Physiologie du rein et bases physiopathologiques des maladies rénales

This review concerns the physiology of the kidney. The first chapter depicts briefly the anatomy of the kidney. The second chapter is focused on the glomerular filtration, with a présentation of the process governing the formation of the pre-urine in the Bowman space, a study of the physiological régulation of glomerular filtration rate (GFR), the normal values of GFR, the évaluation of this glomerular filtration function and a rapid glimpse on glomerular pathologies. The third chapter is about the tubular functions of reabsorption and sécrétion at the level of the différent parts of the néphron. We develop the transport mechanisms of reabsorption of glucose, amino-acids, proteins of low molecular weight and main ions (bicarbonates, phosphates, Na+, CI− and Ca2+) as well as the process of sécrétion concerning H+ ions, ammoniac and drugs in proximal part of the tubule. Then the respective functions of the two descending and ascending limbs of Henlé are presented before studying those of the distal tubule, through the rôle of principal cells, intercalated A and B cells in the maintain of hydromineral and acid-base balance. The study of the différent parts of the tubule ends with the collecting duct and the rôle played by anti-diuretic hormone in the concentration of the urines. The last chapter concerns the 3 endocrine functions of kidney, with synthesis of renin, erythropoietin, and 1,25(OH)2 cholecalciferol.