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.
Original language | English (US) |
---|---|
Title of host publication | Pediatric Critical Care Medicine |
Subtitle of host publication | Volume 3: Gastroenterological, Endocrine, Renal, Hematologic, Oncologic and Immune Systems |
Publisher | Springer-Verlag London Ltd |
Pages | 129-146 |
Number of pages | 18 |
ISBN (Electronic) | 9781447164166 |
ISBN (Print) | 9781447164159 |
DOIs | |
State | Published - Jan 1 2014 |
Keywords
- Endocrine kidney
- Filtration
- Kidney crosstalk
- Renal hemodynamics
- Tubular reabsorption
- Tubuloglomerular feedback
ASJC Scopus subject areas
- General Medicine