Kidneys….how They Work

November 3, 2021

The kidneys are located just under the ribcage in the back, one on each side.The right kidney is located below the liver, so it’s a little lower than the left one. Each adult kidney is about the size of a fist. Each has an outer layer called the cortex, which contains the filtering units. The center part of the kidney, the medulla has 10 to 15 fan-shaped structures called pyramids. These drain urine into cup-shaped tubes called calyxes. A layer of fat surrounds the kidneys to cushion and help hold them in place. Here’s how the kidneys filter blood: Blood travels to each kidney through the renal artery, which enters the kidney at the hilus, the indentation in the kidney that gives it its bean shape. As it enters the cortex, the artery branches to envelope the nephrons — 1 million tiny filtering units in each kidney that remove the harmful substances from the blood. Each of the nephrons contain a filter called the glomerulus, which contains a network of tiny blood vessels known as capillaries. The fluid filtered from the blood by the glomerulus then travels down a tiny tube-like structure called a tubule, which adjusts the level of salts, water, and wastes that are excreted in the urine. Filtered blood leaves the kidney through the renal vein and flows back to the heart.

The continuous blood supply entering and leaving the kidneys gives the kidneys their dark red color. While the blood is in the kidneys, water and some of the other blood components (such as acids, glucose, and other nutrients) are reabsorbed back into the bloodstream. Left behind is urine. Urine is a concentrated solution of waste material containing water, urea, a waste product that forms when proteins are broken down), salts, amino acids, byproducts of bile from the liver, ammonia, and any substances that cannot be reabsorbed into the blood. Urine also contains urochrome, a pigmented breakdown product of blood that gives urine its yellowish color.

The renal pelvis, located near the hilus, collects the urine flowing from the calyxes. From the renal pelvis, urine is transported out of the kidneys through the ureters, tubes that carry the urine out of each kidney to be stored in the urinary bladder — a muscular collection sac in the lower abdomen.

The bladder expands as it fills and can hold about 2 cups (half a liter) of urine at any given time (an average adult produces about 6 cups, or 1½ liters, of urine per day). An adult needs to produce and excrete at least one third of this amount in order to adequately clear waste products from the body. Producing too much or not enough urine may indicate illness.

When the bladder is full, nerve endings in its wall send impulses to the brain. When a person is ready to urinate, the bladder walls contract and the sphincter (a ring-like muscle that guards the exit from the bladder to the urethra) relaxes. The urine is ejected from the bladder and out of the body through the urethra, another tube-like structure. The male urethra ends at the tip of the penis; the female urethra ends just above the vaginal opening.