UROLOGY Schrier Diseases of the Kidney and Urinary Tract 7th ed 2001!!!

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Diseases of the Kidney and Urinary Tract 7th edition (October 15, 2001) (3-Volume Set) : by Robert W., Md. Schrier (Editor) By Lippincott Williams & Wilkins 
Publishers
By OkDoKeY
Diseases of the Kidney and Urinary Tract
Contents
Dedication
Preface
Contributing Authors
Volume 1 Volume 2 Volume 3
Color Figures for Volume I
Color Figures for Volume II
Color Figures for Volume III
VOLUME I
Section I. Biochemical, Structural, and Functional Correlations in the Kidney
Chapter 1 Structural–Functional Relationships in the Kidney
Steven C. Hebert, Robert F. Reilly, Jr., and Wilhelm Kriz
Chapter 2 Renal Circulation and Glomerular Hemodynamics
William J. Arendshorst and L. Gabriel Navar
Chapter 3 Regulation of Water Balance: Urine Concentration and Dilution
Sfren Nielsen, Mark A. Knepper, Tae-Hwan Kwon, and Jfrgen Frfkiaer
Chapter 4 Tubular Sodium Transport
W. Brian Reeves and Thomas E. Andreoli
Chapter 5 Tubular Potassium Transport
Heino E. Velázquez and Fred S. Wright
Chapter 6 Renal Acid–Base Transport
Robert J. Alpern and Patricia A. Preisig
Chapter 7 Renal Metabolism
Anton C. Schoolwerth and Susan R. DiGiovanni
Chapter 8 Renal Transport of Organic Ions and Uric Acid
Françoise Roch-Ramel and Laurent Schild
Chapter 9 Hormones and the Kidney
Kenneth E. Kokko, Angel Montero, Fadi G. Lakkis, and Kamal F. Badr
Section II. Clinical Evaluation
Chapter 10 Urinalysis
Melanie S. Kim and Howard L. Corwin
Chapter 11 Laboratory Evaluation of Renal Function
Richard A. Lafayette, Ronald D. Perrone, and Andrew S. Levey
Chapter 12 Intravenous Urography, Ultrasonography, and Radionuclide Studies
Judith A.W. Webb and Keith E. Britton
Chapter 13 Computed Tomography and Magnetic Resonance Imaging
Silvia D. Chang and Hedvig Hricak
Chapter 14 Diagnostic and Therapeutic Angiography of the Renal Circulation
Christopher S. Morris and Jeffrey M. Rimmer
Chapter 15 Indications for and Interpretation of the Renal Biopsy: Evaluation by Light, Electron, and Immunofluorescence Microscopy
Byron P. Croker and C. Craig Tisher
Section III. Hereditary Diseases
Chapter 16 Introduction to Genetic Renal Disease
Terry Watnick and Gregory G. Germino
Chapter 17 Nephronophthisis, Medullary Cystic and Medullary Sponge Kidney Disease
Friedhelm Hildebrandt, Paul Jungers, Christophe Robino, and Jean-Pierre Grünfeld
Chapter 18 Polycystic Kidney Disease
Godela M. Fick-Brosnahan, Tevfik Ecder, and Robert W. Schrier
Chapter 19 Alport’s Syndrome, Fabry’s Disease, and Nail-Patella Syndrome
Martin C. Gregory and Curtis L. Atkin
Chapter 20 Isolated Renal Tubular Disorders: Molecular Mechanism and Clinical Expression of Disease
Eugene Daphnis, Luzma M. Houseal, and Sandra Sabatini
Section IV. Urological Diseases of the Genitourinary Tract
Chapter 21 Congenital Urologic Anomalies
Anthony Atala
Chapter 22 Disorders of Micturition
Dirk-Henrik Zermann
Chapter 23 Prostatitis, Orchitis, and Epididymitis
J. Curtis Nickel and Darren T. Beiko
Chapter 24 Vesicoureteric Reflux and Reflux Nephropathy
Vicente E. Torres, Thomas M. J. Maling, and Charles P. Swainson
Chapter 25 Urinary Tract Obstruction
Saulo Klahr
Chapter 26 Nephrolithiasis
Keith A. Hruska
Section V. Neoplasms of the Genitourinary Tract
Chapter 27 Molecular Mechanisms of Renal Cancer
Harry A. Drabkin and Robert M. Gemmill
Chapter 28 Primary Neoplasms of the Kidney and Renal Pelvis
Christopher M. George, Walter M. Stadler, and Nicholas J. Vogelzang
Chapter 29 Bladder Cancer
Gunnar Steineck, Carlos Cordon-Cardo, and Howard I. Scher
Chapter 30 Prostatic Carcinoma
L. Michael Glode, E. David Crawford, and Martin E. Gleave
Chapter 31 Testicular Carcinoma
Robert J. Motzer and George J. Bosl
Section VI. Infections of the Urinary Tract and the Kidney
Chapter 32 Host–Parasite Interactions and Host Defense Mechanisms
John W. Warren, Harry L. T. Mobley, and Michael S. Donnenberg
Chapter 33 Cystitis and Urethritis
Walter E. Stamm
Chapter 34 Infections of the Upper Urinary Tract
Allan R. Ronald and Lindsay E. Nicollé
Chapter 35 Renal and Perirenal Abscesses
Louise M. Dembry and Vincent T. Andriole
Chapter 36 Complicated Urinary Tract Infections
Dennis J. Mikolich and Stephen H. Zinner
Chapter 37 Fungal Urinary Tract Infections
Scott F. Davies and George A. Sarosi
Chapter 38 Urinary Tract Tuberculosis
Mark S. Pasternack and Robert H. Rubin
VOLUME II
Section VII. Acute Renal Failure
Chapter 39 Pathophysiology of Ischemic Acute Renal Injury
Charles L. Edelstein and Robert W. Schrier
Chapter 40 Pathophysiology of Nephrotoxic Cell Injury
Brian S. Cummings and Rick G. Schnellmann
Chapter 41 Acute Renal Failure
Robert J. Anderson and Robert W. Schrier
Chapter 42 Antibiotic- and Immunosuppression-Related Renal Failure
George J. Kaloyanides, Jean-Louis Bosmans, and Marc E. De Broe
Chapter 43 Renal Diseases Induced by Antineoplastic Agents
Robert L. Safirstein
Chapter 44 Nephrotoxicity of Nonsteroidal Antiinflammatory Agents, Analgesics, and Angiotensin-Converting Enzyme Inhibitors
Biff F. Palmer and William L. Henrich
Chapter 45 Radiocontrast Media-Induced Acute Renal Failure
Mayer Brezis and Robert E. Cronin
Chapter 46 Nephrotoxicity Secondary to Drug Abuse and Lithium Use
Joel Neugarten, Gloria R. Gallo, and David S. Baldwin
Chapter 47 Nephrotoxicity Secondary to Environmental Agents and Heavy Metals
Richard P. Wedeen
Chapter 48 Acute Tubulointerstitial Nephritis
Garabed Eknoyan
Chapter 49 Acute Renal Failure Associated with Pigmenturia or Crystal Deposits
Burl R. Don, Rudolph A. Rodriguez, and Michael H. Humphreys
Section VIII. Hypertension
Chapter 50 Blood Pressure and the Kidney
H. E. de Wardener and G. A. MacGregor
Chapter 51 Hypertension Associated with Renal Parenchymal Disease
Michael C. Smith, Mahboob Rahman, and Michael J. Dunn
Chapter 52 Renal Artery Stenosis, Renal Vascular Hypertension, and Ischemic Nephropathy
Marc A. Pohl
Chapter 53 Hypertension and Pregnancy
Melissa A. Cadnapaphornchai, Verena A. Briner, and Robert W. Schrier
Chapter 54 Pathogenesis and Treatment of Hypertension in the Diabetic Patient
Raymond Estacio and Robert W. Schrier
Chapter 55 Hypertension Associated with Endocrine Disorders
Myron H. Weinberger
Chapter 56 Malignant Hypertension and Other Hypertensive Crises
Charles R. Nolan
Section IX. Glomerular, Interstitial, and Vascular Renal Diseases
Chapter 57 Mechanisms of Tissue Injury and Repair
Wayne A. Border, Nancy A. Noble, and Lucia R. Languino
Chapter 58 Acute Poststreptococcal Glomerulonephritis and Other Bacterial Infection-Related Glomerulonephritis
Sidney M. Kobrin and Michael P. Madaio
Chapter 59 Viral Glomerular Diseases
Paul L. Kimmel and Jack Moore, Jr.
Chapter 60 Rapidly Progressive Glomerulonephritis
Peter G. Kerr, Steven J. Chadban, and Robert C. Atkins
Chapter 61 Immunoglobulin A Nephropathy and Henoch-Schönlein Purpura
Anthony R. Clarkson, Andrew J. Woodroffe, and Randall J. Faull
Chapter 62 Membranoproliferative Glomerulonephritis
Giovanni Barbiano di Belgiojoso and Franco Ferrario
Chapter 63 Membranous Nephropathy
Colin D. Short and Netar P. Mallick
Chapter 64 Nephrotic Syndrome: Minimal Change Disease, Focal Glomerulosclerosis, and Related Disorders
H. William Schnaper and Alan M. Robson
Chapter 65 Renal Involvement in Systemic Lupus Erythematosus
Brian L. Kotzin, Gregory A. Achenbach, and Sterling G. West
Chapter 66 Renal Disorders Associated With Systemic Sclerosis, Rheumatoid Arthritis, Sjögren’s Syndrome, and Polymyositis-Dermatomyositis
Robert W. Janson and William P. Arend
Chapter 67 Thrombotic Thrombocytopenic Purpura, Hemolytic-Uremic Syndrome, and Acute Cortical Necrosis
Piero Ruggenenti, Arrigo Schieppati, Tullio Bertani, and Giuseppe Remuzzi
Chapter 68 Vasculitic Diseases of the Kidney
Patrick H. Nachman, J. Charles Jennette,
and Ronald J. Falk
Chapter 69 Mixed Cryoglobulinemia
Giuseppe D’Amico
Chapter 70 Renal Artery Thrombosis, Thromboembolism, Aneurysms, Atheroemboli, and Renal Vein Thrombosis
Francisco Llach and Michael Yudd
Chapter 71 The Long-Term Outcome of Glomerular Diseases
Chirag Parikh, Isaac Teitelbaum, and J. Stewart Cameron
Chapter 72 Chronic Tubulointerstitial Nephropathies
Garabed Eknoyan
VOLUME III
Section X. Systemic Diseases of the Kidney
Chapter 73 Diabetic Nephropathy
Michael Mauer, Paola Fioretto, Yalem Woredekal, and Eli A. Friedman
Chapter 74 The Normal and Diseased Kidney in Pregnancy
Marshall D. Lindheimer and Adrian I. Katz
Chapter 75 Liver Disease and the Kidney
Pere Ginès, Andrés Cárdenas, and Robert W. Schrier
Chapter 76 Monoclonal Gammopathies: Multiple Myeloma, Amyloidosis, and Related Disorders
Pierre M. Ronco, Pierre Aucouturier, Béatrice Mougenot
Chapter 77 Hyperuricemia, Gout, and the Kidney
Bryan T. Emmerson
Chapter 78 Sickle Cell Disease
Lodewijk W. Statius van Eps and Paul E. de Jong
Chapter 79 Tropical Nephrology
Rashad S. Barsoum and Visith Sitprija
Chapter 80 Kidney Disease in Children
Godfrey Clark and Cyril Chantler
Chapter 81 Renal Function and Disease in the Aging Kidney
Devasmita Choudhury and Moshe Levi
Section XI. Disorders of Electrolyte, Water, and Acid–Base
Chapter 82 Mechanisms of Diuretic Action
David H. Ellison, Mark D. Okusa, and Robert W. Schrier
Chapter 83 Idiopathic Edema
Graham A. MacGregor and Hugh E. de Wardener
Chapter 84 Cardiac Failure, Liver Disease, and the Nephrotic Syndrome
William T. Abraham, Melissa A. Cadnapaphornchai, and Robert W. Schrier
Chapter 85 The Syndrome of Inappropriate Antidiuretic Hormone Secretion and Other Hypoosmolar Disorders
Joseph G. Verbalis
Chapter 86 Nephrogenic and Central Diabetes Insipidus
Daniel G. Bichet
Chapter 87 Disorders of Potassium and Acid–Base Metabolism in Association with Renal Disease
Mark A. Perazella and Asghar Rastegar
Chapter 88 Disorders of Phosphorus, Calcium, and Magnesium Metabolism
Eduardo Slatopolsky and Keith A. Hruska
Chapter 89 Fluid–Electrolyte and Acid–Base Disorders Complicating Diabetes Mellitus
Horacio J. Adrogué
Section XII. Uremic Syndrome
Chapter 90 Pathophysiology and Nephron Adaptation in Chronic Renal Failure
Radko Komers, Timothy W. Meyer, and Sharon Anderson
Chapter 91 Anemia in Renal Disease
Anatole Besarab
Chapter 92 The Osteodystrophy of Chronic Renal Failure
Dennis L. Andress and Donald J. Sherrard
Chapter 93 Nervous System Manifestations of Renal Failure
Cosmo L. Fraser and Allen I. Arieff
Chapter 94 Cardiac Disease in Chronic Renal Disease
Sean W. Murphy, Claudio Rigatto, and Patrick S. Parfrey
Chapter 95 Metabolic and Endocrine Dysfunctions in Uremia
Shaul G. Massry, Miroslaw J. Smogorzewski, and Saulo Klahr
Section XIII. Management of End-Stage Renal Disease
Chapter 96 Immunobiology and Immunopharmacology of Graft Rejection
Terry B. Strom and Manikkam Suthanthiran
Chapter 97 Outcomes and Complications of Renal Transplantation
Laurence Chan, Wei Wang, and Igal Kam
Chapter 98 Peritoneal Dialysis
Thomas A. Golper, John M. Burkart, and Beth Piraino
Chapter 99 Center and Home Chronic Hemodialysis: Outcome and Complications
Anne Marie Miles and Eli A. Friedman
Chapter 100 Ethical and Legal Considerations in End-Stage Renal Disease
Nancy B. Cummings
Section XIV. Nutrition, Drugs, and the Kidney
Chapter 101 Protein Intake and Prevention of Chronic Renal Disease
Thomas H. Hostetter and William E. Mitch
Chapter 102 Phosphate, Aluminum, and Other Elements in Chronic Renal Failure
Robert F. Reilly, Jr. and Allen C. Alfrey
Chapter 103 Dietary Considerations in Patients with Chronic Renal Failure, Acute Renal Failure, and Transplantation
Joel D. Kopple
Chapter 104 Use of Drugs in Patients with Renal Failure
Suzanne K. Swan and William M. Bennett
Contributing Authors
William T. Abraham, MD
Gill Professor
Department of Preventive Cardiology
Co-director
Gill Heart Institute
Chief
Department of Cardiovascular Medicine
University of Kentucky School of Medicine
Lexington, Kentucky
Gregory A. Achenbach, MD
Chairman
Department of Pathology
Rose Medical Center
Denver, Colorado
Horacio J. Adrogué, MD
Professor
Department of Medicine
Baylor College of Medicine
Chief
Renal Section
Houston Veterans Affairs Medical Center
Houston, Texas
Allen C. Alfrey, MD
Professor Emeritus
Department of Medicine
University of Colorado
Consultant
Veterans Administration Hospital
Denver, Colorado
Robert J. Alpern, MD
Dean
Southwestern Medical School
University of Texas Southwestern Medical Center
at Dallas
Dallas, Texas
Robert J. Anderson, MD
Professor
Department of Medicine
Head
Division of General Internal Medicine
University of Colorado Health Sciences Center
Denver, Colorado
Sharon Anderson, MD
Professor of Medicine
Division of Nephrology
Oregon Health Sciences University
Chief
Nephrology Section
Portland Veterans Affairs Medical Center
Portland, Oregon
Thomas E. Andreoli, MD
Nolan Professor and Chairman
Department of Internal Medicine
University of Arkansas College of Medicine
Little Rock, Arkansas
Dennis L. Andress, MD
Professor
Department of Medicine
University of Washington
Staff Nephrologist
Veterans Affairs Puget Sound Health
Care System
Seattle, Washington
Vincent T. Andriole, MD
Professor of Medicine
Department of Internal Medicine
Yale University School of Medicine
Attending Physician
Yale-New Haven Hospital
New Haven, Connecticut
William P. Arend, MD
Professor
Department of Medicine
University of Colorado Health 
Sciences Center
Denver, Colorado
William J. Arendshorst, MD, PhD
Professor and Interim Chair
Department of Cell and Molecular Physiology
University of North Carolina at Chapel Hill 
School of Medicine
Chapel Hill, North Carolina
Allen I. Arieff, MD
Professor
Department of Medicine
University of California School
of Medicine
San Francisco, California
Anthony Atala, MD
Associate Professor
Department of Surgery
Harvard Medical School
Associate in Surgery
Department of Urology
Children’s Hospital
Boston, Massachusetts
Curtis L. Atkin, PhD (deceased)
Research Associate Professor
Division of Rheumatology
Departments of Medicine and Biochemistry
University of Utah Medical Center
Salt Lake City, Utah
Robert C. Atkins, MSc, PhD, DSc, FRACP
Professor of Medicine
Department of Medicine
Monash University
Director of Nephrology
Department of Nephrology
Monash Medical Center
Clayton, Australia
Pierre Aucouturier, PhD
Associate
Department of Immunology
Faculty of Medicine, Necker
Poitiers, France
Kamal F. Badr, MD
Professor and Chair
Department of Medicine
American University
Beirut, Lebanon
David S. Baldwin, MD
Professor
Department of Medicine/Nephrology
New York University School of Medicine
Attending Physician
Department of Medicine/Nephrology
Tisch Hospital of New York University
New York, New York
Rashad S. Barsoum, MD, FRCP, FRCPE
Professor and Chairman
Department of Internal Medicine
Cairo University
Chairman
Cairo Kidney Center
Cairo, Egypt
Darren T. Beiko, MD, BSc
Chief Resident
Department of Urology
Kingston General Hospital
and Queen’s University
Kingston, ONT, Canada
William M. Bennett, MD
Professor of Medicine (Retired)
Director
Solid Organ and Cellular Transplantation
Transplant Services Department
Legacy Good Samaritan Hospital
Portland, Oregon
Tullio Bertani, MD
Associate Professor
Unit of Nephrology and Dialysis
Ospedali Riuniti di Bergamo
Azienda Ospedaliers
Bergamo, Italy
Anatole Besarab, MD
Professor of Medicine
Section of Nephrology
West Virginia University School of Medicine
Director
Renal Treatment Center
Department of Medicine
West Virginia University Hospital
Morgantown, West Virginia
Daniel G.
Bichet, MD
Professor
Department of Medicine
Université de Montréal
Director
Clinical Research Unit
Hôpital du Sacré-Coeur de Montréal
Montreal, Quebec, Canada
Wayne A. Border, MD
Professor
Department of Medicine
University of Utah
Salt Lake City, Utah
George J. Bosl, MD
Professor
Department of Medicine
Weill Medical College
Cornell University
Chairman
Department of Medicine
Memorial Sloan-Kettering Cancer Center
New York, New York
Jean-Louis Bosmans, MD
Department of Nephrology
University Hospital Antwerp
Antwerp, Belgium
Mayer Brezis, MD
Professor
Department of Medicine
Hebrew University
Chief Physician
Department of Medicine
Hadasah University Hospital,
Mount Scopus
Jerusalem, Israel
Verena A. Briner, MD
Professor
Department of Medicine
Basel University
Basel, Switzerland
Head
Department of Medicine
Kantonsspital
Lucerne, Switzerland
Keith E. Britton, MD, MSc, FRCR, FRCP
Professor and Consultant Physician
in Charge
Nuclear Medicine Department
Queen Mary College
University of London
St. Bartholomew’s Hospital
London, United Kingdom
John M. Burkart, MD
Professor of Medicine
Head of Outpatient Dialysis
Department of Nephrology
Wake Forest University Medical Center
Winston-Salem, North Carolina
Melissa A. Cadnapaphornchai, MD
Assistant Professor
Departments of Pediatrics and Medicine
University of Colorado Health Sciences Center
Assistant Professor
Department of Pediatrics
The Kidney Center
The Children’s Hospital
Denver, Colorado
John Stewart Cameron, MD, FRCP
Emeritus Professor
Department of Renal Medicine
Renal Unit
United Medical and Dental Schools of Guy’s
and St. Thomas’s Hospitals
London, United Kingdom
Andrés Cárdenas, MD
Liver Unit
Institute for Digestive Diseases
Hospital Clínic
University of Barcelona School of Medicine
Barcelona, Catalunya, Spain
Steven J. Chadban, MD, PhD
Senior Lecturer
Department of Medicine
Monash University
Senior Nephrologist
Department of Nephrology
Monash Medical Center
Clayton, Victoria, Australia
Laurence Chan, MD, PhD, FRCP, FACP
Professor of Medicine
Director, Transplant Nephrology
University of Colorado Health
Sciences Center
Denver, Colorado
Silvia D. Chang, MD, FRCPC
Clinical Instructor
Department of Radiology
University of British Columbia
Head
Abdominal MRI
Department of Radiology
Vancouver Hospital and Health
Sciences Center
Vancouver, British Columbia, Canada
Cyril Chantler, MD, FRCP
GKT Department of Pediatric Nephrology
Guy’s Tower
Guy’s Hospital
Vice Principal
King’s College
London, United Kingdom
Devasmita Choudhury, MD
Assistant Professor
Department of Medicine
University of Texas Southwestern Medical
Center at Dallas
Director of Dialysis
Dallas Veterans Affairs Medical Center
Dallas, Texas
Godrey Clark, MD
GKT Department of Pediatric Nephrology
Guy’s Tower
Guy’s Hospital
London, United Kingdom
Anthony R. Clarkson, MD, FRACP, FRCP(Ed)
Associate Professor
Department of Medicine
University of Adelaide
Senior Consultant
Renal Unit
Royal Adelaide Hospital
Adelaide, South Australia, Australia
Carlos Cordon-Cardo, MD, PhD
Division of Molecular Pathology
Department of Pathology
Memorial Sloan-Kettering Cancer Center
New York, New York
Howard L. Corwin, MD
Professor of Medicine and Anesthesiology
Dartmouth Medical School
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire
E. David Crawford, MD
Professor of Surgery
Head
Section of Urologic Oncology
Department of Surgery and Radiation Oncology
University of Colorado Health Sciences Center
Denver, Colorado
Byron P. Croker, MD, PhD
Professor
Department of Pathology, Immunology, 
and Laboratory Medicine
University of Florida
Chief
Department of Pathology and Laboratory
Medicine
North Florida/South Georgia Veterans 
Health System
Gainesville, Florida
Robert E. Cronin, MD
Professor
Department of Internal Medicine
University of Texas Southwestern
Medical Center
Chief of Staff
Executive Office
Veterans Affairs North Texas Health
Care System
Dallas, Texas
Brian S. Cummings, MD
Postdoctoral Fellow
Department of Pharmacology
and Toxicology
University of Arkansas for Medical Sciences
Little Rock, Arizona
Nancy B. Cummings, MD
Clinical Professor of Medicine
Department of Nephrology
Georgetown University School of Medicine
Washington, D.C.
Senior Biomedical Advisor
National Institute of Diabetes & Digestive &
Kidney Diseases
National Institute of Health
Bethesda, Maryland
Giuseppe D’Amico, MD, FRCP
Professor
Department of Medicine
Postgraduate School of Nephrology
University of Milan
Director
Departments of Nephrology and Urology
San Carlo Hospital
Milan, Italy
Eugene Daphnis, MD
Attending Physician
Department of Nephrology
University of Crete School of Medicine
Attending Physician
Department of Nephrology
University Hospital of Heraklion
Crete, Greece
Scott F. Davies, MD
Professor
Department of Medicine
University of Minnesota
Division Chief
Pulmonary Division
Hennepin County Medical Center
Minneapolis, Minnesota
Marc E. De Broe, MD, PhD
Professor in Medicine
Department of Nephrology
University of Antwerp
Head
Department of Nephrology
University Hospital Antwerp
Antwerp, Belgium
Paul E. de Jong, MD, PhD
Professor and Head
Department of Internal Medicine
Division of Nephrology
University Hospital Groningen
Groningen, The Netherlands
Louise-Marie Dembry, MD
Associate Professor of Medicine and Epidemiology
Department of Internal Medicine/Infectious
Diseases
Yale University School of Medicine
Hospital Epidemiologist
Department of Quality Improvement
Support Services
Yale-New Haven Hospital
New Haven, Connecticut
Hugh E. de Wardener, MD, FRCP
Emeritus Professor of Medicine
Department of Clinical Chemistry
Imperial College School of Medicine
Charing Cross Campus
London, United Kingdom
Giovanni Barbiano di Belgiojoso, MD
Professor
Department of Kidney Diseases
University of Milan
Chief
Nephrology Unit
Luigi Sacco Hospital
Milan, Italy
Susan R. DiGiovanni, MD
Assistant Professor of Medicine
Department of Medicine
Division of Nephrology
Virginia Commonwealth University
Richmond, Virginia
Burl R. Don, MD
Associate Professor
Department of Medicine
Director
Department of Clinical Nephrology
Division of Nephrology
University of California Davis Medical Center
Sacramento, California
Michael S. Donnenberg, MD
Professor
Department of Medicine
University of Maryland, Baltimore
Head
Division of Infectious Diseases
Department of Medicine
University of Maryland Medical System
Baltimore, Maryland
Harry A. Drabkin, MD
Professor of Medicine
Department of Medicine/Medical Oncology
University of Colorado Health Sciences Center
Denver, Colorado
Michael J. Dunn, MD
Dean and Executive Vice President
Office of the Dean
Medical College of Wisconsin
Milwaukee, Wisconsin
Tevfik Ecder, MD
Associate Professor
Department of Medicine
University of Istanbul
Istanbul, Turkey
Charles L. Edelstein, MD, PhD
Associate Professor
Department of Renal Diseases
and Hypertension
University of Colorado Health Sciences Center
University Hospital
Denver, Colorado
Garabed Eknoyan, MD
Professor
Department of Medicine
Baylor College of Medicine
Houston, Texas
David H. Ellison, MD
Chief
Division of Nephrology and Hypertension
Oregon Health and Science University
Portland, Oregon
Bryan T. Emmerson, AO, MD, PhD, FRACP
Professor Emeritus and Honorary Research
Consultant
Department of Medicine
University of Queensland
Princess Alexandra Hospital
Brisbane QLD, Australia
Raymond Estacio, MD
Associate Professor
Department of Medicine
University of Colorado Health Sciences Center
Denver, Colorado
General Internist
Department of Community Health
Denver Health Medical Center
Denver, Colorado
Ronald J. Falk, MD
Professor of Medicine
Department of Nephrology
and Hypertension
University of North Carolina
Chapel Hill North Carolina
Randall J. Faull, MD
Senior Lecturer
Department of Medicine
Adelaide University
Consultant Nephrologist
Department of Renal Medicine
Royal Adelaide Hospital
Adelaide, South Australia
Franco Ferrario, MD
Head
Renal Immunopathology Center
Department of Nephro-Urology
Azienda Ospedaliera “Ospedale San Carlo”
Milan, Italy
Godela M. Fick-Brosnahan, MD
Assistant Professor
Department of Medicine
University of Colorado Health Sciences Center
Denver, Colorado
Paola Fioretto, MD
Assistant Professor of Endocrinology
Department of Internal Medicine
University of Padova
Padova, Italy
Cosmo L. Fraser, MD
Department of Medicine
University of California School of Medicine
San Francisco, California
Eli A. Friedman, MD
Distinguished Teaching Professor
Chief
Division of Renal Disease
Department of Medicine
SUNY, Health Science Center at Brooklyn
University Hospital of Brooklyn
Brooklyn, New York
Jfrgen Frfkiaer, MD, PhD
Associate Professor
Institute of Experimental Clinical Research
University of Aarhus
Research Consultant
Department of Clinical Physiology
Aarhus University Hospital
Aarhus N, Denmark
Gloria R. Gallo, MD
Adjunct Professor
Department of Pathology
New York University School of Medicine
Department of Pathology
Tisch Hospital-New York University 
Medical Center
New York, New York
Robert M. Gemmill, PhD
Associate Professor
Department of Medicine/Medical Oncology
University of Colorado Health Sciences Center
Denver, Colorado
Christopher M. George, MD
Department of Medicine
Section of Hematology/Oncology
University of Chicago
Chicago, Illinois
Gregory G. Germino, MD
Associate Professor
Department of Internal Medicine
Division of Nephrology
Johns Hopkins University School of Medicine
Baltimore, Maryland
Pere Ginès, M.D.
Consultant in Hepatology
Associate Professor of Medicine
Liver Unit
Institute for Digestive Diseases
Hospital Clinic
University of Barcelona School of Medicine
Barcelona, Catalunya, Spain
Martin E. Gleave, MD, FACS, FRCSC
Professor
Department of Surgery
Division of Urology
University of British Columbia
Director
Department of Clinical Research
The Prostate Centre
Vancouver, British Columbia, Canada
L. Michael Glode, MD
Professor
Department of Medicine/Medical Oncology
University of Colorado Health Sciences Center
Denver, Colorado
Thomas A. Golper, MD
Professor
Department of Medicine
Division of Nephrology and Hypertension
Vanderbilt University Medical Center
Nashville, Tennessee
Martin C. Gregory, BM, BCh, DPhil
Adjunct Professor
Department of Medicine
University of Utah Health Sciences Center
Salt Lake City, Utah
Director of Nephrology
Department of Medicine
King Edward VII Memorial Hospital
Hamilton, Bermuda
Jean-Pierre Grünfeld, MD
Professor
Université Paris V-René Descartes
Chief
Department of Nephrology
Hospital Necker
Paris, France
Steven C. Hebert, MD
Professor and Chairman
Cellular and Molecular Biology
Professor of Medicine
Yale University School of Medicine
New Haven, Connecticut
William L. Henrich, MD
Professor
Department of Medicine
University of Maryland School of Medicine
Chairman
Department of Medicine
University of Maryland Medical Center
Baltimore, Maryland
Friedhelm Hildebrandt, MD
Professor
Department of Pediatrics
University Children’s Hospital
Freiburg University
Freiburg, Germany
Thomas Heard Hostetter, MD
Department of Medicine Medical School
Division of Renal Diseases and Hypertension
University of Minnesota
Minneapolis, Minnesota
Luzma M. Houseal, MD
Department of Internal Medicine
Texas Tech University Health Sciences Center
Lubbock, Texas
Hedvig Hricak, MD, PhD
Professor and Chair
Department of Radiology
Memorial Sloan-Kettering Cancer Center
New York, New York
Keith A. Hruska, MD
Professor of Medicine and Associate Professor
of Cell Biology
Department of Internal Medicine
Washington University School of Medicine
St. Louis, Missouri
Michael H. Humphreys, MD
Professor
Department of Medicine
University of California, San Francisco
School of Medicine
Chief
Division of Nephrology
San Francisco General Hospital
San Francisco, California
Robert W. Janson, MD
Associate Professor
Department of Medicine
University of Colorado Heath Sciences Center
Chief
Rheumatology Section
Denver Veterans Affairs Medical Center
Denver, Colorado
J. Charles Jennette, MD
Brinkhous Distinguished Professor and Chair
Department of Pathology and Laboratory
Medicine
University of North Carolina
Chapel Hill, North Carolina
Paul Jungers, MD
Professor
Faculty of Medicine, Necker
University of René Descartes
Department of Nephrology
Hôpital Necker
Paris, France
George J. Kaloyanides, MD
Professor
Department of Medicine
Division of Nephrology and Hypertension
State University of New York at Stony Brook
School of Medicine
Health Sciences Center
Stony Brook, New York
Igal Kam, MD
Professor of Surgery
Chief, Transplant Surgery
University of Colorado School of Medicine
Denver, Colorado
Adrian I. Katz, MD
Professor
Department of Medicine
University of Chicago
Attending Physician
Department of Medicine
University of Chicago Medical Center
Chicago, Illinois
Peter G. Kerr, PhD, FRACP
Honorary Clinical Associate Professor
Department of Medicine
Monash University
Deputy Director
Department of Nephrology
Monash Medical Centre
Clayton, Victoria, Australia
Melanie S. Kim, MD
Associate Professor
Department of Pediatrics
Boston University School of Medicine
Associate Program Director
Department of Pediatrics
Boston Medical Center
Boston, Massachusetts
Paul L. Kimmel, MD
Professor
Department of Medicine
George Washington University
Medical Center
Director, HIV Program
Division of Kidney, Urologic and 
Hemtaologic Diseases
National Institute of Diabetes, Digestive
and Kidney Diseases
National Institutes of Health
Bethesda, Maryland
Attending Physician
Department of Medicine
George Washington University Hospital
Washington, DC
Saulo Klahr, MD
Simon Professor of Medicine
Department of Internal Medicine
Washington University School of Medicine
Director
Department of Research and Scientific Affairs
Barnes-Jewish Hospital
St. Louis, Missouri
Mark A. Knepper, MD, PhD
Chief
Renal Mechanisms Section
National Heart, Lung, Blood Institute
National Institutes of Health
Bethesda, Maryland
Sidney M. Kobrin, MD
Associate Professor
Department of Medicine
Director of Inpatient Dialysis
Renal Electrolyte Division
University of Pennsylvania
Philadelphia, Pennsylvania
Kenneth E. Kokko, MD
The Center for Cell and Molecular Signaling
and Renal Division
Emory University School of Medicine
Departments of Physiology and Medicine
Veterans Affairs Medical Center
Atlanta, Georgia
Radko Komers, MD, PhD
Assistant Professor
Division of Nephrology and Hypertension
Oregon Health Science University
Portland, Oregon
Joel D. Kopple, MD
Professor
Departments of Medicine and Public Health
University of California Los Angeles
UCLA Schools of Medicine and Public Health
Los Angeles, California
Chief
Division of Nephrology and Hypertension
Department of Medicine
Harbor-UCLA Medical Center
Torrance, California
Brian L. Kotzin, MD
Professor
Departments of Medicine and Immunology
Co-Head
Division of Clinical Allergy and Immunology
University of Colorado Health Sciences Center
Denver, Colorado
Wilhelm Kriz, MD
Professor
Institute of Anatomy and Cell Biology
University of Heidelberg
Heidelberg, Germany
Tae-Hwan Kwon, MD
Assistant Professor
Department of Physiology
Dongauk University School of Medicine
Kyungju, South Korea
Richard A. Lafayette, MD
Assistant Professor
Department of Medicine
Associate Chief
Department of Nephrology
Stanford University Hospital
Stanford, California
Fadi G.
Lakkis, MD
Assistant Professor
Department of Medicine
Emory University School of Medicine
Staff Physician
Renal Division
Emory University Hospital and Veterans Affairs
Medical Center
Atlanta, Georgia
Lucia R. Languino, PhD
Associate Professor
Department of Pathology
Yale University School of Medicine
New Haven, Connecticut
Andrew S. Levey, MD
Chief
Division of Nephrology
New England Medical Center
Professor
Department of Medicine
Tufts University
Boston, Massachusetts
Moshe Levi, MD
Professor
Department of Medicine
University of Texas Southwestern Medical Center
at Dallas
Chief
Nephrology Section
Dallas Veterans Administration Medical Center
Dallas, Texas
Marshall D. Lindheimer, MD
Professor Emeritus
Departments of Obstetrics and Gynecology
University of Chicago Hospital
Chicago, Illinois
Francisco Llach, MD
Professor of Medicine
Department of Medicine
Georgetown University Medical Center
Director Clinical Nephrology
Department of Nephrology
Georgetown University Medical Center
Washington, DC
Graham A. MacGregor, FRCP
Professor of Cardiovascular Medicine
Blood Pressure Unit
St. George’s Hospital Medical School
London, United Kingdom
Michael P. Madaio, MD
Professor
Department of Medicine
University of Pennsylvania
Philadelphia, Pennsylvania
Thomas M. J. Maling, MD, FRACR
Clinical Lecturer
Department of Radiology
Christchurch School of Medicine
Radiologist
Christchurch Hospital
Christchurch, New Zealand
Netar P. Mallick, MB, ChB, FRCP
Professor
Department of Renal Medicine
University of Manchester
Clinical Director and Consultant Physician
Department of Renal Medicine
Central M/CR Healthcare National Health
Service Trust
Manchester, United Kingdom
Shaul G. Massry, MD
Professor of Medicine
Department of Nephrology
University of Southern California
Los Angeles, California
Michael Mauer, MD
Professor
Department of Pediatrics
University of Minnesota
Minneapolis, Minnesota
Timothy W. Meyer, MD
Associate Professor
Department of Medicine
Stanford University School of Medicine
Stanford, California
Chief
Nephrology Section
Palo Alto VA Medical Center
Palo Alto, California
Dennis J. Mikolich, MD
Clinical Associate Professor
Department of Medicine
Brown University Medical School
Chief
Department of Infectious Diseases
Veterans Administration Medical Center
Providence, Rhode Island
Anne Marie Miles, MD
State University of New York Health Science
Center at Brooklyn
Division of Renal Disease
University Hospital of Brooklyn
Brooklyn, New York
William E. Mitch, MD
E. Garland Herndon Professor
Department of Medicine
Director
Renal Division
Emory University School of Medicine
Atlanta, Georgia
Harry L. T. Mobley, PhD
Professor
Department of Microbiology and Immunology
University of Maryland School
of Medicine
Baltimore, Maryland
Angel Montero, PhD
Assistant Professor
Department of Medicine
Emory University Renal Division and Veterans
Affairs Medical Center
Atlanta, Georgia
Jack Moore, Jr., MD
Associate Professor of Medicine
Department of Nephrology
Uniformed Services University of the
Health Sciences
Bethesda, Maryland
Director
Section of Nephrology
Department of Medicine
Washington Hospital Center
Washington, DC
Christopher S. Morris, MD
Assistant Professor
Department of Radiology
University of Vermont College
of Medicine
Attending Radiologist
Radiology Health Care Service
Fletcher Allen Health Care
Burlington, Vermont
Robert J. Motzer, MD
Associate Attending Physician
Department of Medicine
Joan and Sanford I Weill Medical College
Cornell University
New York, New York
Béatrice Mougenot, MD
Pathologist
Médecin des Hôpitaux
Department de Pathologie
Hôpital Tenon
Paris, France
Sean W. Murphy, MD, BSc, FRCP(C)
Assistant Professor
Department of Medicine
Memorial University of Newfoundland
Department of Medicine
Health Science Center
St. John’s, Newfoundland, Canada
Patrick H. Nachman, MD
Assistant Professor
Department of Medicine
Division of Nephrology and Hypertension
University of North Carolina
Chapel Hill, North Carolina
L. Gabriel Navar, PhD
Professor and Chairman
Department of Physiology
Tulane University Health Sciences Center
New Orleans, Louisiana
Joel Neugarten, MD, JD
Professor
Department of Medicine
Albert Einstein College of Medicine
of Yeshiva University
Site Director
Nephrology Division
Montefiore Medical Center
Renal Lab
Bronx, New York
J. Curtis Nickel, MD
Professor
Department of Urology
Queen’s University
Kingston General Hospital
Kingston, Ontario, Canada
Lindsay E. Nicollé, MD, FRCPC
Professor and Head
Department of Internal Medicine
University of Manitoba
Head
Department of Medicine
Heath Science Centre and St. Boniface
General Hospital
Winnipeg, Manitoba, Canada
Sfren Nielsen, MD, PhD
Professor of Cell Biology
and Pathophysiology
Department of Cell Biology
Institute of Anatomy
University of Aarhus
Aarhus C, Denmark
Nancy A. Noble, PhD
Research Professor
Department of Internal Medicine
University of Utah
Salt Lake City, Utah
Charles R. Nolan, MD
Associate Professor
Department of Medicine
Medical Director of Renal
Transplantation
Department of Medicine/Surgery
University of Texas Health Sciences Center
at San Antonio
San Antonio, Texas
Mark D. Okusa, MD
Associate Professor
Department of Nephrology
University of Virginia School of Medicine
Health Sciences Center
Charlottesville, Virginia
Biff F. Palmer, MD
Professor
Department of Internal Medicine
Clinical Director of Clinical Nephrology
Department of Internal Medicine
University of Texas Southwestern Medical Center
Dallas, Texas
Patrick S. Parfrey, MD
University Research Professor
Department of Medicine
Memorial University of Newfoundland
Department of Medicine
Health Sciences Center
St. John’s, Newfoundland, Canada
Chirag Parikh, MD
Senior Fellow
Department of Renal Diseases and Hypertension
University of Colorado Heath Sciences Center
Denver, Colorado
Mark S. Pasternack, MD
Associate Professor 
Department of Pediatrics
Harvard Medical School
Chief
Department of Pediatric Infectious Disease
Massachusetts General Hospital
Boston, Massachusetts
Mark A. Perazella, MD, FACP
Associate Professor
Department of Medicine
Yale University
Director
Acute Dialysis
Department of Nephrology
Yale-New Haven Hospital
New Haven, Connecticut
Ronald D. Perrone, MD
Professor
Department of Medicine
Tufts University
Associate Chief
Department of Nephorology
New England Medical Center
Boston, Massachusetts
Beth Piraino, MD
Professor
Department of Medicine
University of Pittsburgh School
of Medicine
Director
Peritoneal Dialysis Program
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
Marc A. Pohl, MD
Ray W. Gifford Chair
Head, Section of Clinical Hypertension
and Nephrology
The Cleveland Clinic Foundation
Cleveland, Ohio
Patricia A. Preisig, PhD
Professor
Department of Internal Medicine
University of Texas Southwestern
Medical School
Dallas, Texas
Mahboob Rahman, MD, MS
Assistant Professor
Department of Medicine
Case Western Reserve University School 
of Medicine
Department of Medicine
University Hospitals of Cleveland
Cleveland, Ohio
Asghar Rastegar, MD
Professor of Medicine
Associate Chair for Academic Affairs
Co-Chief
Nephrology Section
Department of Internal Medicine
Yale University School of Medicine
Departments of Internal Medicine
and Nephrology
Yale-New Haven Hospital
New Haven, Connecticut
W. Brian Reeves, MD
Professor
Department of Medicine
Penn State College of Medicine
Chief
Department of Nephrology
Hershey Medical Center
Hershey, Pennsylvania
Robert F. Reilly, Jr., MD
Associate Professor
Department of Medicine
Yale University Medical School
New Haven, Connecticut
Giuseppe Remuzzi, MD
Research Director
Negri Bergamo Laboratories
Head
Unit of Nephrology and Dialysis
Ospedali Riuniti di Bergamo
Azienda Ospedaliera
Bergamo, Italy
Claudio Rigatto, MD, FRCPC
Assistant Professor
Department of Medicine
University of Manitoba
Research Director
Department of Nephrology
St. Boniface General Hospital
Winnipeg, Manitoba, Canada
Jeffrey M. Rimmer, MD
Professor
Department of Medicine
University of Vermont College
of Medicine 
Medical Director
Dialysis Department
Fletcher Allen Healthcare
Burlington, Vermont
Christophe Robino, MD
Service de Medecine Interne
Hôpital Broussais
Paris, France
Alan M. Robson, MD
Professor
Department of Pediatrics
Louisiana State University School of Medicine,
New Orleans
Tulane University School of Medicine
Medical Director
Children’s Hospital of New Orleans
New Orleans, Louisiana
Françoise Roch-Ramel, MD
Professor
Institute of Pharmacology
and Toxicology
University of Lausanne
Lausanne, Switzerland
Rudolph A. Rodriguez, MD
Assistant Clinical Professor of Medicine
Medical Director
Renal Center
University of California, San Francisco
San Francisco, California
Allan R. Ronald, MD, FRCP
Professor
Departments of Internal Medicine and Medical
Microbiology
Section of Infectious Diseases
University of Manitoba Faculty of Medicine
Winnipeg, Manitoba, Canada
Pierre M. Ronco, MD, PhD
Professor of Renal Medicine
Medical Faculty Saint-Antoine
University Pierre et Marie Curie
Head
Department of Nephrology
Tenon Hôpital
Paris, France
Robert H. Rubin, MD
Gordon and Marjorie Osborne Professor of Health
Sciences and Technology
Professor of Medicine
Harvard-MIT Division of Health Sciences
and Technology
Harvard Medical School
Chief of Surgical and Transplant Infectious
Disease
Department of Medicine
Massachusetts General Hospital
Boston, Massachusetts
Piero Ruggenenti, MD
Negri Bergamo Laboratories
Associate Professor
Unit of Nephrology and Dialysis
Ospedali Riuniti di Bergamo
Azienda Ospedaliera
Bergamo, Italy
Sandra Sabatini, PhD, MD, FACP
Professor
Departments of Internal Medicine
and Physiology
The Combined Program in Nephrology and 
Renal Physiology
Texas Tech University School of Medicine
Attending Physician
Departments of Nephrology and
Internal Medicine
University Medical Center
Lubbock, Texas
Robert L. Safirstein, MD
Professor and Vice Chair
Department of Medicine
University of Arkansas for Medical Sciences
Chief
Medical Services
Department of Medicine
Central Arkansas Veterans Healthcare System
Little Rock, Arkansas
George A. Sarosi, MD
Professor
Department of Medicine
Indiana University School of Medicine
Chief
Medical Service
Department of Medicine
Roudebush VA Medical Center
Indianapolis, Indiana
Howard I. Scher, MD
Chief
Genitourinary Oncology Service
Memorial Sloan-Kettering Cancer Center
New York, New York
Arrigo Schieppati, MD
Negri Bergamo Laboratories
Associate Professor
Unit of Nephrology and Dialysis
Ospedali Riuniti di Bergamo
Azienda Ospedaliera
Bergamo, Italy
Laurent Schild, MD
Professor
Institute of Pharmacology and Toxicology
Medical School, University of Lausanne
Lausanne, Switzerland
H. William Schnaper, MD
Professor
Department of Pediatrics
Northwestern University Medical School
Department of Pediatric Medicine
Children’s Memorial Hospital
Chicago, Illinois
Rick G. Schnellmann, PhD
Professor
Department of Pharmacology and Toxicology
University of Arkansas for Medical Sciences
Little Rock, Arkansas
Anton C. Schoolwerth, MD, MSHA
Professor
Department of Internal Medicine
Virginia Commonwealth University
Chairman
Department of Internal Medicine
Division of Nephrology
Medical College of Virginia
Richmond, Virginia
Robert W. Schrier, MD
Professor and Chairman
Department of Medicine 
University of Colorado Health Sciences Center
Denver, Colorado
Donald J. Sherrard, MD
Professor
Department of Medicine
University of Washington
Chief of Nephrology
Department of Medicine
VA Medical Center
Seattle, Washington
Colin D. Short, MD
Department of Renal Medicine
Manchester Royal Infirmary
Manchester, United Kingdom
Visith Sitprija, MD, PhD
Emeritus Professor
Department of Medicine
Chulalongkorn University
Director
Department of Medicine
Queen Saovabha Memorial Institute
Bangkok, Thailand
Eduardo Slatopolsky, MD
Professor of Medicine
Department of Medicine, Renal Division
Washington University School of Medicine
Physician
Department of Medicine
Renal Division
Barnes Hospital
St. Louis, Missouri
Michael C. Smith, MD
Professor
Department of Medicine
Case Western Reserve University School
of Medicine
Physician
Department of Medicine
Division of Nephrology
University Hospitals of Cleveland
Cleveland, Ohio
Miroslaw J. Smogorzewski, MD, PhD
Associate Professor
Department of Medicine
Division of Nephrology
Keck School of Medicine
University of Southern California
Attending Physician
Department of Medicine
University of Southern California Hospital
Los Angeles, California
Walter M. Stadler, MD
Associate Professor
Department of Medicine
University of Chicago
Chicago, Illinois
Walter E. Stamm, MD
Professor
Department of Medicine
University of Washington School of Medicine
Head
Department of Allergy and Infectious Diseases
University Hospital Medical Center
Seattle, Washington
Lodewijk W. Statius van Eps, MD
Emeritus Professor of Geographic Pathology
Department of History of Medicine
Free University of Amersterdam
Consultant
Departments of Internal Medicine, Nephrology, 
and Tropical Diseases
Slotervaart Hospital
Amsterdam, The Netherlands
Gunnar Steineck, MD
Associate Professor
Department of Oncology and Pathology
Karolinska Institute
Radiumhemmet, Karolinska Hospital
Department of Clinical Cancer Epidemiology
Stockholm City Council
Stockholm, Sweden
Terry B. Strom, MD
Professor
Department of Medicine
Division of Nephrology
Harvard Medical School
Director
Departments of Immunology and Medicine
Beth Israel Hospital
Boston, Massachusetts
Manikkam Suthanthiran, MD
Stanton Griffs Distinguished Professor of Medicine
Department of Transplantation Medicine
and Extracorporeal Therapy
Division of Nephrology
Weill Medical College
Cornell University
Chief
Departments of Nephrology and Transplantation
Medicine
New York Presbyterian Hospital
New York, New York
Charles P. Swainson, MD, FRCP
Senior Lecturer
Department of Clinical and Surgical Sciences
University of Edinburgh
Consultant Nephrologist
Department of Renal Medicine
Royal Infirmary
Edinburgh, Scotland
Suzanne K. Swan, MD, FACP
Associate Professor
Department of Medicine
University of Minnesota
Department of Nephrology
Hennepin County Medical Center
Minneapolis, Minnesota
Isaac Teitelbaum, MD
Associate Professor
Department of Medicine
University of Colorado School of Medicine
Medical Director
Dialysis Services
University of Colorado Hospital
Denver, Colorado
C. Craig Tisher, MD
Professor
Departments of Medicine and Pathology
University of Florida College of Medicine
Department of Medicine
Division of Nephrology
Shands Hospital and Clinics, Inc
Gainesville, Florida
Vicente E. Torres, MD
Professor of Medicine
Departments of Nephrology and Internal
Medicine
Mayo Clinic
Rochester, Minnesota
Heino E. Velázquez, PhD
Research Scientist
Department of Medicine
Yale University School of Medicine
New Haven, Connecticut
Joseph G. Verbalis, MD
Professor
Departments of Medicine and Physiology
Georgetown University School of Medicine
Georgetown University Medical Center
Washington, DC
Nicholas J. Vogelzang, MD
Fred C. Buffett Professor
Departments of Medicine and Surgery
University of Chicago
Director
University of Chicago Cancer Research Center
Chicago, Illinois
Wei Wang, MD
Assistant Professor of Medicine
University of Colorado Health Sciences Center
Denver, Colorado
John W. Warren,
MD
Professor
Department of Medicine
University of Maryland School of Medicine
Baltimore, Maryland
Terry Watnick, MD
Department of Internal Medicine
Division of Nephrology
Johns Hopkins University School of Medicine
Baltimore, Maryland
Judith A. W. Webb, MD
Consultant Radiologist
Diagnostic Radiology Department
St. Bartholomew’s Hospital
West Smithfield, London, United Kingdom
Richard P. Wedeen, MD
Professor
Departments of Medicine, Preventive Medicine,
and Community Health
UMDNJ-New Jersey Medical School
Newark, New Jersey
Associate Chief of Staff for Research
and Development
Department of Veterans Affairs
New Jersey Health Care System
East Orange, New Jersey
Myron H. Weinberger, MD
Professor
Department of Medicine
Indiana University School of Medicine
Indianapolis, Indiana
Sterling G. West, MD
Professor
Department of Medicine
University of Colorado Health Sciences Center
Denver, Colorado
Andrew J. Woodroffe, MD, FRACP
Director
Renal Unit
Fremantle Hospital
Fremantle, Western Australia
Yalem Woredekalz, MD
Assistant Professor
Department of Medicine
State University of New York
Health Science Center at Brooklyn
Brooklyn, New York
Fred S. Wright, MD
Professor
Cellular and Molecular Physiology
and Physiology
Yale University
New Haven, Connecticut
Associate Chief of Staff
Department of Research
VA Connecticut Healthcare System
West Haven, Connecticut
Michael Yudd, MD
Assistant Professor of Medicine
University of Medicine and Dentistry
of New Jersey
Newark, New Jersey
Medical Director Dialysis Unit
Nephrology Section
Department of Veterans Affairs New Jersey 
Health Care System
East Orange, New Jersey
Dirk-Henrik Zermann, MD
Department of Urology
University Hospital
Friedrich Schiller University
Jena, Germany
Stephen H. Zinner, MD
Charles S. Davidson Professor of Medicine
Department of Medicine
Harvard Medical School
Chair
Department of Medicine
Mount Auburn Hospital
Cambridge, Massachusetts
Dedication
Carl William Gottschalk, MD, was a man for all seasons – brilliant scholar, committed mentor of students, dedicated citizen 
of the University of North Carolina and the broader academic community, and a gentleman in every sense of the word. Carl 
was a native Virginian whose southern manners and warm demeanor emanated a personal charm to his friends, 
colleagues, and students. He graduated Phi Beta Kappa from Roanoke College in 1942 and received an Honorary Doctor 
of Science from that institution in 1966. An Alpha Omega Alpha graduate from the University of Virginia School of 
Medicine, Carl Gottschalk then received his training in internal medicine at the Massachusetts General Hospital and his 
fellowship in Cardiology at the University of North Carolina. For the next forty years (1952–1992), his loyalty and many 
talents were an integral part of the University of North Carolina, which accounted for the
respect and affection which he received from his many colleagues and friends. He was the Kenan Professor of Medicine and Physiology from1969 until his untimely 
death on October 15, 1997, in Chapel Hill, North Carolina.
Carl Gottschalk’s scientific contributions were recognized by his election to the National Academy of Science. He was President of the American Society of 
Nephrology from 1976–1977, and was a Councilor of the International Society of Nephrology (ISN). Carl founded the History of Medicine Commission of the ISN and 
the ISN Archives in Amsterdam, The Netherlands, which are appropriately named the Carl W. Gottschalk Archives of the ISN. Among many honors, awards, and 
distinguished named lectureships, Carl received the Homer W. Smith Award from the New York Heart Association and the David H. Hume Award from the National 
Kidney Foundation. The American Physiological Society has established the Carl W. Gottschalk Distinguished Lectureship in Renal Physiology and the University of 
North Carolina has inaugurated the Carl W. Gottschalk Lectureship in the Basic Sciences.
Scientist, medical historian, lepidopterist who has a butterfly (Strymon cecrops Gottshalki) named after him, recipient of many honors and awards, the written 
persona of Carl W. Gottschalk can only project a very modest picture of this Renaissance man. His kindness and consideration for others was unparalleled. It was 
my honor to have worked with him on three editions of Diseases of the Kidney and to dedicate this current edition to his memory.
Robert W. Schrier, MD
Preface
The recent advances in all aspects of our knowledge of the kidney and its diseases mandate a new edition of Diseases of the Kidney. As in previous editions, a group 
of international experts was assembled to present this information in a comprehensive, authoritative, concise, and readily accessible fashion. The chapters have been 
extensively revised and updated.
Nephrology is a discipline that combines the basic and clinical sciences. Successful integration of this knowledge is the goal of this seventh edition. The fourteen 
sections of the three volume book are actually individual texts which can stand on their own. Moreover, because a unique feature of the book is a comprehensive 
inclusion of diseases of the urinary tract as well as the kidney, the seventh edition is named Diseases of the Kidney and Urinary Tract.
The first section presents an overall view of the structural, physiologic, and biochemical aspects of the kidney. This section incorporates the latest developments in 
cellular and molecular biology, emphasizing the most current information and concepts on cell signaling, receptors, and ion channels. For the last three editions the 
late Carl Gottschalk, MD, edited the nine chapters in the basic science section. I considered it a privilege to have worked with Dr. Gottschalk in editing this 
authoritative book, which has been totally reorganized from the first four editions. The goal was to publish the most comprehensive material for the practicing 
physician caring for patients with diseases of the kidney and urinary tract. The fourteen sections of the book covering 104 chapters are as follows:
I. Biochemical, Structural, and Functional Correlations in the Kidney includes structural, hemodynamic, hormonal, ion transport and metabolic functions in 
nine chapters.
II. Clinical Evaluation is covered in six chapters on urinalysis, laboratory evaluation, urography, tomography, angiography, and indications for renal biopsy.
III. Hereditary Diseases in five chapters covers genetic mechanisms, medullary cystic and sponge disorders, polycystic kidney disease, Alport’s syndrome, Fabry’s 
disease, and nail-patella syndrome, as well as isolated renal tubular disorders.
IV. Urological Diseases of the Genitourinary Tract are described in six chapters, including congenital abnormalities, urinary tract obstruction, renal calculi, reflux 
nephropathy, prostatic and micturition disorders.
V. Neoplasms of the Genitourinary Tract are addressed in five chapters covering molecular mechanisms in malignancy, testicular carcinoma, prostate and 
bladder cancer, and primary neoplasms of the kidney and renal pelvis.
VI. Infections of the Urinary Tract and the Kidney are contained in seven chapters, including host-defense mechanisms; urinary bacterial infections, including 
tuberculosis and fungal infections; renal abscesses, and cystitis.
VII. Acute Renal Failure is described in twelve chapters, including the pathophysiology of cell ischemia and cell injury, acute tubular necrosis, acute interstitial 
nephritis, and nephrotoxic renal disease.
VIII. Hypertension and its manifestations in the renal system are covered in seven chapters, which include pathophysiology, renal vascular and endocrine-related 
hypertension as well as hypertension in pregnancy and in diabetes.
IX. Glomerular, Interstitial, and Vascular Renal Diseases are discussed in sixteen chapters, including collagen
vascular diseases, chronic interstitial nephritis, 
primary glomerulonephritides and vasculitides.
X. Systemic Diseases of the Kidney are covered in nine chapters, including diabetes, hepatorenal syndrome, sickle cell disease, gout, myeloma/amyloidosis, and 
tropical diseases.
XI. Disorders of Electrolyte, Water, and Acid—Base are covered in eight chapters, including SIADH, central and nephrogenic diabetes insipidus, cardiac failure, 
cirrhosis and the nephrotic syndrome.
XII. Uremic Syndrome section of six chapters covers pathophysiology, anemia, osteodystrophy, the nervous system, cardiovascular complications, and metabolic 
and endocrine dysfunctions.
XIII. Management of End-Stage Renal Disease by transplantation, peritoneal dialysis and hemodialysis, including complications, outcomes, and ethical 
considerations is discussed in five chapters.
XIV. Nutrition, Drugs, and the Kidney are covered in four chapters, including protein and caloric dietary issues as well as drug dosing recommendations in renal 
failure.
I would like to thank our authoritative and remarkably talented contributing authors, whose dedication to academic nephrology is unmatched.
Robert W. Schrier, MD
CHAPTER 1 Structural–Functional Relationships in the Kidney
Diseases of the Kidney and Urinary Tract
CHAPTER 1
Structural–Functional Relationships in the Kidney
Steven C. Hebert, Robert F. Reilly, Jr., and Wilhelm Kriz
S. C. Hebert: Vanderbilt University, Nashville, Tennessee
R. F. Reilly: Yale University Medical School, New Haven, Connecticut
W. Kriz: Institute for Anatomy and Cell Biology I, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany 
Structure–Function Correlations Among the Renal Tubule
 Form of the Human Kidney
 Renal (Uriniferous) Tubules
 Components of the Renal Corpuscle
 Proximal Tubule
 Loop of Henle
 The Distal Tubule
 Distal Convoluted Tubule
 The Collecting Duct System
 The Juxtaglomerular Apparatus
 Renal Blood Vessels
 Interstitium
Some Structure–Function Relationships and Principles
 Tight Junction Structure and Role in Transepithelial Solute and Water Transport
 Structural and Biochemical Aspects of Transcellular Transport Processes in the Nephron
 Structure–Function Relationships in Na+ and K+ Transport
Conclusion
Chapter References
STRUCTURE–FUNCTION CORRELATIONS AMONG THE RENAL TUBULE
The kidney functions as it does, in large part, because of its architecture. In no instance is this more evident than in the urinary concentrating mechanism, where the 
complex nephron and vascular interrelationships permit the coordinated function of different nephron and vascular elements into countercurrent multiplication and 
exchange processes. A recent proliferation of detailed structural, biochemical, and functional information has led to an appreciation of other structural–functional 
relationships that are relevant to solute and water handling by the kidney. Although, in general, a much more complex picture of glomerular and nephron function is 
emerging, some of the structural and functional information has not yet been assembled into a clear organizational pattern. For example, biochemical and 
morphologic heterogeneity may exist among nephron segments without a clear picture of its functional relevance at the level of either the single nephron or the whole 
kidney. This fact should not be discouraging; it merely emphasizes the need for further efforts to resolve or define these relationships.
The purpose of this chapter is to review some of the recent findings, with special emphasis on structural–functional relationships that can be assembled to enhance 
our understanding of overall renal function; therefore, this chapter is divided into two parts. The first part considers the structural and functional interrelationships of 
each morphologic segment of the urinary tubule, stressing the unique characteristics of each segment. The second part discusses structure and function in terms of 
more general mechanisms used by several segments of the renal tubule to accomplish specific functions, such as ion or water transport.
Form of the Human Kidney
Human kidneys are paired, bean-shaped organs situated in a retroperitoneal position on the posterior aspect of the abdominal cavity, on either side of the vertebral 
column against the psoas major muscle. A fibrous capsule located within the perirenal adipose tissue and surrounded by perirenal fascia surrounds each kidney. The 
lateral border of each kidney is convex. The kidneys of an adult man weigh approximately 120 to 170 g each and measure roughly 11 × 6 × 2.5 cm; those of an adult 
woman weigh slightly less and are somewhat smaller. In both men and women, total kidney mass best correlates with body surface area ( 1); however, the size of the 
kidney, observed it in vivo, can vary considerably with the physiologic state (e.g., hydration and blood pressure) of the individual ( 2).
The concave medial margin has a slitlike aperture, called the renal hilum. Branches of the renal artery, vein, nerves, lymphatics, and the expanded pelvis of the ureter 
pass through the hilum. The hilum communicates with a flattened space within the kidney, called the renal sinus. Within this space, the renal pelvis branches into 
major and minor calyces.
Sections through the kidney reveal the cortex and medulla ( Fig. 1-1). The human kidney is a multilobar organ containing four to 18 (average, eight) pyramids of 
medullary substance and is situated so that their bases are adjacent to the cortex. The darker red cortical substance covers the base of each medullary pyramid like 
the cap of an acorn. During fetal life, the kidney surface is demarcated by clefts that gradually disappear in the normal adult kidney ( 3). The apex of each medullary 
pyramid (called the papilla) extends into the renal sinus and is capped by a funnel-shaped, minor calyx. The minor calyces receive the urine that is released from the 
kidney into the extrarenal collecting system. A lobe of the kidney is composed of the conical medullary pyramid and the surrounding cortical substance. During fetal 
development, some lobes may fuse and calyces are remodeled so that mature kidney has fewer calyces and papillae than the original number of papilla anlagen. 
(One calyx may drain a fused papilla developed from up to four anlagen, predominantly at the kidney poles.) Striated elements called medullary rays extend 
peripherally at intervals from the bases of the medullary pyramids and penetrate into the cortex. These rays resemble the medulla in structure, although they extend 
deeply into the cortex; they are part of the cortex. The rest of the cortex is called the cortical labyrinth.
FIG. 1-1. Gross anatomic appearance of a human kidney. A paraffin section through the whole kidney shows elements of the internal structure: C, cortex; M, medulla; 
P, papilla projecting into a minor renal calyx; PE, pelvis; S, sinus; U, ureter.
The medulla can be subdivided further either grossly or microscopically ( Fig. 1-2). The medulla has an outer zone that is adjacent to the cortex and an inner zone that 
includes the papilla. The outer zone is subdivided into an inner and outer stripe. This zonation is important because it represents the location and orientation of the 
various segments of the renal tubules within the kidney.
FIG. 1-2. The relationship of nephron segments to zones of the kidney.
The relative volumes occupied by the cortex, outer medulla, and inner medulla are 70%, 27%, and 3%, respectively ( 4) in humans. The relative thicknesses ( Fig. 1-1) 
vary considerably among mammalian species.
Renal (Uriniferous) Tubules
Human renal morphology resulted from a long evolutionary process in which animals adapted to many changing environmental conditions. The three sequential types 
of kidneys that evolved were the pronephros, mesonephros, and metanephros. The urogenital system of each
human embryo repeats this evolutionary process. The 
pronephros develops first but degenerates before attaining any functional capacity.
The mesonephric kidney functions for a short period in utero, but it also degenerates, with the notable exception of the part of the mesonephric tubules that form a 
portion of the excurrent duct system of the male reproductive tract. The metanephric kidney forms last and eventually becomes the functional kidney of the human. 
The metanephric kidney is well suited to the human condition because of its efficient filtering device and its complex tubule, which allows for the production of not only 
dilute urine but also concentrated urine. This process occurs only in mammals and birds. Although it is well suited for maintaining homeostasis, the mammalian kidney 
is an inefficient organ for the elimination of salt and water. In humans, 180 L of fluid are filtered into the tubular lumen every 24 hours, of which approximately 178 L 
must be returned to the blood.
Each human kidney contains approximately one million functional units, called nephrons. Each nephron is made up of a renal corpuscle (glomerulus) and a complex 
tubular portion, which drain into a unifying tubular system called the collecting duct system. Both kinds of tubules represent the renal (or uriniferous) tubules.
The nephrons are derived from the metanephric blastema, the collecting ducts from the urethral bud. A connecting tubule lies between the nephron and collecting 
ducts. At present, there is controversy as to whether the connecting tubule is derived from the metanephric blastema ( 5,6,7 and 8) or the ureteric bud (9). As is 
discussed in the next section, the connecting tubule has marked morphologic similarities to the cortical collecting duct.
The segmentation of the renal tubule then includes the following regions ( 10).
The Nephron
I. Renal corpuscle (most of which is called glomerulus) 
A. Bowman's capsule
B. Glomerular tuft
II. Proximal tubule 
A. Convoluted part (pars convoluta) consists of P 1 and the first part of P2 (PCT)
B. Straight part (pars recta) consists of the last part of P 2 and all of P3 (PST)
III. Thin limb of the loop of Henle (intermediate tubule) 
A. Thin descending part of short-looped nephrons
B. Upper thin descending part of long-looped nephrons
C. Lower thin descending part of long-looped nephrons
D. Ascending thin part of long-looped nephrons
IV. Distal tubule 
A. Straight part (pars recta) 
1. Medullary thick ascending limb (MTAL), which includes regions located within the inner stripe and outer stripe of the medulla
2. Cortical thick ascending limb (CTAL), which includes the part ascending through the cortex, the macula densa, and the post macula densa segment
B. Convoluted part (pars convoluta) (DCT)
The Collecting Duct System
I. Connecting tubule (CNT)
II. Cortical collecting duct (or tubule) (CCD)
III. Outer medullary-collecting duct (or tubule) (OMCD)
IV. Inner medullary-collecting duct (or tubule) including the papillary collecting ducts (also called the ducts of Bellini) (IMCD)
Nephrons lie in characteristic positions ( Fig. 1-2), with the renal corpuscles and proximal convoluted segments in the cortex (Fig. 1-3 and Fig. 1-4). The straight part of 
the proximal tubule, the thin limb segments, and the straight part of the distal tubule form the loop of Henle, which enters a medullary ray of the cortex and extends 
into the medulla, where it bends, returning to the cortex by means of the same medullary ray. The loops of juxtamedullary nephrons directly connect the outer stripe of 
the medulla without ever being contained in a medullary ray. As the straight part of the distal tubule returns to the cortex, it passes by the renal corpuscle from which 
the nephron originated, forming the macula densa; then, after a short post macula densa segment, it continues as the distal convoluted tubule within the cortex.
FIG. 1-3. Scanning electron micrograph of the cortex. Convoluted tubules are shown, along with renal corpuscles, some of which contain a glomerular tuft (GT) and 
some from which the tuft is removed (arrow). A cortical radial artery (A) and vein (V) are also apparent. Note the thin wall of the vein. (Magnification × 140.)
FIG. 1-4. Light micrograph of renal cortex (rat). Cortical radial vessels ( A, artery; V, vein), glomeruli, and convoluted tubules make up the cortical labyrinth. The 
straight tubular portions are found in the medullary rays of the cortex (one medullary ray is delineated by the hatched line). (Magnification × 80.)
The morphology of the nephron varies with the position of the renal corpuscle in the cortex. Each nephron is classified as superficial, midcortical, or juxtamedullary 
according to the position of its renal corpuscle within the respective regions of the cortex and the pattern of efferent vessel formation ( Fig. 1-2) (11,12 and 13). A given 
segment tends to occupy a specific region of the kidney, which gives rise to the gross zonation referred to in the preceding. In the human kidney, superficial nephrons 
empty singly into a terminal collecting duct, whereas several juxtamedullary nephrons empty into an arched tubular portion (arcade) that courses peripherally in the 
cortex before it turns to enter a medullary ray. Most midcortical nephrons from humans empty individually as well ( 7,14). As known from the study of several species 
(rats and rabbits), an arcade is established by the connecting tubule epithelium; data from studies in humans are not available.
Nephrons also are classified as short- or long looped according to the location of the position where their loops of Henle turn within the kidney. Short-looped nephrons 
arise from renal corpuscles located in superficial and midcortical regions and have loops of Henle that turn within the outer medulla. In humans, some superficial 
nephrons may have loops within the cortex itself. Short-looped nephrons have short, thin limb segments that occur only along the descending limb. Long-looped 
nephrons have loops of Henle that turn within the inner medulla and have thin limb segments in both descending and ascending limbs. Although most species have 
both long- and short-looped nephrons, some species, such as dogs and cats, have only long ones ( 15), whereas other species, such as beavers, have only short ones 
(16,17). In human kidneys, the ratio of short- to long-looped nephrons is 6:1 to 7:1.
The renal corpuscle (first segment of the nephron) is the site at which an ultrafiltrate of the blood is produced ( Fig. 1-5 and Fig. 1-13). The filtrate moves from the 
capillary lumen into Bowman's space. This flow is influenced by the following factors: renal blood flow; the oncotic and hydrostatic pressures in the capillaries and in 
Bowman's space; the size, shape, and charge of plasma molecules; and the various morphologic components of the wall separating the capillary lumen from 
Bowman's space. The filtrate contains only barely detectable quantities of plasma proteins ( 18,19 and 20). The filtration barrier increasingly restricts the passage of 
larger molecules, with very little filtration of molecules larger than albumin (70 kDa) ( 21).
FIG. 1-5. Schematic of a longitudinal section through a glomerulus and juxtaglomerular apparatus (JGA). The direction of blood flow in the glomerular arterioles is 
indicated by arrows. The capillary network, together with the mesangium, is enclosed in a common compartment bounded by the glomerular basement membrane 
(GBM) (shown in dark gray). The outer aspect of the GBM is covered by the glomerular visceral epithelium (podocytes). Note that there is no basement membrane at 
the interface between the capillary endothelium and the mesangium. At the vascular pole, the visceral epithelium, together with the GBM, is reflected into the parietal 
epithelium of Bowman's capsule, which, at the urinary pole, passes over into the epithelium of the
proximal tubule. The JGA consists of the macula densa of the distal 
tubule, the extraglomerular mesangium (which is continuous between both arterioles and continues via the glomerular stalk into the intraglomerular mesangium), and 
the granular cells within the afferent arterioles. All cells that have been suggested to be of smooth muscle origin are shown in black. Note the sympathetic nerve 
terminals at the afferent arteriole. (From: Kriz W, Sakai T, Hosser H. Morphological aspects of glomerular function. In: Davison AM, ed. Nephrology, vol. 1. 
Proceedings of X International Congress of Nephrology, London, 1987. London: Bailliere Tindall, 1988:3, with permission.)
FIG. 1-13. Transmission electron micrograph from a rat renal corpuscle showing the endothelial lining (E), the basement membrane (BM), and the pedicels (P). The 
filtration-slit membrane (arrow) bridges the pedicels. (Magnification × 23,600.)
The renal corpuscle consists of Bowman's capsule and the glomerular tuft. The latter is made up by capillaries, derived from the afferent arteriole, their supporting 
cells, and an envelope consisting of the glomerular basement membrane (GBM) and the visceral (podocyte) layer of Bowman's capsule ( Fig. 1-5). At the vascular pole 
the visceral epithelium becomes the parietal epithelium, which then transforms into the proximal tubule epithelium at the urinary pole ( Fig. 1-5, Fig. 1-7, and Fig. 1-10). 
The space between both layers is the urinary space (Bowman's space).
FIG. 1-7. Transmission electron micrograph of a rat glomerular lobule. Glomerular capillaries and the glomerular mesangium occupy a common compartment 
enclosed by the glomerular basement membrane (GBM). The mesangial cell body (center) gives rise to many processes that fill (together with the mesangial matrix) 
radial arms that extend to the peripherally located capillaries. The outer aspect of the GBM is covered by podocytes. (Magnification × 3,500.)
FIG. 1-10. Scanning electron micrograph showing the elaborate cell shape of rat podocytes. (Magnification × 5,900.)
The human renal corpuscle is roughly ovoid and approximately 150 to 240 µm in diameter. The juxtamedullary glomeruli are larger in size ( 22). The term glomerulus is 
widely used to refer to the entire renal corpuscle. The renal corpuscle without the parietal epithelial cells is referred to as the glomerular tuft. The afferent arteriole 
enters the renal corpuscle at the vascular pole, where it divides into several primary branches that each ramify to form a network of anastomosing capillaries, called a 
lobule. The lobule has a supporting region called the mesangium. All lobules together establish the tuft; the continual mesangial regions are called the glomerular 
stalk, by which the tuft is connected to the extraglomerular mesangium (see Mesangium). The mesangium consists of mesangial cells and mesangial matrix (Fig. 1-6 
and Fig. 1-8). The capillaries then coalesce toward the center of the capillary tuft to form the efferent arteriole, which exits from the vascular pole. The efferent 
arteriole again breaks up to form a second capillary network. The two capillary beds, in series, form an arterial portal system. The second capillary network surrounds 
the tubules and is called the peritubular capillary network.
FIG. 1-6. Schematic of a cross section of a glomerular capillary and its relationships to the mesangium. The capillary is made up of a fenestrated epithelium. The 
peripheral part of the endothelium tubule is surrounded by the glomerular basement membrane (GBM) (shown in dark gray), which, at mesangial angles (arrows), 
deviates from a pericapillary course and covers the mesangium. The outer aspect of the GBM is covered by the interdigitating pattern of podocyte foot processes. In 
the center, a mesangial cell is shown; its many processes contain microfilament bundles and extend toward the GBM, to which they are connected. The mesangial 
matrix contains an interwoven network of microfibrils. (From: Venkatachalam MA, Kriz W. Anatomy of the kidney. In: Heptinstall R, ed. Pathology of the kidney, 4th ed. 
Boston: Little, Brown, 1991, with permission.)
FIG. 1-8. Transmission electron micrographs of glomerular capillaries (C) and associated mesangium. A: A mesangial cell body (M) gives rise to cell processes that 
extend to peripherally located capillaries. Note that there is no basement membrane at the interface between the capillary endothelium and the mesangium. 
(Magnification × 13,000.) B: Capillary mesangium interface. Beneath the endothelium (E), tonguelike mesangial cell processes run toward both opposing turning 
points of the glomerular basement membrane (GBM) (arrows). They contain microfilament bundles that obviously interconnect the GBM of both mesangial angles. 
(Magnification × 24,000.)
Components of the Renal Corpuscle
The renal corpuscle, therefore, consists of the following parts: (a) the parietal epithelium, (b) the visceral epithelium, (c) the endothelial cells lining the capillaries, (d) 
the glomerular basement membrane, and (e) the intraglomerular mesangial cells and matrix. In the rat, the ratio of the number of endothelial cells to mesangial cells to 
visceral epithelial cells is 3:2:1 ( 23).
The Visceral Epithelium of Bowman's Capsule
The visceral epithelial cells (frequently called podocytes) are octopus-shaped cells that reside in Bowman's space. The cells give rise to processes that extend to the 
adjacent capillaries, attaching to the glomerular basement membrane by way of their processes. This shape was well described by Zimmermann ( 24) and is seen to 
advantage in scanning electron micrographs ( Fig. 1-10). The exact details of cell shape differ depending on the species being studied ( 25,26). The cells reside in 
Bowman's space and give rise to large primary processes that branch into smaller processes. Small terminal club-shaped processes, called pedicels (little feet) or foot 
processes, arise from the cell itself or from any of its branches ( Fig. 1-6, Fig. 1-8, Fig. 1-9, and Fig. 1-13). The foot processes are anchored within the glomerular 
basement membrane to a depth of about 40 to 60 nm.
FIG. 1-9. Transmission electron micrograph showing the podocyte (P), pedicels (PC) near the basement membrane (BM), and the endothelial cells lining the capillary 
(C). (Magnification × 34,000.)
The foot processes interdigitate in a complicated manner with those from adjacent cells to form an elaborate layer of small processes along the glomerular basement 
membrane. This interdigitation results in the formation of an extensive series of narrow slits between the pedicels, which provide a long extracellular path for filtration 
of water and solutes (Fig. 1-10). In transmission electron micrographs, these slits are seen to be bridged by a layer of extracellular material of unknown composition 
that is thinner than a cell membrane (4 to 6 nm thick) and is called the filtration-slit membrane (Fig. 1-9 and Fig. 1-13). If tannic acid is added to the fixative solution, a 
highly ordered isoporous substructure is revealed in en face views of the filtration-slit membrane ( 27). Staggered rodlike units project from the podocyte plasmalemma 
and connect to a central linear bar. These rodlike units delineate rectangular pores 4 × 14 nm within the slit membrane. The pores are estimated to be about 2% to 
3% of the area of the total glomerular capillary. These spaces approximate the size~of an albumin molecule and therefore perhaps are related to permselectivity ( 27). 
Quick-freeze studies have raised doubts about the validity of this model ( 28,29), but a convincing alternative has not emerged thus far.
The podocytes have large irregularly shaped nuclei that tend to be indented in the region of their large Golgi apparatus ( Fig. 1-6). In addition, the cells contain 
abundant rough-surfaced endoplasmic reticulum and contain electron-dense material in some of their