Nephrology and Therapeutics

Nephrology

Nephrology is a branch of medical science that deals with function and diseases of the kidneys and it focuses on the diagnosis and treatment of kidney diseases. The kidneys are paired retroperitoneal organs that lie at the level of the T12 to L3 vertebral bodies. The kidney has a fibrous capsule, which is surrounded by pararenal fat. The kidney itself can be divided into renal parenchyma, consisting of renal cortex and medulla, and the renal sinus containing renal pelvis, calyces, renal vessels, nerves, lymphatic’s and perirenal fat. The renal parenchyma has two layers: cortex and medulla. The renal cortex lies peripherally under the capsule while the renal medulla consists of 10-14 renal pyramids, which are separated from each other by an extension of renal cortex called renal columns. The kidneys serve important functions, including filtration and excretion of metabolic waste products (urea and ammonium); regulation of necessary electrolytes, fluid, and acid-base balance; and stimulation of red blood cell production. They also serve to regulate blood pressure via the renin-angiotensin-aldosterone system, controlling reabsorption of water and maintaining intravascular volume. The kidneys also reabsorb glucose and amino acids and have hormonal functions via erythropoietin, calcitriol, and vitamin D activation.