Nephron

The nephron is the microscopic, functional unit of the kidney, responsible for filtering blood and forming urine. Each kidney contains approximately 1 to 1.5 million nephrons. Nephrons are primarily located in the cortex and medulla of the kidney. The renal corpuscle, which includes the glomerulus and Bowman’s capsule, is located in the cortex, while the renal tubule (including the proximal tubule, loop of Henle, distal tubule, and collecting duct) extends into both the cortex and the medulla. The nephron begins in the cortex, dips into the medulla with the loop of Henle, and returns to the cortex before connecting to the collecting ducts, which drain into the renal pelvis.

Anatomy

The nephron is the structural and functional unit of the kidney, responsible for filtering blood and forming urine. Each nephron consists of multiple components that work together to process and filter blood, maintain fluid balance, and ultimately produce urine. Below is a detailed description of its anatomy, including the renal corpuscle and tubules, as well as their organization and location within the kidney.

Renal Corpuscle

The renal corpuscle is the initial part of the nephron and is responsible for the filtration of blood. It is located in the renal cortex and consists of two main structures: the glomerulus and the Bowman’s capsule.

• Glomerulus: The glomerulus is a network of tiny capillaries that receive blood from an afferent arteriole. These capillaries are lined with a specialized filtration membrane that allows water, ions, and small molecules to pass through while preventing the passage of larger molecules, such as proteins and blood cells. The glomerulus is surrounded by Bowman’s capsule.
• Bowman’s Capsule: The Bowman’s capsule, also known as the glomerular capsule, is a cup-like structure that encloses the glomerulus. It has two layers: an inner visceral layer, which is closely associated with the glomerulus, and an outer parietal layer, which forms the outer wall of the capsule. The space between these two layers is called the capsular space, where the initial filtrate from the blood, known as glomerular filtrate, is collected before passing into the next part of the nephron.

Proximal Convoluted Tubule (PCT)

After filtration occurs in the renal corpuscle, the filtrate enters the proximal convoluted tubule (PCT), which is also located in the renal cortex.

• Structure: The proximal tubule is a highly coiled segment of the nephron and is lined by cuboidal epithelial cellsthat contain numerous microvilli on their apical surface. These microvilli form a brush border, which greatly increases the surface area for reabsorption. The cells are also rich in mitochondria, providing the energy needed for active transport processes.
• Location: The PCT is located in the renal cortex and is the first part of the tubular network that follows the renal corpuscle.

Loop of Henle (Nephron Loop)

The Loop of Henle, or nephron loop, is a U-shaped structure that dips into the renal medulla. It is made up of a descending limb and an ascending limb, each of which has different structural features.

• Descending Limb: The descending limb begins in the cortex and extends into the medulla. It is initially composed of cuboidal cells in its thick portion, but as it enters deeper into the medulla, it transitions into simple squamous epithelial cells in its thin segment. This portion of the nephron loop is permeable to water.
• Ascending Limb: The ascending limb returns to the cortex after looping through the medulla. It also has two segments: a thin ascending limb, lined with squamous cells, and a thick ascending limb, which is composed of cuboidal epithelial cells. The thick segment of the ascending limb is impermeable to water but is involved in the active transport of ions out of the filtrate.

Distal Convoluted Tubule (DCT)

The distal convoluted tubule (DCT) is located in the renal cortex and follows the loop of Henle. It is shorter and less convoluted than the proximal tubule.

• Structure: The DCT is lined by cuboidal epithelial cells that are smaller and have fewer microvilli compared to the cells of the PCT. These cells also contain mitochondria, although in smaller amounts than those in the PCT, as the DCT engages in less active transport.
• Macula Densa: A specialized region of the DCT, known as the macula densa, is located near the glomerulus, where it comes into contact with the afferent arteriole. The macula densa is involved in sensing changes in sodium chloride concentration and is part of the juxtaglomerular apparatus, which helps regulate blood pressure and kidney function.

Juxtaglomerular Apparatus (JGA)

The juxtaglomerular apparatus (JGA) is a specialized structure formed by the interaction of the distal convoluted tubule and the afferent arteriole.

• Juxtaglomerular Cells: The afferent arteriole contains specialized juxtaglomerular cells, which produce and secrete renin, an enzyme involved in regulating blood pressure.
• Macula Densa: As part of the JGA, the macula densa cells located in the DCT monitor the concentration of sodium chloride in the filtrate. This information helps the kidney adjust its filtration rate and blood flow.

Collecting Duct System

The final part of the nephron is the collecting duct system, where the urine is further concentrated before being transported to the renal pelvis.

• Connecting Tubules: After the DCT, the filtrate flows into the connecting tubules, which merge with other nephrons to form the larger collecting ducts.
• Collecting Ducts: The collecting ducts are located in both the renal cortex and renal medulla. As the ducts pass deeper into the medulla, they become larger and eventually join to form the papillary ducts. These ducts open into the renal papillae, where the urine is delivered to the minor calyces and then to the renal pelvis.
• Cell Types: The collecting duct is lined with two main cell types:
  • Principal Cells: These cells are responsible for regulating water and sodium reabsorption.
  • Intercalated Cells: These cells play a role in acid-base balance by regulating hydrogen and bicarbonate ions.

Blood Supply

The nephron is closely associated with an intricate network of blood vessels that provide the necessary exchange of materials between the blood and the filtrate.

• Afferent Arterioles: Each nephron receives blood from an afferent arteriole, which branches from the renal artery. This arteriole delivers blood to the glomerulus for filtration.
• Efferent Arterioles: After filtration, blood exits the glomerulus through the efferent arteriole. These arterioles play a role in regulating glomerular filtration pressure.
• Peritubular Capillaries and Vasa Recta: The efferent arterioles branch into peritubular capillaries (surrounding the PCT and DCT) and vasa recta (surrounding the loop of Henle in juxtamedullary nephrons). These capillary networks allow for the exchange of water, solutes, and gases between the blood and the nephron.

Types of Nephrons

There are two types of nephrons, each with specific anatomical features based on their location within the kidney.

• Cortical Nephrons: These nephrons make up about 85% of all nephrons and are located primarily in the renal cortex. Their loops of Henle are relatively short and extend only slightly into the medulla.
• Juxtamedullary Nephrons: These nephrons, which account for about 15% of the total, are located near the corticomedullary junction. They have long loops of Henle that extend deep into the renal medulla, allowing them to play a critical role in concentrating urine.

Function

The nephron is the functional unit of the kidney, responsible for filtering blood, maintaining homeostasis, and producing urine. Each component of the nephron plays a specialized role in ensuring that waste products are efficiently removed from the bloodstream, while necessary substances like water, electrolytes, and nutrients are reabsorbed. Below is a detailed explanation of the functions of each part of the nephron.

Filtration in the Renal Corpuscle

The first and critical function of the nephron is the filtration of blood in the renal corpuscle, which consists of the glomerulus and Bowman’s capsule.

• Glomerular Filtration: Blood enters the glomerulus through the afferent arteriole, and the high pressure in these capillaries forces water, ions, glucose, amino acids, and waste products out of the blood and into Bowman’s capsule. Larger molecules like proteins and blood cells remain in the bloodstream, as they are too large to pass through the glomerular filtration membrane. This process creates a fluid known as glomerular filtrate, which is the starting point for urine production.
• Filtration Barrier: The filtration barrier consists of three layers: the endothelium of the glomerular capillaries, the basement membrane, and the podocytes (cells with foot-like projections). This barrier is selectively permeable, allowing small molecules like water, electrolytes, and waste to pass while retaining larger proteins and cells in the blood.

Reabsorption in the Proximal Convoluted Tubule (PCT)

The next key function of the nephron is reabsorption, which primarily occurs in the proximal convoluted tubule (PCT).

• Reabsorption of Nutrients: Approximately 65-70% of the filtrate is reabsorbed in the PCT. Essential substances, such as glucose, amino acids, bicarbonate, and electrolytes like sodium (Na+), potassium (K+), and chloride (Cl-), are reabsorbed from the filtrate back into the bloodstream via active and passive transport mechanisms.
• Water Reabsorption: Due to the reabsorption of solutes, water follows passively through osmosis. The PCT has a high permeability to water, ensuring that most of the water in the filtrate is reabsorbed early in the nephron.
• Transport Mechanisms: Active transport, facilitated diffusion, and co-transport mechanisms (such as sodium-glucose transporters) are used to reabsorb substances from the filtrate. The cells of the PCT are rich in mitochondria, which provide energy for active transport.

Concentration and Dilution in the Loop of Henle

The Loop of Henle plays a crucial role in the concentration and dilution of urine, helping to establish the osmotic gradient in the kidney.

• Descending Limb (Water Reabsorption): The descending limb of the loop is permeable to water but not to solutes. As the filtrate moves down the descending limb into the hyperosmotic environment of the renal medulla, water is reabsorbed into the surrounding interstitial fluid via osmosis, leading to a more concentrated filtrate.
• Ascending Limb (Solute Reabsorption): The ascending limb of the loop is impermeable to water but allows the active transport of solutes, such as sodium, potassium, and chloride, out of the filtrate. The thick segment of the ascending limb uses active transport pumps to move these ions into the surrounding interstitial fluid, reducing the osmolarity of the filtrate.
• Countercurrent Multiplier System: The interaction between the descending and ascending limbs creates the countercurrent multiplier system, which establishes a concentration gradient in the medulla. This gradient is crucial for the kidney’s ability to produce concentrated urine when needed.

Fine-Tuning in the Distal Convoluted Tubule (DCT)

The distal convoluted tubule (DCT) performs fine-tuning of the filtrate, adjusting electrolyte balance and further regulating fluid reabsorption under hormonal control.

• Selective Reabsorption: In the DCT, sodium is reabsorbed in exchange for potassium or hydrogen ions under the influence of the hormone aldosterone. This process helps regulate blood sodium levels and potassium balance. Calcium reabsorption is also controlled in the DCT by parathyroid hormone (PTH), which increases calcium uptake when blood calcium levels are low.
• Acid-Base Balance: The DCT also plays a role in acid-base regulation. It can secrete hydrogen ions (H⁺) or bicarbonate ions (HCO₃⁻) into the filtrate to maintain the blood’s pH within a narrow range. The ability to adjust acid and base secretion helps the body maintain pH homeostasis.

Hormonal Regulation and Osmoregulation in the Collecting Duct

The collecting duct system is the final site where water reabsorption is regulated, primarily under hormonal control. It plays a major role in osmoregulation.

• Water Reabsorption: In the presence of the hormone antidiuretic hormone (ADH), the walls of the collecting duct become more permeable to water. Aquaporins, which are water channels, are inserted into the cell membranes, allowing water to be reabsorbed from the filtrate into the bloodstream. This process results in the formation of concentrated urine when the body needs to conserve water (e.g., in dehydration).
• Urea Recycling: The collecting duct also plays a role in urea recycling, where urea is passively reabsorbed into the medulla, contributing to the high osmolarity in the medulla, which facilitates water reabsorption from the nephron.
• Final Adjustments to Ion Balance: In addition to water, the collecting duct can regulate the reabsorption or secretion of ions like sodium and potassium. This process is controlled by aldosterone, which promotes sodium reabsorption and potassium secretion, crucial for maintaining blood pressure and electrolyte balance.

Excretion of Waste Products

The nephron ensures the excretion of waste products while retaining essential substances for the body.

• Formation of Urine: After passing through the various segments of the nephron, the final filtrate that reaches the renal pelvis is termed urine. This fluid is composed of water, urea, creatinine, various electrolytes, and other metabolic waste products. The nephron ensures that unwanted substances, such as nitrogenous wastes (urea, ammonia), creatinine, and drugs, are excreted in the urine.
• Elimination via Ureters: The urine formed in the collecting ducts drains into the renal pelvis and then into the ureters, which transport it to the bladder for storage before elimination from the body.

Maintaining Fluid and Electrolyte Balance

The nephron is critical in maintaining the body’s fluid and electrolyte balance.

• Sodium and Potassium Balance: Sodium reabsorption is finely controlled by the nephron, especially in the DCT and collecting ducts. Potassium secretion is also adjusted to maintain the proper balance of these ions, which are essential for normal cell function, particularly in the nervous and muscular systems.
• Water Homeostasis: By regulating water reabsorption based on the body’s hydration status, the nephron helps maintain water homeostasis. The ability to produce dilute or concentrated urine ensures that the body can conserve water when necessary or excrete excess water when hydration levels are adequate.
• Calcium and Phosphate Balance: The nephron also regulates the reabsorption of calcium and phosphate, under the influence of hormones like PTH and calcitriol. This is important for bone health and metabolic functions.

Regulation of Blood Pressure

The nephron contributes to blood pressure regulation through its filtration and reabsorption processes and by the release of hormones.

• Renin-Angiotensin-Aldosterone System (RAAS): The juxtaglomerular apparatus (JGA) in the nephron releases renin in response to low blood pressure or decreased sodium delivery to the DCT. Renin triggers the RAAS, leading to vasoconstriction and the release of aldosterone, which increases sodium and water reabsorption, raising blood pressure.
• Control of Blood Volume: By adjusting the amount of sodium and water that is reabsorbed or excreted, the nephron controls the blood volume, which directly influences blood pressure.

Clinical Significance

The nephron is the functional unit of the kidney, and its health is vital for proper renal function and overall bodily homeostasis. Disorders that affect the nephron can lead to significant clinical issues.

• Kidney Diseases: Conditions like chronic kidney disease (CKD) and acute kidney injury (AKI) involve the damage or loss of nephron function. CKD leads to a gradual loss of nephron function over time, while AKI is a sudden onset of nephron dysfunction. Both conditions can impair the kidney’s ability to filter blood, leading to the buildup of waste products and toxins in the body.
• Glomerulonephritis: Inflammation of the glomeruli (the filtering component of the nephron) can lead to glomerulonephritis, a condition that reduces the nephron’s ability to filter blood properly. This can result in proteinuria (excess protein in urine), hematuria (blood in urine), and eventually kidney failure if untreated.
• Diabetic Nephropathy: Long-term diabetes can damage the nephrons, particularly the glomeruli, leading to diabetic nephropathy, a leading cause of kidney failure.
• Hypertension: Nephron damage can result from or contribute to high blood pressure (hypertension), as the kidney plays a key role in regulating blood volume and pressure. In conditions like renal artery stenosis, reduced blood flow to the nephron activates the renin-angiotensin-aldosterone system (RAAS), worsening hypertension.