Gentile da Foligno was an influential professor and teacher of medicine at the Universities of Bologna, Padua, Siena and Perugia in the first part of the 14th century. He was one of the first physicians to perform human dissection. He authored many important texts and commentaries, among which is the Consilla, a collection of therapeutic advices for many diseases. He made a commentary on Carmina de urinarum iudiciis (Songs of urinary judgements) and to De pulsibus (About pulses) composed by Egidius Corbaliensis. This work is more than a commentary: it is a text attempting to conceptualise the physiology of urine formation. According to his writing, urine associated to the blood passes ‘per poros euritides’ (through the porous tubules) of the kidney and is then delivered to the bladder. Commenting and explaining the writing on De pulsibus, he stressed the importance of heart disease on modulating the colour and output of urine and the relationship between fast pulse rate and urine output. For the originality of his thought and for the conceptualization of the relationship between pulse rate and urine characteristic, Gentile da Foligno could be indicated as the ‘first’ cardionephrologist in the history of medicine.