The kidneys are a pair of bean-shaped organs lying against the posterior abdominal wall, one on each side of the spine. Each is about 11 cm long and filters roughly 180 litres of plasma a day, turning a small fraction of it into urine. They also control blood pressure, salt and water balance, acid-base balance and red blood cell production.
| Location | Retroperitoneal, on the posterior abdominal wall either side of the vertebral column at about T12-L3, embedded in perirenal fat and enclosed by renal fascia |
|---|---|
| Parts |
|
| Nerve Supply | Renal plexus (sympathetic, T10-L1 via the lesser and least splanchnic nerves); Vagus nerve (parasympathetic, via the renal plexus) |
| Blood Supply | Renal artery |
| Venous drainage | |
| Lymphatic drainage |
|
Filters blood to remove waste and excess water, forming urine. Regulates blood pressure (renin), red cell production (erythropoietin), electrolyte and acid-base balance, and activates vitamin D.
The kidneys sit behind the peritoneum at about T12-L3, with the right kidney slightly lower because of the liver. The lower ribs protect their upper poles, so a blow to the flank or lower ribs can bruise or tear a kidney, causing blood in the urine. Loin (flank) pain radiating to the groin is typical of kidney stones or infection. Kidney function is tracked with blood creatinine and the estimated glomerular filtration rate (eGFR).
Crystals of calcium, uric acid or other salts form stones in the collecting system. A stone moving into the ureter causes severe colicky flank pain and blood in the urine.
Bacterial infection of the kidney, usually rising from the bladder, causing fever, flank pain and tenderness at the costovertebral angle.
Gradual, long-term loss of filtering units, most often from diabetes or high blood pressure, which can progress to kidney failure needing dialysis or transplant.
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