查看“︁腎じん”︁的てき源みなもと代だい码

{{Refimprove|time=2024-06-23T09:29:17+00:00}}{{主條目消歧義|本文介紹現代解剖學的腎臟，關於傳統中醫所指的腎，詳見「'''[[腎 (臟腑)]]'''」。}}{{medical}}{{Anatomy-terms}}
{{NoteAT|G1=生命科学}}
{{Infobox anatomy
| Name = 腎
| Latin = Ren
| Greek = νεφρός (nephros)
| Image = Gray1120.png
| Caption = 人體的腎
| Image2 = Gray1123.png
| Caption2 = 肾脏后面观，示血液供应和静脉引流
| Precursor = 
| System = [[泌尿系統]]、[[內分泌系統]]
| Artery = [[肾动脉]]
| Vein = [[肾静脉]]
| Nerve = [[肾丛]]
| Lymph = <!--
| GraySubject = 253
| GrayPage    = 1215
| MeshName    = Kidney
| MeshNumber  = A05.810.453
| DorlandsPre = k_03
| DorlandsSuf = 12470097
-->
}}
'''腎'''（{{lang|en|kidney}}）是[[脊椎动物]]體內的一種[[器官]]，屬於[[泌尿系統]]的一部分，负责濾過血液中的雜質、維持體液和電解質的平衡，最後產生尿液經由後續管道排出體外；同時也具備[[內分泌系統|內分泌]]調節[[血壓]]、刺激骨髓产生红细胞的功能<ref>{{Cite web|title=kidney|url=https://www.cancer.gov/publications/dictionaries/cancer-terms/def/kidney|website=www.cancer.gov|date=2011-02-02|language=en|url-status=no|access-date=2024-06-23|archive-date=2024-06-14|archive-url=https://web.archive.org/web/20240614140232/https://www.cancer.gov/publications/dictionaries/cancer-terms/def/kidney}}</ref><ref name=":5">{{Cite book|chapter=Renal System|title=Translational Regenerative Medicine|url=https://linkinghub.elsevier.com/retrieve/pii/B9780124103962000335|publisher=Elsevier|date=2015|isbn=978-0-12-410396-2|pages=457–468|doi=10.1016/b978-0-12-410396-2.00033-5|language=en|first=Joao Paulo|last=Zambon|first2=Prafulla|last2=Chandra|first3=Anthony|last3=Atala|first4=James J.|last4=Yoo|access-date=2024-06-23|archive-date=2024-06-15|archive-url=https://web.archive.org/web/20240615031922/https://linkinghub.elsevier.com/retrieve/pii/B9780124103962000335|dead-url=no}}</ref>。在正常成人[[人体]]中，具備兩枚腎臟，位於[[腰|腰部]]兩側後方，因此又稱為'''腰子'''，狀似拳頭大小的扁豆子，儘管尺寸不大，通過腎臟的血流卻佔有總血量的四分之一。在生理上，腎臟主要可影響血流量、血液組成、血壓調節、骨骼發育，並帶有部分重要的代謝功能，因此若有[[腎病變|相關病變]]可引起發育異常、水腫或脫水、免疫系統的破壞，甚至可導致死亡。<ref name="robbins">{{cite book |author1=Cotran, RS S. |author2=Kumar, Vinay |author3=Fausto, Nelson |author4=Robbins, Stanley L. |author5=Abbas, Abul K. |title=Robbins and Cotran pathologic basis of disease |publisher=Elsevier Saunders |location=St. Louis, MO |year=2005 |pages= |isbn=0-7216-0187-1 |oclc= |doi= |accessdate=}}</ref>

== 解剖構造 ==
[[File:Surface projections of the organs of the trunk.png|thumb|300px|显示人体躯干和器官位置的图像。肾脏约位于T12至L3的椎体水平，右肾略低于左肾。]]
哺乳动物肾脏为成对的[[实质性器官]]，呈豆形至马蹄形。<ref>{{Cite book|chapter=Renal System|title=Handbook of Toxicology of Chemical Warfare Agents|url=https://linkinghub.elsevier.com/retrieve/pii/B9780128001592000439|publisher=Elsevier|date=2015|isbn=978-0-12-800159-2|pages=627–637|doi=10.1016/b978-0-12-800159-2.00043-9|language=en|first=Sharon M.|last=Gwaltney-Brant|access-date=2024-06-24|archive-date=2018-06-24|archive-url=https://web.archive.org/web/20180624201220/https://linkinghub.elsevier.com/retrieve/pii/B9780128001592000439|dead-url=no}}</ref>成人肾形似蚕豆，重约134～148[[公克]]（男性肾脏平均重量150克，女性平均重135克<ref name=":8">{{Cite book|edition=42nd edition|chapter=Chapter 72: Kidney and ureter|publisher=Elsevier|date=2021|location=Amsterdam|isbn=978-0-7020-7705-0|editor-first=Henry|editor-last=Gray|title=Gray's Anatomy: the anatomical basis of clinical practice|pages=1259}}</ref>），长约10[[厘米]]（8～14cm），宽约6厘米（5～7cm），厚约4cm（3~5cm）<ref name=":0" /><ref>{{Cite web|title=Kidneys {{!}} SEER Training|url=https://training.seer.cancer.gov/anatomy/urinary/components/kidney.html|website=training.seer.cancer.gov|access-date=2024-06-23|quote=3 cm thick, 6 cm wide, and 12 cm long|archive-date=2024-05-17|archive-url=https://web.archive.org/web/20240517204710/https://training.seer.cancer.gov/anatomy/urinary/components/kidney.html|dead-url=no}}</ref>，位於[[腰|腰部]]脊柱两侧[[腹膜]]后间隙内，为腹膜外位器官。左肾位于第11[[胸椎]]（T11）椎体下缘至第2-3[[腰椎]](L2、L3)椎间盘之间，右肾略低于左肾，位于第12胸椎（T12）椎体上缘至第3腰椎（L3）椎体上缘之间。<ref name=":0">{{Cite book|title=系统解剖学|last=丁文龙、刘学政|publisher=人民卫生出版社|year=2018|isbn=978-7-117-26718-2|location=北京市朝阳区潘家园南里19号|pages=142-146}}</ref><ref name=":1">{{Cite book|title=系统解剖学|last=丁文龙、王海杰|publisher=人民卫生出版社|year=2015|isbn=978-7-117-20325-8|location=北京市朝阳区潘家园南里19号|pages=167-168|chapter=泌尿系统}}</ref><ref>{{Cite journal |title=Kidney Anatomy: Overview, Gross Anatomy, Microscopic Anatomy |url=https://emedicine.medscape.com/article/1948775-overview?form=fpf |journal= |date=2021-06-09 |quote=The kidneys are paired retroperitoneal structures that are normally located between the transverse processes of T12-L3 vertebrae, with the left kidney typically somewhat more superior in position than the right. |access-date=2024-06-23 |archive-date=2024-06-23 |archive-url=https://web.archive.org/web/20240623111652/https://emedicine.medscape.com/article/1948775-overview?form=fpf |dead-url=no }}</ref>两肾正面观大体上呈“八”字形，即右肾略低于左肾、两肾上端相距较近，下端相距较远。两肾上端距正中线平均为3.8cm，下端距正中线平均为7.2cm。<ref name=":0" /><ref name=":1" />

=== 毗邻 ===
肾前有[[腹膜]]隔開腸胃和胰臟、後腹壁前方，若將腎臟移開，後側自内向外則有[[腰大肌]]（psoas major）、腰方肌（quadratus lumborum）和[[腹横肌]]，且原來腎臟的位置可見肋下神經（subcostal n.）、[[髂腹下神經]]（iliohypogastric n.）及[[髂鼠蹊神經]]（ilioinguinal n.）走過，具體的高度約在第十二[[胸椎]]至第三[[腰椎]]之間，因右腎上方有肝臟，所以右腎較低於左腎，另外左腎比右腎大。肾的上端与肾上腺相邻并为肾筋膜所分隔，右侧的肾上腺呈金字塔形，位于右肾的顶部，左侧的肾上腺呈新月形，偏向左肾的内侧。<ref name=":4">{{Cite book|chapter=Anatomy, Abdomen and Pelvis: Kidneys|title=StatPearls|url=http://www.ncbi.nlm.nih.gov/books/NBK482385/|publisher=StatPearls Publishing|date=2024|location=Treasure Island (FL)|pmid=29494007|first=Roberto M.|last=Soriano|first2=Dana|last2=Penfold|first3=Stephen W.|last3=Leslie|access-date=2024-06-23|archive-date=2024-06-16|archive-url=https://web.archive.org/web/20240616074757/https://www.ncbi.nlm.nih.gov/books/NBK482385/|dead-url=no}}</ref>左肾前上部与[[肝]]相邻，中部与[[胰腺]]尾部和[[脾]]血管相邻，下部靠近[[空肠]]和[[结肠]]左曲；右肾上邻肝脏，中部内侧缘靠近[[十二指肠]]降部，下邻结肠右曲。<ref name=":1" /><ref name=":4" />

=== 形态 ===
人腎臟外型是一內側面凹下的橢圓形扁豆狀器官，如蠶豆般，凹下的位置稱為[[腎門]]（hilus），为肾[[血管]]、[[淋巴管]]、[[神经]]及[[肾盂]]进出之门户，其中肾盂向下移行为[[输尿管]]并连于[[膀胱]]。<ref name=":0" /><ref>{{Cite book|chapter=Renal System|title=Translational Regenerative Medicine|url=https://linkinghub.elsevier.com/retrieve/pii/B9780124103962000335|publisher=Elsevier|date=2015|isbn=978-0-12-410396-2|pages=457–468|doi=10.1016/b978-0-12-410396-2.00033-5|language=en|first=Joao Paulo|last=Zambon|first2=Prafulla|last2=Chandra|first3=Anthony|last3=Atala|first4=James J.|last4=Yoo|access-date=2024-06-23|archive-date=2024-06-15|archive-url=https://web.archive.org/web/20240615031922/https://linkinghub.elsevier.com/retrieve/pii/B9780124103962000335|dead-url=no}}</ref>上述出入肾门的结构为结缔组织所包裹，称[[肾蒂]]，为腹腔镜肾切除术中需要寻找的关键结构之一<ref>{{cite journal |last1=Yang |first1=F |last2=Zhou |first2=Q |last3=Li |first3=X |last4=Xing |first4=N |title=The methods and techniques of identifying renal pedicle vessels during retroperitoneal laparoscopic radical and partial nephrectomy. |journal=World journal of surgical oncology |date=2019-02-22 |volume=17 |issue=1 |pages=38 |doi=10.1186/s12957-019-1580-1 |pmid=30795777}}</ref><ref>{{cite journal |title=后腹腔镜下肾蒂解剖定位的临床研究 |url=https://rs.yiigle.com/cmaid/449191 |journal=中华泌尿外科杂志 |language=zh |date=2011-09-15 |volume=32 |issue=09 |pages=614–616 |doi=10.3760/cma.j.issn.1000-6702.2011.09.010 |issn=1000-6702 |access-date=2024-06-23 |archive-date=2024-06-23 |archive-url=https://web.archive.org/web/20240623194219/https://rs.yiigle.com/cmaid/449191 |dead-url=no }}</ref>，肾蒂中，由人體腹側向背側依序有[[腎靜脈]]、[[腎動脈]]和[[肾盂]]的進出，自上而下则依次有肾动脉、肾静脉和肾盂。<ref name=":0" />肾门向肾内的凹陷称为肾窦，为一充满[[脂肪]]的空间，容纳肾大盏、肾小盏、肾血管和肾盂<ref name=":10">{{Cite book|chapter=Urinary System|title=Comparative Anatomy and Histology|url=https://linkinghub.elsevier.com/retrieve/pii/B9780128029008000166|publisher=Elsevier|date=2018|isbn=978-0-12-802900-8|pages=275–301|doi=10.1016/b978-0-12-802900-8.00016-6|language=en|first=Martha A.|last=Delaney|first2=Jolanta|last2=Kowalewska|first3=Piper M.|last3=Treuting|access-date=2024-06-23|archive-date=2018-06-04|archive-url=https://web.archive.org/web/20180604211715/https://linkinghub.elsevier.com/retrieve/pii/B9780128029008000166|dead-url=no}}</ref><ref name=":1" />，肾窦内丰富的脂肪使之为肾脏内最高回声的结构。<ref>{{Cite journal |last=Cole |first=Laura |last2=Humm |first2=Karen |last3=Dirrig |first3=Helen |title=Focused Ultrasound Examination of Canine and Feline Emergency Urinary Tract Disorders |url=https://linkinghub.elsevier.com/retrieve/pii/S0195561621000851 |journal=Veterinary Clinics of North America: Small Animal Practice |language=en |date=2021-11 |volume=51 |issue=6 |doi=10.1016/j.cvsm.2021.07.007 |access-date=2024-06-23 |archive-date=2022-07-20 |archive-url=https://web.archive.org/web/20220720173223/https://linkinghub.elsevier.com/retrieve/pii/S0195561621000851 |dead-url=no }}</ref>

人类婴儿肾脏的表面通常是凸起且不规则的，有12个小叶<ref name=":8" />，这反映了多个[[肾锥体]]的发育，肾脏中肾锥体的数量因物种而异，如[[啮齿动物]]的肾脏是单锥体的。<ref name=":10" />

由於腎臟除了三個主要的管道連接，沒有其他的[[结缔组织]]固定它在體內的相對位置，因此正常人的腎臟外圍充滿了許多[[脂肪]]減少晃動和撞擊的風險，此外，腎臟上方則有具備重要[[內分泌系統|內分泌]]功能的腎上腺埋在一團[[脂肪組織]]之中。

腎臟最外層由外而內依序有腎筋膜（renal fascia）、脂肪囊（adipose capsule）和一層透著水亮光澤的[[腎囊]]（renal capsule）。
在切开的肾脏中可见肾脏分为浅层暗红色的[[肾皮质]]和深部色浅红的肾髓质两个部分。髓质由多个底向髓质，尖端指向肾窦的圆锥形的结构构成，称为肾锥体。肾锥体尖端形成乳头，将尿液排放到肾小盏中。<ref>{{cite journal |last1=Akilesh |first1=S. |title=Normal Kidney Function and Structure |journal=Pathobiology of Human Disease |date=2014 |pages=2716–2733 |doi=10.1016/B978-0-12-386456-7.05402-2}}</ref>錐體尖端朝向腎臟中央排列約有個

* [[肾皮質]]：腎柱(renal column)、皮質迷路(cortical labyrinth)
* 肾髓質：腎錐體、腎小盞(calyx)、腎大盞、輸尿管(ureter)、髓質放射部
* 腎門(renal hilum)：腎盂(pelvis)
* [[腎單位]]：[[腎小體]]（[[鮑氏囊]]、[[腎小球]]）、腎小管（近曲小管、亨利氏環、遠曲小管）

{| class="wikitable" style="margin: 1em auto 1em auto" align=left
! 編號||名稱|| 解剖示意圖 ||編號||名稱
|-
|1||腎錐體|| rowspan="9" |[[File:Kidney PioM.png|250px]] ||10||腎囊（下部）
|-
|2||葉間動脈||11||腎囊（上部）
|-
|3||腎動脈||12||葉間靜脈
|-
|4||腎靜脈||13||[[腎單位]]
|-
|5||腎門||14||腎竇
|-
|6||[[腎盂]]||15||腎大盞
|-
|7||輸尿管||16||腎乳頭
|-
|8||腎小盞||17||腎柱
|-
|9||腎囊||  ||
|}
{{Clear}}

=== 血流供应 ===
{{主条目|肾动脉}}肾脏的血流来自[[腹主動脈]]在L1至L2椎间盘水平，紧邻[[肠系膜上动脉]]的起点下方向左右各分一支的[[肾动脉]]<ref name=":13">{{Cite book|chapter=Anatomy, Abdomen and Pelvis, Renal Artery|title=StatPearls|url=http://www.ncbi.nlm.nih.gov/books/NBK459158/|publisher=StatPearls Publishing|date=2024|location=Treasure Island (FL)|pmid=29083626|first=Stephen W.|last=Leslie|first2=Hussain|last2=Sajjad|access-date=2022-03-16|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624180526/https://www.ncbi.nlm.nih.gov/books/NBK459158/|dead-url=no}}</ref>。成人双肾的血流量大约为心输出量的20-25%。<ref>{{Cite book|edition=Updated ed|chapter=|publisher=Elsevier Saunders|date=2005|location=Philadelphia, Pa|isbn=978-1-4160-2328-9|first=Walter F.|last=Boron|first2=Emile L.|last2=Boulpaep|title=Medical physiology: a cellular and molecular approach|url=https://archive.org/details/medicalphysiolog0000boro}}</ref><ref>{{Citation|title=Urinary system|date=2015|url=https://www.cambridge.org/core/books/design-of-mammals/urinary-system/E76848B86DA00C151DA92EDD8AB2F418|work=The Design of Mammals: A Scaling Approach|pages=195–203|editor-last=Prothero|editor-first=John William|place=Cambridge|publisher=Cambridge University Press|doi=10.1017/CBO9781316275108.016|isbn=978-1-107-11047-2|access-date=2022-06-25|archive-date=2018-06-17|archive-url=https://web.archive.org/web/20180617094738/https://www.cambridge.org/core/books/design-of-mammals/urinary-system/E76848B86DA00C151DA92EDD8AB2F418|url-status=live}}</ref><ref>{{Cite book|last1=Martini|first1=Frederic|title=Human Anatomy|last2=Tallitsch|first2=Robert B.|last3=Nath|first3=Judi L.|publisher=Pearson|year=2017|isbn=9780134320762|edition=9th|pages=689}}</ref>肾动脉在[[肾静脉]]的后方进入肾门，并在肾门处通常第一次分为前、后两支(干)，较粗的前支再分出4个二级分支，随后支进入肾实质内。以上即为五支[[肾段动脉]]，每支肾段动脉分布到一定区域的肾实质称为肾段，每个肾可分5个肾段，即上段、上前段、下前段、下段和后段。<ref name=":0" /><ref>{{cite web |last1=Bashir |first1=Omar |title=Renal artery {{!}} Radiology Reference Article {{!}} Radiopaedia.org |url=https://radiopaedia.org/articles/renal-artery#:~:text=The%20dorsal%20and%20ventral%20rami,and%20posterior%20segmental%20renal%20arteries. |website=Radiopaedia |access-date=2024-06-24 |archive-date=2022-10-06 |archive-url=https://web.archive.org/web/20221006104737/https://radiopaedia.org/articles/renal-artery#:~:text=The%20dorsal%20and%20ventral%20rami,and%20posterior%20segmental%20renal%20arteries. |dead-url=no }}</ref><ref>{{cite journal |last1=Rani |first1=Neerja |title=Surgical Importance of Arterial Segments of Human Kidneys: An Angiography and Corrosion Cast Study |journal=JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH |date=2014 |doi=10.7860/JCDR/2014/7396.4086}}</ref>各肾段间少血管的段间组织称乏血管带。<ref name=":0" />

肾段动脉延伸至髓質時則成為腎葉間動脈（interlobar a.），並且沿著髓質和皮質的邊界以弧形的樣式延伸成弓狀動脈（arcuate a.），再向腎臟最外圈的皮質區分出許多細小的腎小葉間動脈（interlobular a.）。<ref name="组胚">{{cite book |author1=李继承 |author2=曾园山 |author3=周莉 |author4=周国明 |title=组织学与胚胎学 |publisher=人民卫生出版社 |isbn=978-7-117-26638-3 |pages=170-171 |edition=2018}}</ref>

====变异====

大约30%的人拥有[[副肾动脉]]<ref name=":13" />，副肾动脉通常来自腹主动脉，亦有肠系膜下动脉的报道。<ref>{{Cite journal |last=Ali Mohammed |first=Ammar Mohammed |last2=Elseed Abdalrasol |first2=Rami Gusm |last3=Alamin Abdalhai |first3=Khatim |last4=Gommaa Hamad |first4=Mohamed |title=Accessory renal vessels |url=https://pubmed.ncbi.nlm.nih.gov/23322980 |journal=Acta informatica medica: AIM: journal of the Society for Medical Informatics of Bosnia & Herzegovina: casopis Drustva za medicinsku informatiku BiH |date=2012-09 |volume=20 |issue=3 |doi=10.5455/aim.2012.20.196-197 |issn=0353-8109 |pmc=3508858 |pmid=23322980 |access-date=2024-06-24 |archive-date=2024-06-24 |archive-url=https://web.archive.org/web/20240624180334/https://pubmed.ncbi.nlm.nih.gov/23322980/ |dead-url=no }}</ref><ref>{{Cite journal |last=Ramulu |first=Mutyalapati Venkata |last2=Prasanna |first2=Lokadolalu Chandracharya |title=Accessory renal arteries – Anatomical details with surgical perceptions |url=https://linkinghub.elsevier.com/retrieve/pii/S0003277816300132 |journal=Journal of the Anatomical Society of India |language=en |date=2016-08 |volume=65 |doi=10.1016/j.jasi.2016.06.003 |access-date=2024-06-24 |archive-date=2024-05-25 |archive-url=https://web.archive.org/web/20240525110807/https://linkinghub.elsevier.com/retrieve/pii/S0003277816300132 |dead-url=no }}</ref>在少数情况下，副肾动脉不经过肾门而是从肾表面进入肾脏。<ref name=":13" /><ref>{{Cite journal |last=Aristotle |first=Sharmila |title=Anatomical Study of Variations in the Blood Supply of Kidneys |url=http://www.jcdr.net/article_fulltext.asp?issn=0973-709x&year=2013&volume=7&issue=8&page=1555&issn=0973-709x&id=3203 |journal=JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH |date=2013 |doi=10.7860/JCDR/2013/6230.3203 |pmc=3782894 |pmid=24086837 |access-date=2024-06-24 |archive-date=2024-04-27 |archive-url=https://web.archive.org/web/20240427123347/http://www.jcdr.net/article_fulltext.asp?issn=0973-709x&year=2013&volume=7&issue=8&page=1555&issn=0973-709x&id=3203 |dead-url=no }}</ref>

=== 神經支配 ===
來自迷走神經的副交感神經及交感神經，進入腎臟控制血管平滑肌及腎元。肾脏的传出神经仅由[[交感神经]]构成。<ref>{{Cite book|chapter=Anatomy, Abdomen and Pelvis: Kidney Nerves|title=StatPearls|url=http://www.ncbi.nlm.nih.gov/books/NBK459339/|publisher=StatPearls Publishing|date=2024|location=Treasure Island (FL)|pmid=29083631|first=Joshua J.|last=Kirkpatrick|first2=Spencer|last2=Foutz|first3=Stephen W.|last3=Leslie}}</ref>

==胚胎發育==
{{主条目|{{tsl|en|Kidney development|肾脏发育}}|前肾|中肾|后肾}}与所有泌尿生殖系统的主要器官一致，哺乳动物的肾起源于胚胎早期的[[间介中胚层]]。<ref>{{Cite book|chapter=Stem cells in kidney development and regeneration|title=Principles of Tissue Engineering|url=https://linkinghub.elsevier.com/retrieve/pii/B9780128184226000460|publisher=Elsevier|date=2020|isbn=978-0-12-818422-6|pages=805–823|doi=10.1016/b978-0-12-818422-6.00046-0|language=en|first=Kyle W.|last=McCracken|first2=Joseph V.|last2=Bonventre|access-date=2024-06-24|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624180338/https://www.sciencedirect.com/science/article/abs/pii/B9780128184226000460?via%3Dihub|dead-url=no}}</ref><ref name=":11">{{Cite book|chapter=Development of the Urinary System|title=Reference Module in Biomedical Sciences|url=https://linkinghub.elsevier.com/retrieve/pii/B9780128012383054568|publisher=Elsevier|date=2015|isbn=978-0-12-801238-3|doi=10.1016/b978-0-12-801238-3.05456-8|language=en|first=Bruce M.|last=Carlson|access-date=2024-06-23|archive-date=2018-06-09|archive-url=https://web.archive.org/web/20180609140540/https://linkinghub.elsevier.com/retrieve/pii/B9780128012383054568|dead-url=no}}</ref>人肾的发生可分为[[前肾]]、[[中肾]]、[[后肾]]三个阶段，分别发育与第四周初、第四周末和第五周初，前肾是仅在最低等的脊椎动物中发现的肾脏发育同源物。<ref name=":11" />起源于[[输尿管芽]]和[[生后肾组织]]的后肾最终发育成人体的永久肾，后肾在人胚的第11周即可作为功能性排泄单位，于第32周完成生成。<ref name=":12">{{Cite book|chapter=Embryology, Kidney, Bladder, and Ureter|title=StatPearls|url=http://www.ncbi.nlm.nih.gov/books/NBK547747/|publisher=StatPearls Publishing|date=2024|location=Treasure Island (FL)|pmid=31613527|first=Sana|last=Rehman|first2=Danish|last2=Ahmed|access-date=2024-06-24|archive-date=2023-04-24|archive-url=https://web.archive.org/web/20230424161540/http://www.ncbi.nlm.nih.gov/books/NBK547747/|dead-url=no}}</ref>在发育的第六周，起源于[[中肾管]]的输尿管芽反复分支产生集合小管和肾大盏、肾小盏、肾盂，该分支过程在大约 14 周时完成；<ref>{{Cite book|chapter=Structural and Functional Development of the Kidney|title=Comprehensive Pediatric Nephrology|url=https://linkinghub.elsevier.com/retrieve/pii/B978032304883550012X|publisher=Elsevier|date=2008|isbn=978-0-323-04883-5|pages=91–129|doi=10.1016/b978-0-323-04883-5.50012-x|language=en|first=Tino D.|last=Piscione|first2=Aoife M.|last2=Waters|access-date=2024-06-24|archive-date=2024-04-11|archive-url=https://web.archive.org/web/20240411075224/https://linkinghub.elsevier.com/retrieve/pii/B978032304883550012X|dead-url=no}}</ref><ref name=":12" /><ref>{{Cite book|chapter=URETERAL DUPLICATION, ECTOPY, AND URETEROCELES|title=Pediatric Urology|url=https://linkinghub.elsevier.com/retrieve/pii/B9781416032045000268|publisher=Elsevier|date=2010|isbn=978-1-4160-3204-5|pages=337–352|doi=10.1016/b978-1-4160-3204-5.00026-8|language=en|first=Kenneth G.|last=Nepple|first2=Christopher S.|last2=Cooper|first3=Howard M.|last3=Snyder|access-date=2024-06-24|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624180557/https://www.sciencedirect.com/science/article/abs/pii/B9781416032045000268?via%3Dihub|dead-url=no}}</ref>生后肾组织主要形成肾小囊、近端小管、细端和远端小管，其中，肾小囊与伸入囊中的毛细血管构成的血管球共同构成肾小球。<ref>{{Cite book|title=组织学与胚胎学|last=李继承、曾园山|publisher=人民卫生出版社|year=2018|isbn=978-7-117-26638-3|location=北京|pages=232-234|language=zh-hans}}</ref>

人类肾单位的形成一直持续到接近出生，并最终形成约100万个肾单位(单侧)，出生后肾单位的数量不再增加<ref>{{Cite journal |last=Bertram |first=John F. |last2=Douglas-Denton |first2=Rebecca N. |last3=Diouf |first3=Boucar |last4=Hughson |first4=Michael D. |last5=Hoy |first5=Wendy E. |title=Human nephron number: implications for health and disease |url=http://link.springer.com/10.1007/s00467-011-1843-8 |journal=Pediatric Nephrology |language=en |date=2011-09 |volume=26 |issue=9 |doi=10.1007/s00467-011-1843-8 |issn=0931-041X}}</ref>，并随着衰老逐渐丢失<ref>{{cite journal |last1=Denic |first1=Aleksandar |last2=Lieske |first2=John C. |last3=Chakkera |first3=Harini A. |last4=Poggio |first4=Emilio D. |last5=Alexander |first5=Mariam P. |last6=Singh |first6=Prince |last7=Kremers |first7=Walter K. |last8=Lerman |first8=Lilach O. |last9=Rule |first9=Andrew D. |title=The Substantial Loss of Nephrons in Healthy Human Kidneys with Aging |journal=Journal of the American Society of Nephrology |date=2017-01 |volume=28 |issue=1 |pages=313–320 |doi=10.1681/ASN.2016020154}}</ref>。早产或宫内生长受限的胎儿可能存在肾单位数量减少、肾小球滤过功能下降的问题，更易患肾脏疾病和[[高血压]]。<ref>{{Cite book|chapter=MicroRNAs in Renal Development and Regeneration|title=MicroRNA in Regenerative Medicine|url=https://linkinghub.elsevier.com/retrieve/pii/B9780128207192000119|publisher=Elsevier|date=2023|isbn=978-0-12-820719-2|pages=293–313|doi=10.1016/b978-0-12-820719-2.00011-9|language=en|first=Elise J.|last=Tucker|first2=Darling|last2=Rojas-Canales|first3=Saira R.|last3=Ali|first4=Jonathan M.|last4=Gleadle|access-date=2024-06-24|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624180412/https://www.sciencedirect.com/science/article/abs/pii/B9780128207192000119?via%3Dihub|dead-url=no}}</ref>

== 生理功能 ==
腎臟的基本生理功能為以下五點： 

# 分泌尿液，排出代謝廢物、毒物和藥物：腎血流量約占全身血流量的1/4～1/5左右，腎小球濾液每分鐘約生成120mL，一天總濾液量約170～180L。濾液經腎小管時，99%被回吸收，故正常人尿量約爲1500mL/d。葡萄糖、氨基酸、維生素、多肽類物質和少量蛋白質，在近曲小管幾乎被全部回收，而肌酐、尿素、尿酸及其他代謝產物，經過選擇，或部分吸收，或完全排出。腎小管尚可分泌排出藥物及毒物，如酚紅、對氨馬尿酸、青黴素類、頭孢黴素類等；藥物若與蛋白質結合，則可通過腎小球濾過而排出。
# 調節體內水和滲透壓：調節人體水及滲透壓平衡的部位主要在腎小管。近曲小管爲等滲性再吸收，爲吸收Na+及分泌H+的重要場所。在近曲小管中，葡萄糖及氨基酸被完全回收，碳酸氫根回收70%～80%，水及鈉的回收約65%～70%。濾液進入髓袢後進一步被濃縮，約25%氯化鈉和15%水被回吸收。遠曲及集合小管不透水，但能吸收部分鈉鹽，因之液體維持在低滲狀態。
# 調節電解質濃度：腎小球濾液中含有多種電解質，當進入腎小管後，鈉、鉀、鈣、鎂、碳酸氫、氯及磷酸離子等大部分被回吸收，按人體的需要，以起到维持人体生命活动的作用。
# 調節酸碱平衡：人体血浆的酸碱度取决于其H+浓度。正常人动脉血PH为7.35~7.45。生命活动中，随时机体细胞的代谢不断产生酸性或碱性物质，而机体PH始终保持稳定，这主要依靠体内各种缓冲系统和肺、肾的调节来实现。肾脏通过排出酸性物质、回吸收碱性物质的方式来调节人体体内的酸碱平衡，还可通过控制酸性和碱性物质排出量的比例来维持酸碱平衡。
# 內分泌功能：可分泌不少激素並銷毀許多多肽類激素。腎臟分泌的內分泌激素主要有[[血管活性激素]]和[[腎素]]、[[前列腺素]]、[[激肽]]類物質，參加腎內外血管舒縮的調節；又能生成1，25-二羥維生素D3及紅細胞生成素。總之，腎臟是通過排泄代謝廢物、調節體液、分泌內分泌激素，以維持體內環境穩定，使新陳代謝正常進行。

== 有关疾病 ==
=== 慢性肾病 ===
{{主条目|慢性肾脏病}}[[慢性肾病]]是指随着长期肾功能进行性下降的临床异常状况，即肾脏受损，无法以应有的方式滤过血液。<ref>{{Cite web|title=Chronic kidney disease|url=https://www.nhs.uk/conditions/kidney-disease/|website=nhs.uk|date=2017-10-20|language=en|access-date=2024-06-23|archive-date=2021-01-26|archive-url=https://web.archive.org/web/20210126172751/https://www.nhs.uk/conditions/kidney-disease/|dead-url=no}}</ref><ref>{{Cite book|edition=26th edition|chapter=121: Chronic Kidney Disease|publisher=Elsevier|date=2020|location=Philadelphia, PA|isbn=978-0-323-76018-8|editor-first=Lee|editor-last=Goldman|title=Goldman-Cecil medicine. Volume 1|pages=799}}</ref>全球慢性肾脏病（chronic kidney disease，CKD）患病率约为14.3%，中国患病率约为10.8%。<ref>{{Cite journal |last=中国医师协会肾脏内科医师分会 |last2=中国中西医结合学会肾脏疾病专业委员会营养治疗指南专家协作组 |title=中国慢性肾脏病营养治疗临床实践指南（2021版） |url=https://rs.yiigle.com/cmaid/1311092 |journal=中华医学杂志 |language=zh |date=2021-03-02 |volume=101 |issue=08 |doi=10.3760/cma.j.cn112137-20201211-03338 |issn=0376-2491 |access-date=2024-06-23 |archive-date=2024-06-23 |archive-url=https://web.archive.org/web/20240623122327/https://rs.yiigle.com/cmaid/1311092 |dead-url=no }}</ref>据新华社2021年报道，中国每十个成年人就有一人患慢性肾脏病。<ref>{{Cite web|title=生命不能承受之“重”：一亿多人的肾怎么了？-新华每日电讯|url=http://www.xinhuanet.com/mrdx/2021-03/12/c_139805015.htm|website=www.xinhuanet.com|access-date=2024-06-23|archive-date=2024-06-23|archive-url=https://web.archive.org/web/20240623122327/http://www.xinhuanet.com/mrdx/2021-03/12/c_139805015.htm|dead-url=no}}</ref>[[糖尿病]]和[[高血压]]是慢性肾病的两个最常见病因。<ref>{{Cite journal |last=Drawz |first=Paul |last2=Rahman |first2=Mahboob |title=Chronic Kidney Disease |url=https://www.acpjournals.org/doi/10.7326/AITC201506020 |journal=Annals of Internal Medicine |language=en |date=2015-06-02 |volume=162 |issue=11 |doi=10.7326/AITC201506020 |issn=0003-4819 |pmc=4747330 |pmid=26030632 |access-date=2024-06-23 |archive-date=2022-12-26 |archive-url=https://web.archive.org/web/20221226181006/https://www.acpjournals.org/doi/10.7326/AITC201506020 |dead-url=no }}</ref>

=== 终末期肾病 ===
[[终末期肾病]]（end-stage renal disease）指各种慢性肾脏疾病的终末阶段，患者肾功能已不足以在不进行[[肾移植]]或[[透析]]的情况下长期生存<ref name=":6">{{Cite journal |last=Wouk |first=Noah |title=End-Stage Renal Disease: Medical Management |url=https://pubmed.ncbi.nlm.nih.gov/34783494 |journal=American Family Physician |date=2021-11-01 |volume=104 |issue=5 |issn=1532-0650 |pmid=34783494 |access-date=2024-06-23 |archive-date=2024-06-23 |archive-url=https://web.archive.org/web/20240623182750/https://pubmed.ncbi.nlm.nih.gov/34783494/ |dead-url=no }}</ref>，俗称“[[尿毒症]]”<ref>{{Cite web|title=认识终末期肾炎|url=https://www.rmhospital.com/article/id/6972.html|website=www.rmhospital.com|date=2020-08-27|language=zh-hans|author=王玉娟|access-date=2024-06-23|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624180357/https://www.rmhospital.com/article/id/6972.html|dead-url=no}}</ref>。在美国，大约有 100 万患者患有终末期肾病，[[肾移植]]是该病目前唯一的治愈性治疗方法<ref name=":5" />，大多数患者接受透析治疗。<ref name=":6" />

=== 多囊肾病 ===
{{主条目|多囊性腎病變}}[[多囊性腎病變|多囊肾病]]是由基因突变所导致的一类遗传性肾病，按遗传方式可分为常染色体显性多囊肾病和常染色体隐性多囊肾病。常染色体显性多囊肾病是最常见的遗传性肾脏疾病<ref name=":9">{{Cite book|chapter=Structure and Function of the Kidneys|title=Renal Physiology|url=https://linkinghub.elsevier.com/retrieve/pii/B9780323086912000028|publisher=Elsevier|date=2013|isbn=978-0-323-08691-2|pages=15–26|doi=10.1016/b978-0-323-08691-2.00002-8|language=en|first=Bruce M.|last=Koeppen|first2=Bruce A.|last2=Stanton|access-date=2024-06-23|archive-date=2024-04-11|archive-url=https://web.archive.org/web/20240411122731/https://linkinghub.elsevier.com/retrieve/pii/B9780323086912000028|dead-url=no}}</ref>，新生儿患病率约为1/1000，常染色体隐性多囊肾病在新生儿中的发病率约为1/26500。<ref name=":2">{{Cite journal |last=中华医学会医学遗传学分会遗传病临床实践指南撰写组 |last2=徐德超 |last3=梅长林 |title=多囊肾病的临床实践指南 |url=https://rs.yiigle.com/cmaid/1190176 |journal=中华医学遗传学杂志 |language=zh |date=2020-03-10 |volume=37 |issue=03 |doi=10.3760/cma.j.issn.1003-9406.2020.03.009 |issn=1003-9406 |access-date=2024-06-23 |archive-date=2024-06-23 |archive-url=https://web.archive.org/web/20240623123753/https://rs.yiigle.com/cmaid/1190176 |dead-url=no }}</ref>该病主要是由PKD1（85%的病例）和PKD2（约15%）基因突变引起，主要表现为肾脏肿大，形成数百至数千个直径可达20厘米的肾囊肿<ref name=":9" />，最终将导致[[终末期肾病]]<ref name=":2" />。

=== 肾性贫血 ===
[[肾性贫血]]是指各种肾脏病致肾功能下降时，肾脏[[红细胞生成素]]生成减少及血浆中一些毒性物质干扰[[红细胞]]生成并缩短其寿命而导致的[[贫血]]。<ref name=":3">{{Cite journal |last=中华医学会肾脏病学分会肾性贫血诊断和治疗共识专家组 |title=肾性贫血诊断与治疗中国专家共识（2018修订版） |url=https://rs.yiigle.com/cmaid/1079950 |journal=中华肾脏病杂志 |language=zh |date=2018-11-15 |volume=34 |issue=11 |doi=10.3760/cma.j.issn.1001-7097.2018.11.012 |issn=1001-7097 |access-date=2024-06-23 |archive-date=2024-06-23 |archive-url=https://web.archive.org/web/20240623125916/https://rs.yiigle.com/cmaid/1079950 |dead-url=no }}</ref>肾性贫血是慢性肾病的常见并发症，中国约有50%以上慢性肾病病人合并贫血。<ref name=":3" />该病通常在肾功能丧失超过 50% 后发生，贫血的严重程度会随着慢性肾脏病的进展而恶化。<ref>{{Cite book|chapter=Anemia of Chronic Renal Disease|title=StatPearls [Internet]|url=https://www.ncbi.nlm.nih.gov/books/NBK539871/|publisher=StatPearls Publishing|date=2023-02-24|pmid=30969693|language=en|first=Hira|last=Shaikh|first2=Muhammad F.|last2=Hashmi|first3=Narothama R.|last3=Aeddula|access-date=2024-06-23|archive-date=2023-08-09|archive-url=https://web.archive.org/web/20230809075102/http://www.ncbi.nlm.nih.gov/books/NBK539871/|dead-url=no}}</ref>

=== 肾结石 ===
{{主条目|肾结石}}肾结石是[[尿液]]中的矿物质[[过饱和]]形成的结晶在肾盂和肾盏内沉积所致。<ref>{{Cite web|title=审“石”度势 带你认识肾结石|url=https://www.beijing.gov.cn/fuwu/bmfw/jhsyfwzdzx/jkbj/dt/202306/t20230609_3129109.html|website=北京市人民政府门户网站|date=2023-06-09|language=zh|author=北京市卫生健康委员会|url-status=no|access-date=2024-06-24|archive-date=2024-06-24|archive-url=https://web.archive.org/web/20240624040742/https://www.beijing.gov.cn/fuwu/bmfw/jhsyfwzdzx/jkbj/dt/202306/t20230609_3129109.html}}</ref>较小的肾结石通常是无症状的，较大的肾结石可引起腹部或腹股沟一侧疼痛的疼痛、高热、[[血尿]]等症状。<ref>{{cite web |title=Kidney stones - Symptoms |url=https://www.nhs.uk/conditions/kidney-stones/symptoms/ |website=nhs.uk |language=en |date=2017-10-23 |access-date=2024-06-24 |archive-date=2024-03-04 |archive-url=https://web.archive.org/web/20240304112224/https://www.nhs.uk/conditions/kidney-stones/symptoms/ |dead-url=no }}</ref>

== 节日 ==

=== 世界肾脏日 ===
{{主条目|世界肾脏日}}
[[国际肾脏病学会]]和[[国际肾脏基金联盟]]联合提议设立每年3月份的第二个星期四为[[世界肾脏日]]<ref>{{Cite web|title=世界肾脏日|url=http://www.nhc.gov.cn/jnr/szjrjj/szj_lmtt.shtml|website=[[中华人民共和国国家卫生健康委员会]]|language=zh-hans|url-status=no|access-date=2024-06-23|archive-date=2022-10-27|archive-url=https://web.archive.org/web/20221027201109/http://www.nhc.gov.cn/jnr/szjrjj/szj_lmtt.shtml}}</ref>，旨在提高全世界人们对肾脏疾病的认识，从而减少肾脏病的发生率及肾脏相关疾病对健康造成的影响。<ref name=":7" /><ref>{{Cite web|title=Homepage|url=https://www.worldkidneyday.org/|website=World Kidney Day 2024|language=en-GB|access-date=2024-06-23|archive-date=2024-06-01|archive-url=https://web.archive.org/web/20240601184839/https://www.worldkidneyday.org/|dead-url=no}}</ref><ref name=":7">{{Cite web|title=世界肾脏日_中华医学会肾脏病学分会|url=https://csnchina.cma.org.cn/cn/page.asp?pageid=46.html|website=csnchina.cma.org.cn|language=zh|access-date=2024-06-23|archive-date=2023-04-01|archive-url=https://web.archive.org/web/20230401042047/https://csnchina.cma.org.cn/cn/page.asp?pageid=46.html|dead-url=no}}</ref>

==圖集==
<gallery>
File:Slide22222.JPG| 腎後視圖
File:Slide42222.JPG|左腎前壁關聯圖
File:Blausen 0593 KidneyAnatomy 02.png|腎臟的結構
File:Blausen 0592 KidneyAnatomy 01.png|腎臟解剖學

File:Kidney Cross Section.png|腎橫斷面
</gallery>
{| class="wikitable collapsible collapsed"
|-
!解剖圖像
|-
| <gallery>
File:Slide4nn.JPG|右腎
File:Slide5pp.JPG|腎臟
File:Slide3ppp.JPG|右腎
File:Right kidney.jpg|右腎
File:Left kidneys.jpg|左腎
File:Kidneys.jpg|腎臟
File:Left kidney.jpg|左腎
</gallery>

|}

== 参见 ==
* [[腎臟科]]
* [[腎單位]]（又称'''肾元'''，由'''[[腎小體]]'''和'''肾小管'''组成）
* [[肾素]]
* [[腎結石]]
* [[腎炎]]
* [[腎毒性]](Nephrotoxicity)
* [[腎萎縮]]
* [[肾移植]]

==参考文献==
{{reflist}}

== 外部链接 ==
{{wikt|肾}}
{{Commons category|Kidneys}}
*[https://web.archive.org/web/20150524115359/http://hilzbook.com/organs/kidney/ The Kidney in 3D Viewer - At Hilzbook]
*[http://www.nephcure.org The NephCure Foundation offers educational materials on the kidney diseases/conditions Nephrotic Syndrome and FSGS] {{Wayback|url=http://www.nephcure.org/ |date=20201003092333 }}
*[http://www.kidney.ca The Kidney Foundation of Canada] {{Wayback|url=http://www.kidney.ca/ |date=20191006094737 }}
*[http://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/EM/EMNiereE.html electron microscopic images of the kidney (Dr. Jastrow's EM-Atlas)] {{Wayback|url=http://www.uni-mainz.de/FB/Medizin/Anatomie/workshop/EM/EMNiereE.html |date=20090914015501 }}
*[https://web.archive.org/web/20070928013749/http://www.euregene.org/euregene/pages/kidney_tut_e.html European Renal Genome project kidney function tutorial]
*[https://web.archive.org/web/20070928012124/http://www.kidneyquebec.ca/ang/kidney_disease/index.htm Kidney Foundation of Canada kidney disease information]
*[http://www.perhealthy.com/long-take-pass-kidney-stone/ How long does it take to pass a Kidney Stone?] {{Wayback|url=http://www.perhealthy.com/long-take-pass-kidney-stone/ |date=20161107023008 }}
*[http://www.kidney-stone.us Kidney Diseases] {{Wayback|url=http://www.kidney-stone.us/ |date=20170912082340 }}
*[http://www.redurine.com/urinary_tract/kidney_facts.html Kidney Information] {{Wayback|url=http://www.redurine.com/urinary_tract/kidney_facts.html |date=20201222083454 }}
*[https://web.archive.org/web/20101229000953/http://www.davita.com/kidney_animation/ Animated Presentation on Kidney Function]
*[http://www.ctcases.net/ct-cases-database/4%20Abdomen%20And%20Pelvis/6%20Kidneys/ CAT Scans of various kidney diseases and conditions] {{Wayback|url=http://www.ctcases.net/ct-cases-database/4%20Abdomen%20And%20Pelvis/6%20Kidneys/ |date=20120105014829 }} - CT Cases
*[http://www.mountsinai.org/patient-care/service-areas/urological-conditions-and-surgery/areas-of-care/kidney-disease-program Kidney Stones; Information and Treatments] {{Wayback|url=http://www.mountsinai.org/patient-care/service-areas/urological-conditions-and-surgery/areas-of-care/kidney-disease-program |date=20131006022453 }}
*[https://radiology-universe.org/calculator/pediatric-kidney-sizes/calculator.php Pediatric Kidney Size Percentile Calculator and Normal Size Range for Age] {{Wayback|url=https://radiology-universe.org/calculator/pediatric-kidney-sizes/calculator.php |date=20210124212531 }}

{{人體系統與器官|state=collapsed}}
{{泌尿系統}}

{{Authority control}}
[[Category:腹部]]
[[Category:器官]]
[[Category:內分泌系統]]
[[Category:泌尿系統]]