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Hematopoiesis and the Kidney


Kurtz, A; Wenger, R H; Eckardt, Kai-Uwe (2013). Hematopoiesis and the Kidney. In: Alpern, Robert J; Caplan, Michael J; Moe, Orson W. Seldin and Giebisch's THE KIDNEY Physiology and Pathophysiology. USA: Elsevier, 3087-3124.

Abstract

During ontogeny,hematopoiesis—comprising eryth ropoiesis, granulocytopoiesis, andthrombopoiesis—is initiated in the blood islands of the yolk sac before the development of the kidneys.Later during gestation,at a time when hematopoiesis is fully established in the bone marrow,the kidney starts to play an important role in the control of erythro-andthrombopoiesis.This control is achieved through renal production oft hehematopoi- etic growth factors erythropoietin and thrombopoietin. Thus,in addition to its role in waste excretion and water and electrolyte homeostasis,the kidney is also important in tissue oxygenation and coagulation. With the exception of the growth period,the circulating red blood cell(RBC)mass,and hence the oxygen-carrying capacity of the blood,is normally fairly constant.Since the erythron is a continuously regenerating organ,a daily production of 20ml of red blood cells is required in human adults to compensate for the physiologic demise of 120-day-old erythrocytes. In addition,when increased blood loss occurs or the oxygen saturation of hemoglobin falls,the bone mar- row is capable of increasing this normal production rate of red blood cells three-to five-fold within a few days, and even up to seven-fold under chronic condi- tions. Similarly,the number of circulating platelets is kept constant(although in a wider range than red blood cells),and any decrease of platelet number results in activation of thrombocytopoiesis. The predominant and essential regulators of redcell and platelet formation,erythropoietin and thrombopoie- tin are true hormones that a reproduced outside the bone marrow,and mainly in the kidney and in the liver. This chapter is designed to summarize current knowledge about the specific role of the kidney in the humoral control of hematopoies is both under physio- logic and pathophysiologic conditions.

During ontogeny,hematopoiesis—comprising eryth ropoiesis, granulocytopoiesis, andthrombopoiesis—is initiated in the blood islands of the yolk sac before the development of the kidneys.Later during gestation,at a time when hematopoiesis is fully established in the bone marrow,the kidney starts to play an important role in the control of erythro-andthrombopoiesis.This control is achieved through renal production oft hehematopoi- etic growth factors erythropoietin and thrombopoietin. Thus,in addition to its role in waste excretion and water and electrolyte homeostasis,the kidney is also important in tissue oxygenation and coagulation. With the exception of the growth period,the circulating red blood cell(RBC)mass,and hence the oxygen-carrying capacity of the blood,is normally fairly constant.Since the erythron is a continuously regenerating organ,a daily production of 20ml of red blood cells is required in human adults to compensate for the physiologic demise of 120-day-old erythrocytes. In addition,when increased blood loss occurs or the oxygen saturation of hemoglobin falls,the bone mar- row is capable of increasing this normal production rate of red blood cells three-to five-fold within a few days, and even up to seven-fold under chronic condi- tions. Similarly,the number of circulating platelets is kept constant(although in a wider range than red blood cells),and any decrease of platelet number results in activation of thrombocytopoiesis. The predominant and essential regulators of redcell and platelet formation,erythropoietin and thrombopoie- tin are true hormones that a reproduced outside the bone marrow,and mainly in the kidney and in the liver. This chapter is designed to summarize current knowledge about the specific role of the kidney in the humoral control of hematopoies is both under physio- logic and pathophysiologic conditions.

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Additional indexing

Item Type:Book Section, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > Institute of Physiology
07 Faculty of Science > Institute of Physiology
Dewey Decimal Classification:570 Life sciences; biology
Language:English
Date:2013
Deposited On:08 Feb 2013 10:21
Last Modified:05 Apr 2016 16:30
Publisher:Elsevier
Number:Volume 2
ISBN:9780123814623
Publisher DOI:https://doi.org/10.1016/B978-0-12-381462-3.00092-6
Permanent URL: https://doi.org/10.5167/uzh-73684

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