Renal Physiology: Mosby Physiology Monograph Series

258 Pages·2012·7.75 MB·English

Renal
Physiology
Look for these other volumes in the Mosby Physiology Monograph Series:
■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■ ■
BLAUSTEIN ET AL: Cellular Physiology and Neurophysiology
HUDNALL: Hematology: A Pathophysiologic Approach
JOHNSON: Gastrointestinal Physiology
LEVY & PAPPANO: Cardiovascular Physiology
WHITE & PORTERFIELD: Endocrine and Reproductive Physiology
CLOUTIER: Respiratory Physiology
Renal
Physiology
F I F T H E D I T I O N
BRUCE M. KOEPPEN, MD, PhD
Dean
Frank H. Netter MD School of Medicine
Quinnipiac University
Hamden, Connecticut
BRUCE A. STANTON, PhD
Professor of Microbiology and Immunology, and of Physiology
Andrew C. Vail Memorial Professor
The Geisel School of Medicine at Dartmouth
Hanover, New Hampshire
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
RENAL PHYSIOLOGY, FIFTH EDITION ISBN: 978-0-323-08691-2
Copyright © 2013 by Mosby, an imprint of Elsevier Inc.
Copyright © 2007, 2001, 1997, 1992 by Mosby, Inc., an affliate of Elsevier Inc.
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Notices
Knowledge and best practice in this feld are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.
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using any information, methods, compounds, or experiments described herein. In using such information or
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ISBN: 978-0-323-08691-2
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our family, friends, colleagues, and, most especially, our students.
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P R E F A C E
W
hen we wrote the frst edition of Renal To the instructor: This book is intended to provide
Physiology in 1992, our goal was to provide a clear and students in the biomedical and health sciences with a
concise overview of the function of the kidneys for basic understanding of the workings of the kidneys.
health professions students who were studying the We believe that it is better for the student at this stage
topic for the frst time. The feedback we have received to master a few central concepts and ideas rather than
over the years has affrmed that we met our goal, and to assimilate a large array of facts. Consequently, this
that achievement has been a key element to the book’s book is designed to teach the important aspects and
success. Thus, in this ffth edition we have adhered to fundamental concepts of normal renal function. We
our original goal, maintaining all the proven elements have emphasized clarity and conciseness in presenting
of the last four editions. the material. To accomplish this goal, we have been
Since 1992, much has been learned about kidney selective in the material included. The broader feld of
function at the cellular, molecular, and clinical level. nephrology, with its current and future frontiers, is
Although this new information is exciting and pro- better learned at a later time and only after the “big
vides new and greater insights into the function of the picture” has been well established. For clarity and sim-
kidneys in health and disease, it can prove daunting plicity, we have made statements as assertions of fact
to frst-time students and in some cases may cause even though we recognize that not all aspects of a par-
them to lose the forest for the trees. In an attempt to ticular problem have been resolved.
balance the needs of the frst-time student with our To the student: As an aid to learning this material,
desire to present some of the latest advances in the each chapter includes a list of objectives that refect the
feld of renal physiology, we have updated the high- fundamental concepts to be mastered. At the end of each
lighted text boxes, titled “At the Cellular Level” and chapter, we have provided a summary and a list of key
“In the Clinic,” to supplement the main text for stu- words and concepts that should serve as a checklist while
dents who wish additional detail. The other features of working through the chapter. We have also provided a
the book, which include clinical material that illus- series of self-study problems that review the central prin-
trates important physiologic principles, multiple- ciples of each chapter. Because these questions are learn-
choice questions, self-study problems, and integrated ing tools, answers and explanations are provided in
case studies, have been retained and updated. To Appendix D. Multiple-choice questions are presented at
achieve our goal of keeping the book concise, we have the end of each chapter. Comprehensive clinical cases are
removed some old material as new material was added. included in other appendixes. We recommend working
We hope that all who use this book fnd that the through the clinical cases in Appendix A only after com-
changes have made it an improved learning tool and a pleting the book. In this way, they can indicate where
valuable source of information. additional work or review is required.
vii
viii PREFACE
We have provided a highly selective bibliography We encourage all who use this book to send us your
that is intended to provide the next step in the study of comments and suggestions. Please let us know what we
the kidney; it is a place to begin to add details to the have done right as well as what needs improvement.
subjects presented here and a resource for exploring
other aspects of the kidney not treated in this book. Bruce M. Koeppen
Bruce A. Stanton