A version of the OpenStax text

The strengths of this popular text { its conciseness and logical progr ession through renal physiology and pathophysiology { are retained in the 4th edition. The text has been updated throughout, and the content has been expanded to make the book eminently suitable for 'systems-ba sed' courses.

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The structure, function, and pathologies of the human kidney -- simplified and explained A Doody's Core Title for 2011! 4 STAR DOODY'S REVIEW! "This seventh edition of a concise, well written book on renal physiology continues the legacy of the book as a major contributor in the field....This well written book is an excellent review of renal function and is one of the best concise reviews of the topic."--Doody's Review Service Written in a concise, conversational style, this trusted text reviews the fundamental principles of renal physiology that are essential for an understanding of clinical medicine. Combining the latest research with a fully integrated teaching approach, Vander's Renal Physiology explains how the kidneys affect other body systems and how they in turn are affected by these systems. Filled with the learning tools you need to truly learn key concepts rather than merely memorize facts, Vander's will prove valuable to you at every stage of your studies or practice. Features: New Global case studies New An online physiology learning center that offers additional exam questions, artwork, and graphs Offers the best review of renal physiology available for the USMLE Step 1 Begins with the basics and works up to advanced principles Distills the essence of renal processes and their regulation in a concise, integrated manner that focuses on the logic of renal processes Features learning aids such as flow charts, diagrams, key concepts, clinical examples, learning objectives, and review questions with answers and explanations Explains the relationship between blood pressure and renal function Presents the normal functions of the kidney with clinical correlations to disease states Includes the most current research on the molecular and genetic principles underlying renal physiology

The kidney is innervated with efferent sympathetic nerve fibers reaching the renal vasculature, the tubules, the juxtaglomerular granular cells, and the renal pelvic wall. The renal sensory nerves are mainly found in the renal pelvic wall. Increases in efferent renal sympathetic nerve activity reduce renal blood flow and urinary sodium excretion by activation of α1-adrenoceptors and increase renin secretion rate by activation of β1-adrenoceptors. In response to normal physiological stimulation, changes in efferent renal sympathetic nerve activity contribute importantly to homeostatic regulation of sodium and water balance. The renal mechanosensory nerves are activated by stretch of the renal pelvic tissue produced by increases in renal pelvic tissue of a magnitude that may occur during increased urine flow rate. Activation of the sensory nerves elicits an inhibitory renorenal reflex response consisting of decreases in efferent renal sympathetic nerve activity leading to natriuresis. Increasing efferent sympathetic nerve activity increases afferent renal nerve activity which, in turn, decreases efferent renal sympathetic nerve activity by activation of the renorenal reflexes. Thus, activation of the afferent renal nerves buffers changes in efferent renal sympathetic nerve activity in the overall goal of maintaining sodium balance. In pathological conditions of sodium retention, impairment of the inhibitory renorenal reflexes contributes to an inappropriately increased efferent renal sympathetic nerve activity in the presence of sodium retention. In states of renal disease or injury, there is a shift from inhibitory to excitatory reflexes originating in the kidney. Studies in essential hypertensive patients have shown that renal denervation results in long-term reduction in arterial pressure, suggesting an important role for the efferent and afferent renal nerves in hypertension. Table of Contents: Part I: Efferent Renal Sympathetic Nerves / Introduction / Neuroanatomy / Neural Control of Renal Hemodynamics / Neural Control of Renal Tubular Function / Neural Control of Renin Secretion Rate / Part II: Afferent Renal Sensory Nerves / Introduction / Neuroanatomy / Renorenal Reflexes / Mechanisms Involved in the Activation of Afferent Renal Sensory Nerves / Part III: Pathophysiological States / Efferent Renal Sympathetic Nerves / Afferent Renal Sensory Nerves / Conclusions / References