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Histology Study Guide
Kidney and Urinary Tract

The essential tissue composition of kidney is that of a gland with highly modified secretory units and highly specialized ducts.  Kidneys excrete urine, produced by modifying a filtrate of blood plasma. 

[For an overview of glandular organization, see the webpage page on glands in the introductory unit.]

Click here or scroll down to continue this introduction to kidney.  To go directly to specific topics, see the table below.

Please note that this is an ancillary resource, NOT a substitute for textbooks or for time spent studying real specimens with a microscope.  If you use this on-line study aid, please refer to your textbooks and atlases and resource sessions for richer, more detailed information.

Renal Image Index

 

 

Distal urinary tract
Ureters, bladder and urethra

SAQ, Renal System
SAQ, Introduction (microscopy, cells, basic tissue types, blood cells
SAQ slides
SAQ Pathology Quiz

 

Online slides of the kidney and urinary tract -- normal  |  pathology

These specimens at the Virtual Slidebox (University of Iowa Department of Pathology) may be examined with full range of magnification and movement.  Requires Java and fast internet connection


 

Simple overview of kidney function:

"Kidney Physiology in a Nutshell" (outside link, University of Stellenbosch, South Africa)

 

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Renal pathology

CLINICAL NOTE:  From a clinical perspective, the renal corpuscle is probably the most significant histological feature of the kidney.  Several pathological processes interfere with glomerular filtration and thus have a critical impact on kidney function.  Diagnosis of renal pathology often involves biopsy of renal cortex and careful examination of renal corpuscles.  Several special stains as well as electron microscopy are used to reveal details of the glomerular basement membranes, podocytes, and mesangial cells. 

External links to WebPath provide additional information and images.

Also see renal pathology tutorial [external link, Division of Nephropathology, University of North Carolina at Chapel Hill]

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Overview of kidney histology

The essential tissue composition of kidney is that of a gland with highly modified secretory units and highly specialized ducts. 

If you are unfamiliar with the basic histology of glands, you might find the page on glands to be helpful.  Don't try to master all the details.  Just try to get a sense of how epithelial cells arrange themselves to form the basic structure of secretory units and ducts.

Typical gland (alveoli and ducts)
The bulk of a typical exocrine gland, such as a salivary gland, consists of secretory epithelial cells.  These cells form secretory units, called acini, which drain their secretory product into a branching tree of ducts.

 In this cartoon, orange color represents acini, blue color indicates the short "striated" ducts, where secretory product is concentrated by active reabsorption, and lavendar color indicates interlobular and interlobar ducts, whose function is more passive.

Kidney (corpuscles and tubules)
In contrast, the secretory units of the kidney, called renal corpuscles, comprise a relatively small proportion of the kidney.  The bulk of the kidney consists of highly specialized tubules, which correspond to the duct tree of a typical gland.  Together, the renal corpuscle and its associated tubule is called a nephron

In this cartoon, orange color represents renal corpuscles, blue color indicates tubules of each nephron, whose function is analogous to that of striated ducts, and lavendar color indicates collecting ducts, whose function is more passive.

Typical glandular alveolus
In a typical exocrine gland, each acinus uses raw materials supplied by blood to manufacture a secretory product.  As this product drains away, it may be concentrated by a striated duct

Kidney corpuscle
In the kidney, each renal corpuscle is essentially just a highly modified secretory acinus.  Each corpuscle "secretes" a filtrate of blood plasma which drains into its associated renal tubule
Kidney tubule
Renal tubules in turn function like exaggerated striated ducts, modifying the filtrate by reabsorbing everything that is not waste. Renal tubules have wiggly portions, called convoluted tubules, straight segments, called loops of Henle, and collecting ducts.  Different aspects of filtrate reabsorption are localized in these different segments. 
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Cortex and Medulla

nephron
This diagram is not drawn to scale.  Millions of nephrons are packed into each kidney.

A gross section of the kidney reveals that the outer cortex has a somewhat different texture from the deeper medulla.  This difference reflects the disposition of various portions of the many nephrons which comprise the kidney.  

renal cortex
renal medulla
renal pelvis

The cortex / medulla organization has considerable functional significance, reflected in the arrangement of renal tubules and vasculature.

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Lobes and lobules

Each kidney lobe consists of a medullary pyramid (a roughly pyramidal region that projects into the pelvis) and its associated cortex

Lobes are visible to gross inspection of a sectioned kidney.  Regions of cortex which separate medullary pyramids from one another are called "columns of Bertini".

A renal lobule is defined as a portion of the kidney containing those nephrons that are served by a common collecting duct.  

Lobules are generally inconspicuous, even to microscopic inspection. 

Lobules are centered on "medullary rays", bundles of straight tubules (collecting ducts and loops of Henle) which resemble the substance of the medulla but extend into the cortex.

A complementary grouping of nephrons is provided by the distribution of afferent arterioles from a common interlobular artery.  The interlobular artery ascends through the cortex between lobules and sends out afferent arterioles to nearby glomeruli.

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The nephron

  The nephron is the functional unit of the kidney.  Each nephron consists of one renal corpuscle and its associated tubule.  The kidney as a whole consists of many nephrons (millions) with their associated blood vessels.

The renal corpuscles are the sites where the process of urine formation begins with a filtrate of blood plasma.

Renal tubules are differentiated into several segments.  Click on any tubule segment for more detailed information.

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The renal corpuscle

The renal corpuscle is perhaps the most distinctive microscopic feature of the kidney.  Renal corpuscles produce a filtrate of blood plasma.  (For more on this glomerular function, see below.  Also see CLINICAL NOTE.)

(Renal corpuscles may also be called "Malpighian corpuscles", after Marcello Malpighi, who introduced microscopy to medicine).

Click on image for enlargement.

Examples of renal corpuscles

H&E
stain

PAS
stain

Each renal corpuscle has several parts.  Click on any feature for more detailed information, or continue down the page.

  • Bowman's capsule is the outer, epithelial wall of the corpuscle.
  • Bowman's space, also called "urinary space", is the space lying within Bowman's capsule.
     
  • The glomerulus is the conspicuous "little ball" which occupies most of the corpuscle, comprising several distinct elements.
    • Glomerular capillaries have an endothelium that is fenestrated (full of holes).
    • Podocytes are epithelial cells covering the glomerular capillaries.
    • Immediately adjacent to each glomerular capillary, in between the podocytes and the capillary endothelium, is the filtration membrane (not labelled on this diagram).
    • Mesangium is a supporting tissue consisting of mesangial cells and matrix.
       
       
  • The beginning of the proximal tubule is the "drain" carrying fluid away from Bowman's space.

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Bowman's space and Bowman's capsule

Bowman's space, also called the urinary space, is the space within Bowman's capsule surrounding the loops and lobules of the glomerulus.  This is the space into which the glomerular plasma filtrate collects as it leaves the capillaries through the filtration membrane

Bowman's capsule is the outer epithelium which encloses Bowman's space.  This epithelium is simple squamous, becoming cuboidal at the proximal tubule

Although Bowman's capsule is rather obviously a simple squamous epithelium, it is less apparent that the glomerulus is also closely enveloped by epithelium.  The peculiar structure of podocytes obscures the fact that they are indeed epithelial cells.  Thus Bowman's space is entirely lined by epithelium.  

One way to appreciate the essential epithelial construction of renal corpuscles is by examining fetal developmentClick on diagram or image to view a series of micrographs of developing renal corpuscles.


Each renal corpuscle is roughly spherical and has two "poles" at opposite ends.

Associated with the vascular pole is the juxtaglomerular complex.

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The glomerulus

The glomerulus ("little ball") is essentially a small knot of capillaries and supporting structures suspended within Bowman's capsule.  The glomerulus is the source of the initial filtrate of plasma that is eventually processed into urine.  With this function, the glomerulus is arguably the most significant component of the nephron.

Examples of glomeruli

H&E
stain

PAS
stain

 

Several elements comprise the glomerulus.  Click on any feature for more detailed information, or continue down the page.

In typical histological specimens, it is often difficult to discern the relationships among these elements.  Very thin sections (2µm or less) are much better than routine thick (5-10µm) sections.  Electron microscopy is essential for demonstrating functional details like capillary fenestrations and podocyte filtration slits (consult your histology text or atlas, e.g., Rhodin figures 32-9, 32-10, 32-11).

Several pathological processes modify glomerular structure and thereby interfere with glomerular filtration.  Histological examination of glomerular details (including electron microscopy) is standard practice for diagnosis of renal pathology.  See examples from WebPath:

 

Examples of glomerular pathology
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Glomerular capillary endothelium 

Introductory note about capillaries.

In the kidney, the endothelium of glomerular capillaries is perforated with many small holes, or fenestrated (from Latin fenestra, window).  Each endothelial cell has a shape like a slice of very holey Swiss cheese, rolled into a cylinder to make a segment of capillary.  The fenestrations are too small to allow blood cells through, but plasma can pass freely out of the holes and into the filtration membrane.

The capillaries of renal glomeruli are exceptionally leaky.  Although the filtration membrane holds back cells and plasma proteins, the remaining fluid (water, mineral ions, and small molecules) passes freely into Bowman's space and hence along the renal tubule. 

Consult your histology textbook and/or atlas (e.g., Rhodin, figure 32-9 , 32-10, and 32-11) for additional detail and electron micrographs of these cells.  

 

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Filtration membrane

Immediately outside the capillary endothelium is the filtration membrane.  This membrane represents a fusion of the endothelial basement membrane with the basement membrane of the glomerular epithelium (the podocytes). 

Pathology:  Anything which clogs or thickens the filtration membrane can interfere with the passage of fluid and hence reduce the rate of filtration.  See WebPath.

As plasma passes through the capillary fenestrations, water, ions, and small molecules pass through the filtration membrane into Bowman's space, while serum proteins are retained in the capillaries.  The outside of the filtration membrane is supported by podocytes.

The filtrate which accumulates in Bowman's space drains into the proximal tubule, and hence to the loop of Henle, the distal tubule, and the collecting duct.  In these various segments of the renal tubule, the filtrate is modified into urine, chiefly by reabsorption of non-waste components. 

The filtration membrane is not apparent on H&E stained histological specimens but may be demonstrated with PAS or silver stain.  Electron microscopy is the best way to visualize the filtration membrane.

 

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Podocytes

Podocytes ("footed cells") are extraordinary (one might say bizarre) epithelial cells which support the filtration membrane without obstructing the flow of filtrate.  Each podocyte stands upon branched pedicels, or "foot processes", which rest on the filtration membrane.  Between adjacent pedicels are gaps called filtration slits which permit free passage of fluid filtrate into Bowman's space.

The epithelial nature of podocytes is not obvious in mature renal corpuscles.  Nevertheless, observation of fetal development reveals that podocytes form from the epithelial lining of Bowman's capsule.

In typical histological preparations, podocyte nuclei tend to be oval and fairly euchromatic.  They may be recognized because they look more "epithelial" than those of capillary endothelial cells or mesangial cells, and because they lie immediately adjacent to Bowman's space (no intervening tissue).

Consult your histology textbook and/or atlas (e.g., Rhodin, figure 32-9 , 32-10, and 32-11) for additional detail and electron micrographs of these cells.  

Pathology:  Anything which occludes filtration slits or Bowman's space can interfere with the passage of fluid and hence reduce the rate of filtration.  

Fusion of adjacent pedicels can block filtration (e.g., see WebPath), as can reduction in Bowman's space caused by proliferation of any of the cell types of the renal corpuscle (podocytes, mesangial cells, Bowman's capsule cells, capillary endothelial cells).

This diagram is not drawn to scale, and does not show the filtration membrane. 

 

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Mesangial cells and matrix

Glomerular mesangial cells are inconspicuous and rather non-descript cells concentrated toward the vascular pole of the glomerulus.  These cells produce the mesangial matrix and may contribute to maintenance of the filtration membrane.

Mesangial cell nuclei may sometimes be recognized as small, irregularly shaped, and rather heterochromatic nuclei within the glomerulus.

Consult your histology textbook and/or atlas (e.g., Rhodin, figure 32-9 and 32-10) for additional detail and electron micrographs of these cells.  

Exra-glomerular mesangial cells, also called lacis cells or cells of Goormaghtigh, occupy the space between the glomerulus and the macula densa of the distal tubule.

The mesangial matrix is extracellular material which surrounds the mesangial cells.  Apart from offering some mechanical support to the glomerular capillaries, the function of mesangial matrix is unknown.

The mesangial matrix is not apparent on H&E stained histological specimens, but( like the filtration membrane) it may be visualized with PAS or silver stain

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Tubules

The renal tubule receives plasma filtrate from the glomerulus and processes it into urine. 

The functional differentiation of the different tubular segments is associated with variation in the structure of tubular epithelial cells.  This structural specialization is in turn reflected in the microscopic appearance of the tubules.

Click on any feature for more detailed information, or continue down the page.

Renal tubules

collecting duct
(not to scale)
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Proximal convoluted tubule

The initial segment of the tubule is the proximal convoluted tubule.  It is called proximal because it is nearest to the starting point (the renal corpuscle) and convoluted because it twists about (in contrast to the straight segments of tubule which form the loop of Henle).  This segment of the renal tubule restores much of the filtrate to the blood in the peritubular capillaries, by actively pumping small molecules out of the tubule lumen into the interstitial space.  (Water then follows the concentration gradient.)

The length of a proximal convoluted tubule tends to be several times greater than that of a distal convoluted tubule, so sections of proximal tubules are much more common than those of distal tubules in a typical histological slide of renal cortex.

The epithelium of the initial descending segment of the loop of Henle is similar to that of the proximal convoluted tubule, and is sometimes called the pars recta of the proximal tubule (in contrast to the convoluted pars convoluta).
 

The proximal convoluted tubule is lined by a simple cuboidal epithelium whose cells have several characteristic features.

  • The apical end of each cell has a brush border of microvilli.  This provides an increased surface area to accommodate the membrane channels that are responsible for absorbing into the cell small molecules from the filtrate in the tubular lumen.
    • The brush border is seldom plainly visible in routine histological preparations, but proximal tubule cells tend to have indistinct apical ends (in contrast to the more definite apical border of cells comprising distal tubules and collecting ducts).
       
  • The cells have a high proportion of mitochondria in their cytoplasm, to provide the energy for pumping ions and molecules against their concentration gradient. 
    • The abundance of mitochondria makes the cells rather intensely acidophilic
       
  • The plasma membranes of adjacent proximal tubule cells are extensively interdigitated.  This increases the basal membrane surface area available for pumping molecules out the basal end of each cell. 
    • As a consequence of such interdigitated cell membranes, boundaries between adjacent proximal tubule cells are inconspicuous (i.e., in section the epithelium looks like a continuous band of cytoplasm with nuclei appearing at irregular intervals).

Consult your histology textbook and/or atlas (e.g., Rhodin, figure 32-13 and 32-14) for additional detail and electron micrographs of these cells.  

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Loop of Henle

The loop of Henle is a remarkable feature of the renal tubule, associated with the remarkable function of the renal medulla in water conservation.  Basically, the loop helps to establish a hypertonic saline environment in the medulla, which in turn allows subsequent recovery of water from collecting ducts (and associated concentration of urine within the collecting ducts).  For further explanation of this function, see physiology resources, such as counter-current exchange.

The loop of Henle consists of a descending limb, having an initial short thick segment followed by a long thin segment, and an ascending limb, having a thin segment followed by a thick segment.

Medullary tubules (loops of Henle and collecting ducts)

 

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Distal convoluted tubule

The distal convoluted tubule continues into the cortex from the ascending limb of the loop of Henle.  Like the proximal convoluted tubule, it is called convoluted because it twists about.  It is distal because it is further "downstream" from the starting point, the renal corpuscle.  This segment of the renal tubule continues the return of useful materials from the filtrate to the blood in the peritubular capillaries, like the proximal convoluted tubule by actively pumping small molecules out of the tubule lumen into the interstitial space. 

Each distal tubule returns to the vascular pole of the renal corpuscle from which the tubule arose.  At this site is a special region of the distal tubule called the macula densa (macula densa = "dense spot", named for the close clustering of epithelial nuclei in the wall of the distal tubule) which is part of the juxtaglomerular apparatus.

Sections of distal convoluted tubules tend to be relatively uncommon in typical histological slides of renal cortex, because distal tubules tend to be much shorter than proximal tubules.

The distal convoluted tubule is lined by a simple cuboidal epithelium whose cells have several characteristic features.

  • Unlike the proximal convoluted tubule, the apical end of each distal tubule cell does not have a brush border, although there may be scattered microvilli.  Because most of the "heavy lifting" has already been done in the proximal tubule, distal tubule cells are not so highly specialized.
    • The apical ends of distal tubule cells tend to be more distinct than those of proximal tubule cells, conferring the usual appearance of a larger, clearer lumen in each distal tubule.
       
  • Distal tubule cells have a high proportion of mitochondria in their cytoplasm, to provide the energy for pumping ions and molecules against their concentration gradient. 
    • However, distal tubule cells are less extremely specialized than those of the proximal tubules.  They have fewer mitochondria and therefore a lesser degree of acidophilia
       
  • The plasma membranes of adjacent distal tubule cells are extensively interdigitated (as are those of proximal tubules).  This increases the basal membrane surface area available for pumping molecules out the basal end of each cell. 
    • As a consequence of such interdigitated cell membranes, boundaries between adjacent distal tubule cells are inconspicuous (i.e., in section the epithelium looks like a continuous band of cytoplasm with nuclei appearing at irregular intervals).

Consult your histology textbook and/or atlas (e.g., Rhodin, figure 32-19 and 32-20) for additional detail and electron micrographs of these cells.  

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Macula densa / juxtaglomerular apparatus (juxtaglomerular complex)

The juxtaglomerular apparatus is a complex of structures associated with the vascular pole of each renal corpuscle.  The juxtaglomerular apparatus has two principal components:

  • The macula densa is a patch of densely-packed epithelial cell nuclei along the distal convoluted tubule, adjacent to the afferent arteriole at the vascular pole of the corpuscle from which the tubule arose.  It may function as a sensor for sodium and/or chloride concentration.
     
  • Juxtaglomerular cells ("J-G cells") in the wall of the afferent arteriole are specialized smooth muscle cells containing secretory granules, the source of the hormone renin.
    • Consult your histology textbook and/or atlas (e.g., Rhodin, figure 32-6 and 32-7) for additional detail and electron micrographs of these cells.  
       
  • The juxtaglomerular region also includes extra-glomerular mesangial cells, also called lacis cells or cells of Goormaghtigh

The juxtaglomerular apparatus is thought to participate in the regulation of blood flow through the glomerular capillaries (and hence the rate of urine formation).

 

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Collecting ducts

Collecting ducts are named because they "collect" the urine from distal tubules.  Collecting ducts are lined by simple cuboidal epithelium which appears less specialized than that of the proximal or distal tubules.  The cytoplasm is relatively clear (i.e., not as intensely eosinophilic) and cell borders are usually distinct.  Collecting ducts merge and become larger as they descend through the medulla, so different sizes of collecting ducts may be observed at different levels in the kidney, with the smallest in the cortex and the largest near the pelvis.

Collecting ducts are readily recognized in the renal medulla, as relatively large tubules lined by cuboidal epithelium, in which the epithelial cells are relatively clear (i.e., not as eosinophilic as proximal and distal tubules) and have distinct cell borders.

Medullary tubules (loops of Henle and collecting ducts)
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Renal vasculature

In most organs the particular disposition of arteries, veins and capillaries serves only to distribute blood uniformly throughout the organ.  In the kidney, however, the arrangement of blood vessels has special functional significance.  Therefore, here we will offer a more-detailed-than-usual account of the within-organ arrangement of blood vessels.  (Click here for a general introduction to blood vessels.)

Distributing vessels.  See clinical note for the surgical significance of renal vessel arrangement.

  • Interlobar arteries and veins arise from the renal artery and vein and ascend between lobes (as the adjective interlobar suggests) from the pelvis across the medulla toward the cortex.
     
  • Arcuate arteries and veins branch from the interlobar vessels and "arch" (as the adjective arcuate suggests) across the boundary between cortex and medulla.

CLINICAL NOTE:  Interlobar and arcuate vessels do not extend into the cortex.  Therefore, to minimize the risk of bleeding during renal biopsy, the biopsy needle should be aimed tangentially through the cortex to avoid damaging one of these larger vessels.

  • Interlobular arteries and veins ascend from the arcuate vessels and pass up into the cortex perpendicular to the surface of the kidney.  (These may also be called "cortical radial vessels".  "Radial" describes their orientation in the cortex.  "Interlobular" refers to renal lobules, which are generally inconspicuous.)

In some of our kidney specimens, the distributing vessels display conspicuous atherosclerosis.

Microvasculature.  The kidney has three distinct capillary networks, each with a different function.

  • Afferent arteriole and glomerular capillaries
    • Each glomerulus receives its blood from one afferent arteriole (afferent means "incoming" and refers to the glomerular capillaries).  The afferent arterioles arise from interlobular arteries.

      Within each renal corpuscle, glomerular capillaries perform the critical role of expressing a filtrate across the capillary wall and filtration membrane.  Blood leaving the glomerulus has been thickened by loss of water and other components (but most of these components are immediately reabsorbed from the proximal tubule into peritubular capillaries).  

    • The wall of the afferent arteriole includes specialized smooth cells which together with the macula densa of the distal tubule comprise the juxtaglomerular apparatus.

  • Efferent arteriole and peritubular capillaries
     
    • Blood leaves the glomerulus through a short and inconspicuous efferent arteriole (efferent means "outgoing") and enters either peritubular capillaries or vasa recta.

    • Peritubular capillaries envelope all of the convoluted tubules of the cortex and recover the materials (water, ions, nutrient molecules) which are pumped across the tubular epithelium.
       
    •  Peritubular capillaries eventually return blood to the interlobular veins.
       
  • Vasa recta
     
    • Vasa recta ("straight vessels") are bundles of thin vessels (but generally larger than capillaries) which carry blood into and out of the medulla.
    • The parallel clustering of arterial and venous flow creates a counter-current exchange so that blood flow does not erase the salt gradient of the medulla
    • Vasa recta eventually return blood to arcuate veins.
Interlobular arteries, glomeruli, and peritubular capillaries.
Vasa recta

 

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Urinary Tract

The tissue composition of renal pelvis, ureters, bladder and urethra is comparatively simple.  Each of these elements has a wall lined by transitional epithelium (urothelium) and containing smooth muscle.

renal pelvis
ureter
bladder
urethra

 

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Image Index

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David KingComments and questions: dgking@siu.edu

SIUC / School of Medicine / Anatomy / David King

http://www.siumed.edu/~dking2/crr/rnguide.htm
Last updated:  16 October 2013 / dgk