1. Water in the body 1.1 Intra- and extra-cellular compartments: volumes and composition of body fluids. Osmolality and its estimation. Water exchange between compartments.
2 Renal function 2.1 The nephron: structure, vascularization, innervation, iuxta-glomerular apparatus- Renal blood flow and its control, autoregulatory mechanisms. 2.2 Glomerular filtration: membrane, pressure and rate of filtration. Measurement of filtration: clearance of inulin. Intrinsic and extrinsic factors of filtration control. 2.3: Characteristics of tubular transport: gradient-time and tubular maximum systems. Renal threshold. Mechanism of water reabsorption. Mechanism of reabsorption/secretion of main ions (Na+, K+, Cl-, HCO3-.); of glucose, aminoacids and urea. Secretion of organic acids and bases. Clearance of glucose and para-amino-ippuric acid. Measurement of renal plasmatic flow. Clearance of creatinine. 2.4 Role of the different tubular segments in the urine formation: transport mechanisms and characteristics of proximal tubule, Henle loop, distal and collecting tubules. Composition and volume of tubular fluid in the successive segments of the tubule. Mean composition of the urine. 2.5 Concentration and diluting mechanisms: countercurrent multiplier system, renal medulla and concentration gradient. Role of urea and of vasa recta. 2.6 Control of osmolality and volume of extra-cellular water. Water and sodium balance. Regulation of water reabsorption: Antidiuretic hormone (effects, control of secretion). Regulation of sodium excretion: glomerular-tubular balance; pressure of reabsorption; fraction of filtration. Renin-angiotensin-aldosterone system. Natriuretic hormones. 2.7 Renal control of potassium and calcium excretion. 2.8 Acid-base regulation by the kidneys. Reabsorption of bicarbonate ions and secretion of acids: mechanisms and regulating factors..