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Essentials of Clinical Nephrology (Shorouk Press, Cairo, 2000, ISBN ...

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2. The epithelioid cells which are modified cells in the wall <strong>of</strong> the afferent and<br />

to less extent efferent arterioles.<br />

3. The lacis cells which are interstitial cells in continuity with mesangial cells.<br />

4. The peripolar cells which are present at the vascular pole <strong>of</strong> the<br />

glomerulus, separating the podocytes from the flat parietal epithelial cells<br />

<strong>of</strong> Bowman's capsule. More details about JGA will be given on discussing<br />

renovascular hypertension (Page 316).<br />

Proximal convoluted tubule:<br />

Is the longest segment <strong>of</strong> the nephron, lined by a single layer <strong>of</strong> cells<br />

with prominent brush border towards the lumen. The basal part <strong>of</strong> these cells<br />

contains large mitochondria which are important for the high reabsorptive<br />

activity <strong>of</strong> these cells.<br />

Loop <strong>of</strong> Henle:<br />

Morphologically and according to the type <strong>of</strong> epithelial cells covering it,<br />

loop <strong>of</strong> Henle can be divided into thick descending limb, thin descending limb,<br />

then thin ascending limb and the thick ascending limb. The loops <strong>of</strong> Henle <strong>of</strong><br />

superficial and middle cortical nephrons are short while those <strong>of</strong> deep cortical<br />

and corticomedullary junction nephrons are long and go deep in the medulla<br />

to reach renal papillae before they ascend up. These later loops are arranged<br />

in bundles in association with the collecting ducts and vasa recta (all are<br />

participating in the counter current system). Since the morphology <strong>of</strong> these<br />

segments is different, their function is also different.<br />

Distal nephron:<br />

Begins with distal convoluted tubule which starts at juxta-glomerular<br />

apparatus and end at the renal papilla. Morphologically and functionally, this<br />

can be sub-divided into:<br />

A. Distal convoluted tubule with its early part somewhat similar to the<br />

proximal convoluted tubule and distal part is similar to the cortical<br />

collecting tubule.<br />

B. Cortical part <strong>of</strong> collecting tubule.<br />

C. Medullary part <strong>of</strong> collecting tubule.<br />

D. Papillary part <strong>of</strong> the collecting tubule.

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