2180:
758:
746:
734:
710:
722:
698:
347:
808:
292:
Though the renal medulla only receives a small percentage of the renal blood flow, the oxygen extraction is very high, causing a low oxygen tension and more importantly, a critical sensitivity to hypotension, hypoxia, and blood flow. The renal medulla extracts oxygen at a ratio of ~80% making it
288:
Blood is filtered in the glomerulus by solute size. Ions such as sodium, chloride, potassium, and calcium are easily filtered, as is glucose. Proteins are not passed through the glomerular filter because of their large size, and do not appear in the filtrate or urine unless a disease process has
2200:
40:
285:(both spuria and vera), the venulae rectae, the medullary capillary plexus, the loop of Henle, and the collecting tubule. The renal medulla is hypertonic to the filtrate in the nephron and aids in the reabsorption of water.
293:
exquisitely sensitive to small changes in renal blood flow. The mechanisms of many perioperative renal insults are based on the disruption of adequate blood flow (and therefore oxygen delivery) to the renal medulla.
996:
Phua YL, Gilbert T, Combes A, Wilkinson L, Little MH (April 2016). "Neonatal vascularization and oxygen tension regulate appropriate perinatal renal medulla/papilla maturation".
1196:
603:' Loops of Henle and collecting ducts. The base of each pyramid originates at the corticomedullary border and the apex terminates in a papilla, which lies within a
1049:
Phua YL, Martel N, Pennisi DJ, Little MH, Wilkinson L (April 2013). "Distinct sites of renal fibrosis in Crim1 mutant mice arise from multiple cellular origins".
536:
194:
745:
1659:
1746:
757:
1654:
314:
1793:
1144:
930:
879:
512:
170:
1189:
848:
675:. Perturbed renal papillary development has also been shown to be associated with onset of functional obstruction and renal fibrosis.
904:
250:. At the glomerulus the blood reaches a highly disfavourable pressure gradient and a large exchange surface area, which forces the
234:. Blood enters into the kidney via the renal artery, which then splits up to form the segmental arteries which then branch to form
1456:
1839:
1696:
1466:
1461:
1182:
326:
2137:
1739:
1623:
1548:
1428:
1324:
599:, points internally towards the pelvis. The pyramids appear striped because they are formed by straight parallel segments of
651:, damage the renal papillae. Damage to the renal papillae may result in death to cells in this region of the kidney, called
254:
portion of the blood out of the vessel and into the renal tubules. Flow continues through the renal tubules, including the
2056:
1354:
531:
189:
2170:
1408:
1314:
2115:
1824:
1666:
733:
2064:
1919:
1844:
1834:
1446:
1991:
1759:
682:
and can be quantified according to the papillary grading score, which accounts for contour, pitting, plugging and
2147:
2074:
2031:
1819:
1732:
1641:
1618:
1525:
2036:
1872:
1783:
1473:
948:"Association between congenital defects in papillary outgrowth and functional obstruction in Crim1 mutant mice"
652:
495:
153:
2205:
2142:
1877:
1349:
1283:
2179:
1574:
1478:
1261:
790:
779:
632:
543:
519:
507:
413:
407:
318:
201:
177:
165:
817:
2079:
1998:
1676:
1329:
243:
2104:
2084:
2069:
1724:
1538:
683:
664:
2023:
1980:
1964:
1882:
1829:
1701:
1646:
1403:
1398:
1334:
1319:
1150:
1094:"Endoscopic Evidence That Randall's Plaque is Associated with Surface Erosion of the Renal Papilla"
359:
247:
235:
947:
281:
responsible for maintaining the salt and water balance of the blood. These structures include the
2041:
1970:
1686:
1369:
1153:
at the SUNY Downstate
Medical Center - "Posterior Abdominal Wall: Internal Structure of a Kidney"
1074:
1031:
978:
1092:
Cohen AJ, Borofsky MS, Anderson BB, Dauw CA, Gillen DL, Gerber GS, et al. (January 2017).
583:. In humans, the renal medulla is made up of 10 to 18 of these conical subdivisions. The broad
2099:
2094:
2008:
1867:
1681:
1483:
1298:
1123:
1066:
1023:
970:
926:
900:
875:
844:
822:
576:
572:
289:
affected the glomerular capsule or the proximal and distal convoluted tubules of the nephron.
946:
Wilkinson L, Kurniawan ND, Phua YL, Nguyen MJ, Li J, Galloway GJ, et al. (August 2012).
709:
2120:
1862:
1788:
1755:
1595:
1418:
1364:
1156:
1113:
1105:
1058:
1013:
1005:
962:
721:
697:
239:
2201:
Knowledge (XXG) articles incorporating text from the 20th edition of Gray's
Anatomy (1918)
1798:
1613:
1584:
1390:
1278:
1159: – Histology Learning System at Boston University - "Urinary System: neonatal kidney"
679:
419:
377:
267:
255:
101:
2184:
1929:
1713:
1706:
1691:
1605:
1488:
1256:
1206:
1118:
1093:
668:
636:
620:
471:
231:
129:
107:
2194:
2111:
1949:
1939:
1600:
1500:
1495:
1451:
1234:
813:
795:
596:
443:
401:
306:
263:
259:
251:
73:
67:
1078:
1035:
1975:
1814:
1533:
1515:
1438:
1359:
1309:
1244:
1239:
1229:
982:
588:
466:
449:
383:
365:
124:
91:
85:
55:
1167:
500:
158:
2152:
2017:
2003:
1914:
1909:
1510:
1505:
1268:
1174:
1162:
785:
672:
648:
624:
604:
437:
431:
395:
282:
309:
in the medulla. It functions in renal water reabsorption by building up a high
1955:
1934:
1854:
1344:
1273:
774:
371:
95:
49:
524:
182:
17:
2013:
1543:
1423:
660:
1127:
1070:
1027:
974:
1109:
1413:
310:
1018:
549:
346:
230:. The renal medulla is split up into a number of sections, known as the
207:
39:
1959:
1633:
1381:
1288:
600:
425:
278:
1062:
1009:
966:
782:, a theory to explain how a gradient is generated in the inner medulla
751:
Vertical section of kidney. (Label "medullary sub." visible near top.)
1566:
1214:
656:
628:
580:
389:
271:
227:
79:
592:
2157:
1924:
1768:
483:
141:
639:
to channel the fluid. Transitional epithelium begins to be seen.
2089:
1165:
at The
Anatomy Lesson by Wesley Norman (Georgetown University) (
655:. The most common toxic causes of renal papillary necrosis are
322:
1728:
1178:
841:
The Netter
Collection of Medical Illustrations: Urinary System
270:, leading to the renal pelvis, the dilated portion of the
843:. Vol. 5 (2nd ed.). Elsevier Health Sciences.
607:, made of parallel bundles of urine collecting tubules.
925:(6 ed.). Philadelphia, PA: Elsevier. p. 293.
1147:
at Human
Anatomy Online, SUNY Downstate Medical Center
897:
Medical
Physiology: A Cellular And Molecular Approaoch
2168:
678:
Renal papillary damage has also been associated with
321:. Hypertonicity, in turn, is created by an efflux of
226:'marrow of the kidney') is the innermost part of the
2130:
2055:
1990:
1948:
1902:
1895:
1853:
1807:
1776:
1766:
1632:
1583:
1565:
1524:
1437:
1389:
1380:
1297:
1222:
1213:
575:, a seventeenth-century anatomist) are cone-shaped
530:
518:
506:
494:
482:
477:
465:
460:
339:
238:. The interlobar arteries each in turn branch into
188:
176:
164:
152:
140:
135:
123:
118:
32:
277:The renal medulla contains the structures of the
763:Kidney anatomy, with pyramids labeled at right
266:and finally leaves the kidney by means of the
1740:
1190:
8:
874:(8th ed.). Elsevier. pp. 553–554.
647:Some chemicals toxic to the kidney, called
631:. Histologically it is marked by medullary
1899:
1773:
1747:
1733:
1725:
1386:
1219:
1197:
1183:
1175:
345:
38:
1117:
1017:
315:thin descending limb of the loop of Henle
2175:
831:
693:
921:Young B, O'Dowd G, Woodford P (2014).
812:This article incorporates text in the
547:
336:
205:
29:
7:
865:
863:
623:in the medulla empty urine into the
899:. Elsevier/Saunders. p. 1300.
839:Kelly CR, Landman J (March 2012).
739:Frontal section through the kidney
25:
2178:
806:
756:
744:
732:
720:
708:
696:
327:inner medullary collecting duct
313:, which draws water out of the
242:, which in turn branch to form
2138:Fractional excretion of sodium
1549:Extraglomerular mesangial cell
1429:Intraglomerular mesangial cell
923:Wheater's Functional Histology
305:is the tissue surrounding the
246:, and these finally reach the
1:
872:Miller's Basics of Anesthesia
1409:Glomerular basement membrane
27:Innermost part of the kidney
2116:Effective renal plasma flow
1960:Intracellular fluid/Cytosol
820:of the 20th edition of
587:of each pyramid faces the
2222:
2065:Glomerular filtration rate
2057:Assessment and measurement
1920:Atrial natriuretic peptide
1447:Proximal convoluted tubule
619:is the location where the
2148:Tubuloglomerular feedback
2075:Augmented renal clearance
2032:Bicarbonate buffer system
1756:Physiology of the kidneys
1642:Internal urethral orifice
1619:Median umbilical ligament
1526:Juxtaglomerular apparatus
1157:Histology image: 15901loa
542:
344:
200:
37:
2037:Respiratory compensation
1794:Clearance of medications
1474:Distal convoluted tubule
1151:Anatomy photo:40:06-0107
1145:Anatomy figure: 40:03-02
1051:The Journal of Pathology
998:The Journal of Pathology
955:The Journal of Pathology
653:renal papillary necrosis
2143:BUN-to-creatinine ratio
1878:Countercurrent exchange
1350:Peritubular capillaries
1575:Ureteropelvic junction
1479:Collecting duct system
1262:medullary interstitium
1098:Journal of Endourology
791:Medullary interstitium
780:Kokko and Rector Model
671:, in combination with
544:Anatomical terminology
414:Superior renal capsule
408:Inferior renal capsule
319:collecting duct system
303:medullary interstitium
202:Anatomical terminology
2080:Renal clearance ratio
1999:Darrow Yannet diagram
1539:Juxtaglomerular cells
1110:10.1089/end.2016.0537
870:Pardo M, ed. (2022).
643:Clinical significance
635:converging to form a
244:interlobular arteries
2105:Hemodialysis product
2085:Urea reduction ratio
2070:Creatinine clearance
1910:Antidiuretic hormone
1760:acid–base physiology
665:acetylsalicylic acid
569:Malpighi's pyramids
1981:Transcellular fluid
1965:Extracellular fluid
1883:Filtration fraction
1702:Lacunae of Morgagni
1647:Urethral sphincters
565:malpighian pyramids
360:Interlobular artery
236:interlobar arteries
2042:Renal compensation
1971:Interstitial fluid
2166:
2165:
2100:Dialysis adequacy
2095:Standardized Kt/V
2051:
2050:
2009:Davenport diagram
1992:Acid–base balance
1891:
1890:
1868:Renal plasma flow
1722:
1721:
1561:
1560:
1557:
1556:
1484:Connecting tubule
1063:10.1002/path.4155
1010:10.1002/path.4690
967:10.1002/path.4036
932:978-0-7020-4747-3
895:Boron WG (2003).
881:978-0-323-79677-4
573:Marcello Malpighi
558:
557:
553:
489:pyramides renales
216:
215:
211:
16:(Redirected from
2213:
2183:
2182:
2174:
2121:Extraction ratio
2024:Winters' formula
1900:
1863:Renal blood flow
1789:Pharmacokinetics
1774:
1749:
1742:
1735:
1726:
1596:Vesical arteries
1419:Filtration slits
1404:Bowman's capsule
1387:
1220:
1199:
1192:
1185:
1176:
1163:posteriorabdomen
1132:
1131:
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1089:
1083:
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987:
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952:
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760:
748:
736:
724:
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700:
684:Randall's plaque
633:collecting ducts
550:edit on Wikidata
355:1. Renal pyramid
349:
337:
240:arcuate arteries
208:edit on Wikidata
86:Pelvis of kidney
42:
30:
21:
2221:
2220:
2216:
2215:
2214:
2212:
2211:
2210:
2191:
2190:
2189:
2177:
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2167:
2162:
2126:
2047:
1986:
1944:
1896:Other functions
1887:
1873:Ultrafiltration
1849:
1803:
1799:Urine flow rate
1762:
1753:
1723:
1718:
1697:navicular fossa
1628:
1614:Detrusor muscle
1579:
1553:
1520:
1467:Thick ascending
1433:
1391:Renal corpuscle
1376:
1293:
1279:Cortical lobule
1209:
1205:Anatomy of the
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1135:
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680:nephrolithiasis
645:
613:
554:
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420:Interlobar vein
335:
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268:collecting duct
256:proximal tubule
212:
147:medulla renalis
114:
113:
112:
28:
23:
22:
15:
12:
11:
5:
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2206:Kidney anatomy
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1987:
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1940:Prostaglandins
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1930:Erythropoietin
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1763:
1754:
1752:
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1737:
1729:
1720:
1719:
1717:
1716:
1714:Urinary meatus
1711:
1710:
1709:
1707:urethral gland
1704:
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1606:Vaginal artery
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1489:Papillary duct
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1471:
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1469:
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1462:Thin ascending
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1207:urinary system
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1140:
1139:External links
1137:
1134:
1133:
1084:
1057:(5): 685–696.
1041:
1004:(5): 665–676.
988:
961:(4): 499–510.
938:
931:
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887:
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850:978-1437722383
849:
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823:Gray's Anatomy
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669:phenylbutazone
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637:papillary duct
621:renal pyramids
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561:Renal pyramids
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232:renal pyramids
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130:Urinary system
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2112:PAH clearance
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1950:Fluid balance
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1841:
1840:Oligopeptides
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1708:
1705:
1703:
1700:
1698:
1695:
1693:
1690:
1688:
1685:
1683:
1680:
1678:
1677:pre-prostatic
1675:
1674:
1673:Male urethra
1672:
1668:
1665:
1661:
1658:
1656:
1653:
1652:
1650:
1649:
1648:
1645:
1643:
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1635:
1631:
1625:
1622:
1620:
1617:
1615:
1612:
1607:
1604:
1602:
1601:Vesical veins
1599:
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1588:
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1527:
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1517:
1514:
1512:
1509:
1507:
1504:
1502:
1501:Renal papilla
1499:
1497:
1496:Tubular fluid
1494:
1490:
1487:
1485:
1482:
1481:
1480:
1477:
1475:
1472:
1468:
1465:
1463:
1460:
1458:
1455:
1454:
1453:
1452:Loop of Henle
1450:
1448:
1445:
1444:
1442:
1440:
1436:
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1427:
1425:
1422:
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1300:
1296:
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1287:
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1284:Medullary ray
1282:
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1020:
1015:
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1007:
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984:
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976:
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968:
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949:
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934:
928:
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917:
914:
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906:1-4160-2328-3
902:
898:
891:
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883:
877:
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866:
864:
860:
856:
852:
846:
842:
835:
832:
828:
827:
824:
821:
819:
815:
814:public domain
801:
797:
796:Renal capsule
794:
792:
789:
787:
784:
781:
778:
776:
773:
772:
768:
759:
754:
747:
742:
735:
730:
727:Renal papilla
723:
718:
715:Renal medulla
711:
706:
703:Renal medulla
699:
694:
690:Image gallery
689:
687:
685:
681:
676:
674:
670:
666:
662:
658:
654:
650:
642:
640:
638:
634:
630:
626:
622:
618:
617:renal papilla
610:
608:
606:
602:
598:
594:
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586:
582:
578:
574:
570:
566:
562:
551:
545:
541:
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481:
476:
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470:
468:
464:
459:
451:
447:
445:
444:Renal papilla
441:
439:
435:
433:
429:
427:
423:
421:
417:
415:
411:
409:
405:
403:
402:Renal capsule
399:
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369:
367:
363:
361:
357:
354:
353:
348:
343:
338:
332:
330:
328:
324:
320:
316:
312:
311:hypertonicity
308:
307:loop of Henle
304:
296:
294:
290:
286:
284:
280:
275:
273:
269:
265:
264:distal tubule
261:
260:loop of Henle
257:
253:
249:
245:
241:
237:
233:
229:
225:
224:medulla renis
221:
220:renal medulla
209:
203:
199:
196:
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191:
187:
184:
181:
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175:
172:
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145:
143:
139:
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117:
109:
105:
103:
99:
97:
93:
89:
87:
83:
81:
77:
75:
71:
69:
68:Perirenal fat
65:
63:
59:
57:
53:
51:
47:
46:
41:
36:
33:Renal medulla
31:
19:
18:Renal papilla
1815:Solvent drag
1808:Reabsorption
1687:intermediate
1592:Circulation
1534:Macula densa
1516:Renal pelvis
1439:Renal tubule
1330:interlobular
1310:Renal artery
1251:
1166:
1104:(1): 85–90.
1101:
1097:
1087:
1054:
1050:
1044:
1019:11343/291071
1001:
997:
991:
958:
954:
941:
922:
916:
896:
890:
871:
854:
840:
834:
825:
811:
805:
677:
649:nephrotoxins
646:
616:
614:
589:renal cortex
584:
571:named after
568:
564:
560:
559:
513:A08.1.01.020
488:
450:Renal column
384:Renal pelvis
366:Renal artery
302:
300:
297:Interstitium
291:
287:
276:
223:
219:
217:
171:A08.1.01.020
146:
92:Renal artery
61:
2153:Natriuresis
2018:Delta ratio
2004:Base excess
1915:Aldosterone
1511:Major calyx
1506:Minor calyx
1299:Circulation
1168:renalpelvis
786:Renal sinus
673:dehydration
625:minor calyx
605:minor calyx
478:Identifiers
438:Major calyx
432:Renal sinus
396:Minor calyx
378:Renal hilum
283:vasa rectae
136:Identifiers
2195:Categories
2028:Buffering
1956:Body water
1935:Calcitriol
1855:Filtration
1457:Descending
1399:Glomerulus
1365:interlobar
1355:Vasa recta
1345:Renal vein
1320:interlobar
802:References
775:Medullipin
659:, such as
591:, and its
372:Renal vein
96:Renal vein
50:Parenchyma
2014:Anion gap
1784:Clearance
1777:Secretion
1767:Creating
1682:prostatic
1651:External
1544:Mesangium
1424:Mesangium
1315:segmental
1306:Arteries
855:plate 337
818:page 1221
661:ibuprofen
325:from the
248:glomeruli
1903:Hormones
1825:Chloride
1667:Internal
1608:(female)
1414:Podocyte
1370:efferent
1335:afferent
1257:pyramids
1128:27824271
1079:22837861
1071:23224993
1036:13482413
1028:26800422
975:22488641
911:Page 837
769:See also
601:nephrons
333:Pyramids
317:and the
279:nephrons
222:(Latin:
2185:Anatomy
1845:Protein
1835:Glucose
1634:Urethra
1624:Trigone
1585:Bladder
1567:Ureters
1382:Nephron
1360:arcuate
1325:arcuate
1289:Nephron
1252:Medulla
1235:Capsule
1215:Kidneys
1119:5220550
983:2777257
627:in the
611:Papilla
597:papilla
579:of the
577:tissues
501:D007679
461:Details
426:Nephron
159:D007679
119:Details
74:Capsule
62:Medulla
2171:Portal
1976:Plasma
1820:Sodium
1692:spongy
1660:female
1341:Veins
1245:column
1240:Cortex
1230:Fascia
1223:Layers
1126:
1116:
1077:
1069:
1034:
1026:
981:
973:
929:
903:
878:
847:
826:(1918)
667:, and
657:NSAIDs
629:kidney
581:kidney
467:System
390:Ureter
272:ureter
258:, the
228:kidney
125:System
80:Ureter
56:Cortex
2158:Urine
2131:Other
1925:Renin
1769:urine
1269:Sinus
1075:S2CID
1032:S2CID
979:S2CID
951:(PDF)
816:from
595:, or
548:[
537:74268
484:Latin
252:serum
206:[
195:74268
142:Latin
108:Calyx
102:Hilus
2090:Kt/V
1830:Urea
1758:and
1655:male
1274:Lobe
1124:PMID
1067:PMID
1024:PMID
971:PMID
927:ISBN
901:ISBN
876:ISBN
845:ISBN
615:The
593:apex
585:base
563:(or
525:3369
508:TA98
496:MeSH
448:17.
442:16.
436:15.
430:14.
424:13.
418:12.
412:11.
406:10.
323:urea
301:The
218:The
183:3369
166:TA98
154:MeSH
106:10:
94:and
1114:PMC
1106:doi
1059:doi
1055:229
1014:hdl
1006:doi
1002:238
963:doi
959:227
567:or
532:FMA
520:TA2
400:9.
394:8.
388:7.
382:6.
376:5.
370:4.
364:3.
358:2.
190:FMA
178:TA2
100:9:
90:8:
84:7:
78:6:
72:5:
66:4:
60:3:
54:2:
48:1:
2197::
1958::
1122:.
1112:.
1102:31
1100:.
1096:.
1073:.
1065:.
1053:.
1030:.
1022:.
1012:.
1000:.
977:.
969:.
957:.
953:.
862:^
853:.
686:.
663:,
329:.
274:.
2173::
2123:)
2114:(
2020:)
2016:(
1983:)
1969:(
1748:e
1741:t
1734:v
1198:e
1191:t
1184:v
1171:)
1130:.
1108::
1081:.
1061::
1038:.
1016::
1008::
985:.
965::
935:.
909:.
884:.
552:]
210:]
20:)
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