, a LANGE medical book
b b b
Vander’sRenal b b
Physiology
Eighth Edition
b
Douglasb C.bEaton,b PhD
DistinguishedbProfessorbofbPhysiologyban
dbProfessorbofbPediatricsbDepartment
bofbPhysiology
EmorybUniversitybSchoolbofbMedicinebAtl
anta,bGeorgia
JohnbP.bPooler,bPhD
ProfessorbofbPhysiologybEmeritusbDepart
mentbofbPhysiology
EmorybUniversitybSchoolbofbMedicinebAtl
anta,bGeorgia
NewbYorkb Chicagob SanbFranciscob Lisbonb Londonb Madridb MexicobCit
ybMilanb NewbDelhib SanbJuanb Seoulb Singaporeb Sydneyb Toronto
,Copyrightb©b2013bbybMcGraw-
HillbEducation,bLLC.bAllbrightsbreserved.bExceptbasbpermittedbunderbtheb UnitedbStatesbCopyrightbActb
ofb1976,bnobpartbofbthisbpublicationbmaybbebreproducedborbdistributedbinbanyb formborbbybanybmeans,bo
rbstoredbinbabdatabaseborbretrievalbsystem,bwithoutbthebpriorbwrittenbpermissionb ofbthebpublisher.
ISBN:b978-0-07-179749-8
MHID:b0-07-179749-1
ThebmaterialbinbthisbeBookbalsobappearsbinbthebprintbversionbofbthisbtitle:bISBN:b978-0-07-179748-
1,b MHID:b0-07-179748-3.
Allbtrademarksbarebtrademarksbofbtheirbrespectivebowners.bRatherbthanbputbabtrademarkbsymbolbafterbeve
ryb occurrencebofbabtrademarkedbname,bwebusebnamesbinbanbeditorialbfashionbonly,bandbtobthebbenefitbo
fbtheb trademarkbowner,bwithbnobintentionbofbinfringementbofbthebtrademark.bWherebsuchbdesignationsba
ppearbinb thisbbook,btheybhavebbeenbprintedbwithbinitialbcaps.
McGraw-
HillbEducationbeBooksbarebavailablebatbspecialbquantitybdiscountsbtobusebasbpremiumsbandbsalesb promo
tions,borbforbusebinbcorporatebtrainingbprograms.bTobcontactbabrepresentativebpleasebe-
mailbusbatb .
Notice
Medicinebisbanbever-
changingbscience.bAsbnewbresearchbandbclinicalbexperiencebbroadenbourbknowledge,b changesbinbtreatm
entbandbdrugbtherapybarebrequired.bThebauthorsbandbthebpublisherbofbthisbworkbhaveb checkedb withb so
urcesb believedb tob beb reliableb inb theirb effortsb tob provideb informationb thatb isb completeb andbgenerally
binbaccordbwithbthebstandardsbacceptedbatbthebtimebofbpublication.bHowever,binbviewbofbtheb possibility
b ofb humanb errorb orb changesb inb medicalb sciences,b neitherb theb authorsb norb theb publisherb norb anybot
herbpartybwhobhasbbeenbinvolvedbinbthebpreparationborbpublicationbofbthisbworkbwarrantsbthatbtheb info
rmationbcontainedbhereinbisbinbeverybrespectbaccurateborbcomplete,bandbtheybdisclaimballbresponsibilityb f
orbanyberrorsborbomissionsborbforbthebresultsbobtainedbfrombusebofbthebinformationbcontainedbinbthisbwor
k.b Readersbarebencouragedbtobconfirmbthebinformationbcontainedbhereinbwithbotherbsources.bForbexampl
ebandb inbparticular,breadersbarebadvisedbtobcheckbthebproductbinformationbsheetbincludedbinbthebpackag
ebofbeachb drugbtheybplanbtobadministerbtobbebcertainbthatbthebinformationbcontainedbinbthisbworkbisbacc
uratebandbthatb changesbhavebnotbbeenbmadebinbthebrecommendedbdoseborbinbthebcontraindicationsbforb
administration.b Thisbrecommendationbisbofbparticularbimportancebinbconnectionbwithbnewborbinfreque
ntlybusedbdrugs.
TERMSbOFbUSE
ThisbisbabcopyrightedbworkbandbMcGraw-
HillbEducation,bLLC.bandbitsblicensorsbreserveballbrightsbinbandb tob theb work.b Useb ofb thisb workb isb sub
jectb tob theseb terms.b Exceptb asb permittedb underb theb CopyrightbActb ofb1976bandbthebrightbtobstoreband
bretrievebonebcopybofbthebwork,byoubmaybnotbdecompile,bdisassemble,b reversebengineer,breproduce,bm
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ebthebworkborbanybpartbofbitbwithoutbMcGraw-
HillbEducation’sbpriorb consent.bYoubmaybusebthebworkbforbyourbownbnoncommercialbandbpersonalbuse;b
anybotherbusebofbthebworkb isbstrictlybprohibited.bYourbrightbtobusebthebworkbmaybbebterminatedbifbyoubfa
ilbtobcomplybwithbthesebterms.
THEbWORKbISbPROVIDEDb“ASbIS.”bMcGRAW-
HILLbEDUCATIONbANDbITSbLICENSORSb MAKEbNObGUARANTEESbORbWARRANTIESbASb
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b McGraw-Hillb Education
andbitsblicensorsbdobnotbwarrantborbguaranteebthatbthebfunctionsbcontainedbinbthebworkbwillbmeetbyourb
requirementsb orb thatb itsb operationb willb beb uninterruptedb orb errorb free.b Neitherb McGraw-
Hillb Educationbnorbitsblicensorsbshallbbebliablebtobyouborbanyonebelsebforbanybinaccuracy,berrorborbomi
ssion,b regardlessbofbcause,binbthebworkborbforbanybdamagesbresultingbtherefrom.bMcGraw-
HillbEducationbhasbnob responsibilitybforbthebcontentbofbanybinformationbaccessedbthroughbthebwork.bUnd
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HillbEducationband/orbitsblicensorsbbebliablebforbanybindirect,bincidental,bspecial,bpunitive,b consequenti
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orbcausebwhatsoeverbwhetherbsuchbclaimborbcausebarisesbinbcontract,btortborbotherwise.
b b b
Vander’sRenal b b
Physiology
Eighth Edition
b
Douglasb C.bEaton,b PhD
DistinguishedbProfessorbofbPhysiologyban
dbProfessorbofbPediatricsbDepartment
bofbPhysiology
EmorybUniversitybSchoolbofbMedicinebAtl
anta,bGeorgia
JohnbP.bPooler,bPhD
ProfessorbofbPhysiologybEmeritusbDepart
mentbofbPhysiology
EmorybUniversitybSchoolbofbMedicinebAtl
anta,bGeorgia
NewbYorkb Chicagob SanbFranciscob Lisbonb Londonb Madridb MexicobCit
ybMilanb NewbDelhib SanbJuanb Seoulb Singaporeb Sydneyb Toronto
,Copyrightb©b2013bbybMcGraw-
HillbEducation,bLLC.bAllbrightsbreserved.bExceptbasbpermittedbunderbtheb UnitedbStatesbCopyrightbActb
ofb1976,bnobpartbofbthisbpublicationbmaybbebreproducedborbdistributedbinbanyb formborbbybanybmeans,bo
rbstoredbinbabdatabaseborbretrievalbsystem,bwithoutbthebpriorbwrittenbpermissionb ofbthebpublisher.
ISBN:b978-0-07-179749-8
MHID:b0-07-179749-1
ThebmaterialbinbthisbeBookbalsobappearsbinbthebprintbversionbofbthisbtitle:bISBN:b978-0-07-179748-
1,b MHID:b0-07-179748-3.
Allbtrademarksbarebtrademarksbofbtheirbrespectivebowners.bRatherbthanbputbabtrademarkbsymbolbafterbeve
ryb occurrencebofbabtrademarkedbname,bwebusebnamesbinbanbeditorialbfashionbonly,bandbtobthebbenefitbo
fbtheb trademarkbowner,bwithbnobintentionbofbinfringementbofbthebtrademark.bWherebsuchbdesignationsba
ppearbinb thisbbook,btheybhavebbeenbprintedbwithbinitialbcaps.
McGraw-
HillbEducationbeBooksbarebavailablebatbspecialbquantitybdiscountsbtobusebasbpremiumsbandbsalesb promo
tions,borbforbusebinbcorporatebtrainingbprograms.bTobcontactbabrepresentativebpleasebe-
mailbusbatb .
Notice
Medicinebisbanbever-
changingbscience.bAsbnewbresearchbandbclinicalbexperiencebbroadenbourbknowledge,b changesbinbtreatm
entbandbdrugbtherapybarebrequired.bThebauthorsbandbthebpublisherbofbthisbworkbhaveb checkedb withb so
urcesb believedb tob beb reliableb inb theirb effortsb tob provideb informationb thatb isb completeb andbgenerally
binbaccordbwithbthebstandardsbacceptedbatbthebtimebofbpublication.bHowever,binbviewbofbtheb possibility
b ofb humanb errorb orb changesb inb medicalb sciences,b neitherb theb authorsb norb theb publisherb norb anybot
herbpartybwhobhasbbeenbinvolvedbinbthebpreparationborbpublicationbofbthisbworkbwarrantsbthatbtheb info
rmationbcontainedbhereinbisbinbeverybrespectbaccurateborbcomplete,bandbtheybdisclaimballbresponsibilityb f
orbanyberrorsborbomissionsborbforbthebresultsbobtainedbfrombusebofbthebinformationbcontainedbinbthisbwor
k.b Readersbarebencouragedbtobconfirmbthebinformationbcontainedbhereinbwithbotherbsources.bForbexampl
ebandb inbparticular,breadersbarebadvisedbtobcheckbthebproductbinformationbsheetbincludedbinbthebpackag
ebofbeachb drugbtheybplanbtobadministerbtobbebcertainbthatbthebinformationbcontainedbinbthisbworkbisbacc
uratebandbthatb changesbhavebnotbbeenbmadebinbthebrecommendedbdoseborbinbthebcontraindicationsbforb
administration.b Thisbrecommendationbisbofbparticularbimportancebinbconnectionbwithbnewborbinfreque
ntlybusedbdrugs.
TERMSbOFbUSE
ThisbisbabcopyrightedbworkbandbMcGraw-
HillbEducation,bLLC.bandbitsblicensorsbreserveballbrightsbinbandb tob theb work.b Useb ofb thisb workb isb sub
jectb tob theseb terms.b Exceptb asb permittedb underb theb CopyrightbActb ofb1976bandbthebrightbtobstoreband
bretrievebonebcopybofbthebwork,byoubmaybnotbdecompile,bdisassemble,b reversebengineer,breproduce,bm
odify,bcreatebderivativebworksbbasedbupon,btransmit,bdistribute,b disseminate,bsell,bpublishborbsublicens
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ilbtobcomplybwithbthesebterms.
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HILLbEDUCATIONbANDbITSbLICENSORSb MAKEbNObGUARANTEESbORbWARRANTIESbASb
TObTHEbACCURACY,bADEQUACYbORb COMPLETENESSbOFbORbRESULTSbTObBEbOBTAINE
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DbWARRANTIESbOFb MERCHANTABILITYb ORb FITNESSb FORb Ab PARTICULARb PURPOSE.
b McGraw-Hillb Education
andbitsblicensorsbdobnotbwarrantborbguaranteebthatbthebfunctionsbcontainedbinbthebworkbwillbmeetbyourb
requirementsb orb thatb itsb operationb willb beb uninterruptedb orb errorb free.b Neitherb McGraw-
Hillb Educationbnorbitsblicensorsbshallbbebliablebtobyouborbanyonebelsebforbanybinaccuracy,berrorborbomi
ssion,b regardlessbofbcause,binbthebworkborbforbanybdamagesbresultingbtherefrom.bMcGraw-
HillbEducationbhasbnob responsibilitybforbthebcontentbofbanybinformationbaccessedbthroughbthebwork.bUnd
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HillbEducationband/orbitsblicensorsbbebliablebforbanybindirect,bincidental,bspecial,bpunitive,b consequenti
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orbcausebwhatsoeverbwhetherbsuchbclaimborbcausebarisesbinbcontract,btortborbotherwise.
