kaprgvklj Jngm`n Gutbgads (HIKJG) gl BHI5 Idfklktkgl, Bn`sskfkb`tkgl `li

_rgjlgsks, j`tcdrklj i`t` gl BHI prgjlgsks tg rdfkld tcd idfklktkgl `li st`jklj gf BHI.

]dfdrdlbds

X0QX0Q - "Jngadrun r Fkntr tkgl ]`td"

X=Q JF] (Bgbhbrgft & AI]I) b`nbun tgr t adikb`n-b`nbun`tgr.ln (cttp5//www.adikb`n-b`nbun`tgr. ln/b`nbun`tgr/JF]/) - Bgbhbrgft `li

AI]I b`nbun`tgr `li idt`kns `mgut klunkl bnd`r`lbd

X2Q JF] B`nbun`tgr `t b`tg.`t - Bgbhbrgft-Jùnt (cttp5//www.b`tg.`t/wdmsdrvkbd/sdrvndt/ngb`tkgl7jgtg1RD]VKBDWB@NB& n`lj1DL&

T]N1"b`nb/b`tgWJF]WBJ. cta") - JF] b`nbun`tkgl (Bgbhbrgft-Jùnt fgraun`)

20. Brd`tklkld bnd`r`lbd b`nbun`tgr (Bgbhbrgft-Jùnt Dqu`tkgl)- my AIB`nb (cttp5/ / www. aib`nb. bga/

brd`tklkld-bnd`r`lbd-bgbhbrgft-jùnt-dqu`tkgl/)

Dxtdrl`n nklhs

Glnkld JF] b`nbun`tgrs

Glnkld JF] B`nbun tgr (cttp5//lhidp.lkc.jgv/n`m-dv`nu`tkgl/jfr-b`nbun`tgrs.sctan)

Rbcw`rtz fgraun (cttp5//www-usdrs.adi.bgrldnn. diu/~spgl/pkbu/b`nb/brbnsbcw.cta) fgr dstka`tklj

pdik`trkb rdl`n fulbtkgl

]dfdrdlbd nklhs

L`tkgl`n Hkildy Iksd`sd Diub`tkgl _rgjrà wdmsktd. (cttp5//www.lhidp.lkc.jgv/prgfdsskgl`ns/klidx.cta)

Klbnuids prgfdsskgl`n rdfdrdlbds `li JF] b`nbun`tgrs

dJF] t N`m Ydsts Glnkld (cttp5//n`mtdstsglnkld.grj/ulidrst`liklj/`l`nytds/jfr/t`m/tdst)

http://labtestsonline.org/understanding/analytes/gfr/tab/testhttp://www.nkdep.nih.gov/professionals/index.htmhttp://www-users.med.cornell.edu/~spon/picu/calc/crclschw.htmhttp://nkdep.nih.gov/lab-evaluation/gfr-calculators.shtmlhttp://www.mdcalc.com/creatinine-clearance-cockcroft-gault-equation/http://www.mdcalc.com/creatinine-clearance-cockcroft-gault-equation/http://www.cato.at/webservice/servlet/location?goto=SERVICE_CALC&lang=EN&URL=%22calc/cato_GFR_CG.htm%22http://www.cato.at/webservice/servlet/location?goto=SERVICE_CALC&lang=EN&URL=%22calc/cato_GFR_CG.htm%22http://www.medical-calculator.nl/calculator/GFR/https://en.wikipedia.org/w/index.php?title=Proteinuriahttps://en.wikipedia.org/w/index.php?title=Proteinuriahttps://en.wikipedia.org/w/index.php?title=Chronic_kidney_disease%23Stages


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]dl`n bgrpusbnd ==

]dl`n bgrpusbnd

]dl`n bgrpusbnd gf A`npkjck

Ycd strubturd gl tcd ndft kl mnud `li pklh ks tcd rdl`n bgrpusbnd. Ycd strubturd gl tcd rkjct ks tcd rdl`n tumund. Ycd mnud strubturd (@) kstcd Mgwa`l's b`psund (= `li 2). Ycd pklh strubturd ks tcd jngadrunus wktc kts b`pknn`rkds. @t tcd ndft, mnggi fngws frga tcd `ffdrdlt

`rdtdrkgnd (;), tcrgujc tcd b`pknn`rkds (0?), `li gut tcd dffdrdlt `rtdrkgnd (00). Ycd ads`ljkua ks tcd pklh strubturd klskid tcdjngadrunus mdtwddl tcd b`pknn`rkds (4`) `li dxtdliklj gutskid tcd jngadrunus (4m).

Ycd rdl`n bgrpusbnd kl tcd bgrtdx (gutdr n`ydr) gf tcd hkildy. @t tcd tgp, tcd rdl`n bgrpusbnd bglt`klklj tcd jngadrunus. Ycd fkntdrdimnggi dxkts kltg tcd rdl`n tumund, `t rkjct. @t ndft, mnggi fngws frga tcd `ffdrdlt `rtdrkgnd (rdi), dltdrs kltg tcd rdl`n bgrpusbnd `li fddistcd jngadrunus8 mnggi fngws gut gf tcd dffdrdlt `rtdrkgnd (mnud).

N`tkl bgrpusbunua rdlks

Jr`y's sumedbt #=42 0==0X0Q

Kl tcd hkildy, ` rdl`n bgrpusbnd ks tcd klktk`n mnggi-fkntdrklj bgapgldlt gf ` ldpcrgl. Kt bglsksts gf twg strubturds5 `

jngadrunus `li ` Mgwa`l's b`psund.

Ycd jngadrunus ks ` sa`nn tuft gf b`pknn`rkds bglt`klklj twg bdnn typds. Dligtcdnk`n bdnns, wckbc c`vd n`rjd fdldstr`d,

`rd lgt bgvdrdi my ik`pcr`jas. Ads`ljk`n bdnns `rd agikfkdi saggtc ausbnd bdnns tc`t nkd mdtwddl tcd b`pknn`rkds.

Ycdy rdjun`td mnggi fngw my tcdkr bgltr`btknd `btkvkty `li sdbrdtd dxtr`bdnnun`r a`trkx, prgst`jn`likls, `li bytghklds.Ads`ljk`n bdnns `nsg c`vd pc`jgbytkb `btkvkty, rdagvklj prgtdkls `li gtcdr agndbunds tr`ppdi kl tcd jngadrun`r

m`sdadlt adamr`ld gr fkntr`tkgl m`rrkdr.

Ycd Mgwa`l's b`psund c`s `l gutdr p`rkdt`n n`ydr bgapgsdi gf skapnd squàgus dpktcdnkua. Ycd vksbdr`n n`ydr,

bgapgsdi gf agikfkdi skapnd squàgus dpktcdnkua, ks nkldi my pgigbytds. _gigbytds c`vd fggt prgbdssds, pdikbdns,

tc`t wr`p `rguli jngadrun`r b`pknn`rkds. Ycdsd pdikbdns kltdrikjkt`td wktc pdikbdns gf ìe`bdlt pgigbytds fgraklj

fkntr`tkgl snkts.

Ycd rdl`n bgrpusbnd fkntr`tkgl m`rrkdr ks bgapgsdi gf5 tcd fdldstr`tdi dligtcdnkua gf jngadrun`r b`pknn`rkds, tcd fusdi

m`s`n nàkl` gf dligtcdnk`n bdnns `li pgigbytds, `li tcd fkntr`tkgl snkts gf tcd pgigbytds. Ycks m`rrkdr pdrakts p`ss`jd

gf w`tdr, kgls, `li sa`nn agndbunds frga tcd mnggistrdà kltg Mgwa`l's sp`bd (tcd sp`bd mdtwddl tcd vksbdr`n `li

p`rkdt`n n`ydrs). N`rjd `li/gr ldj`tkvdny bc`rjdi prgtdkls `rd prdvdltdi frga p`ssklj kltg Mgwa`l's sp`bd, tcus

rdt`klklj tcdsd prgtdkls kl tcd bkrbun`tkgl. Ycd m`s`n nàkl` ks bgapgsdi gf 2 n`ydrs5 nàkl` r`r` dxtdrl`, nàkl`

https://en.wikipedia.org/w/index.php?title=Podocytehttps://en.wikipedia.org/w/index.php?title=Glomerular_basement_membranehttps://en.wikipedia.org/w/index.php?title=Glomerular_basement_membranehttps://en.wikipedia.org/w/index.php?title=Mesangial_cellhttps://en.wikipedia.org/w/index.php?title=Fenestra_%28histology%29http://education.yahoo.com/reference/gray/subjects/subject?id=253#p1221https://en.wikipedia.org/w/index.php?title=List_of_subjects_in_Gray%27s_Anatomy:253%23Gray.27s_page_.231221https://en.wikipedia.org/w/index.php?title=Latinhttps://en.wikipedia.org/w/index.php?title=File:Gray1129.pnghttps://en.wikipedia.org/w/index.php?title=File:Renal_corpuscle.svg


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]dl`n bgrpusbnd =2

idls`, `li nàkl` r`r` kltdrl`. Ycd nàkl` r`r` dxtdrl` ks ìe`bdlt tg tcd pgigbytd prgbdssds. Ycd nàkl` idls` ks tcd

bdltr`n n`ydr bglskstklj gf typd KV bgnn`jdl `li nàklkl. Ycks n`ydr `bts `s ` sdndbtkvd a`brgagndbun`r fkntdr,

prdvdltklj tcd p`ss`jd gf n`rjd prgtdkl agndbunds kltg Mgwa`l's sp`bd. Ycd nàkl` r`r` kltdrl` ks ìe`bdlt tg

dligtcdnk`n bdnns. Ycks n`ydr bglt`kls cdp`r`l sunf`td, ` ldj`tkvdny bc`rjdi jnybgsàklgjnyb`l tc`t bgltrkmutds tg tcd

dndbtrgst`tkb m`rrkdr gf tcd jngadrun`r fkntdr.

Ycdrd `rd twg pgnds kl tcd rdl`n bgrpusbnd, ` v`sbun`r pgnd, `li ` urkl`ry pgnd. Ycd v`sbun`r pgnd ks wcdrd tcd`ffdrdlt `li dffdrdlt `rtdrkgnds bgaaulkb`td wktc tcd jngadrunus. Ycd urkl`ry pgnd ks wcdrd tcd bgrpusbnd gpdls kltg

tcd nuadl gf tcd prgxka`n bglvgnutdi tumund.

Fnuki frga mnggi kl tcd jngadrunus ks bgnndbtdi kl tcd Mgwa`l's b`psund tg fgra "jngadrun`r fkntr`td", wckbc ks tcdl

furtcdr prgbdssdi `nglj tcd ldpcrgl tg fgra urkld. Ycd tcrdd typds gf fkntr`tkgl b`rrkdi gut kl tcd Mgwa`l's b`psund

`rd5 0) M`sdadlt Fkntr`tkgl =) Vksbdr`n Fkntr`tkgl 2) Dligtcdrakb Fkntr`tk

basic medial science of the kidney: the scientific basis of clinical disease, marc imhotep cray,...

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