Aldosterone and distal tubule

Calvin Chong

Two major players

Presence of ENaC (Epithelial sodium channel) Concentration gradient of Na across the collecting duct border

GNa = Positive

Na

Na ingestion high, Hypoaldosteronism (Aldosterone LOW) Diuretics, Congenital salt-wasting disorders (Aldosterone HIGH)

GNa = Negative

Na

Low salt intake, hypovolaemia, decreased renal perfusion etc.

ENaC present

Na

Aldosterone Present (ENaCs are induced by Aldosterone)

ENaC

Other players
Cellular K ROMK channel
Permits potassium ion flowing down its electrochemical gradient Usually cells are negative with respect to tubular fluid i.e. only when depolarization occur will potassium flow out

GNa negative
Na

In the absence of ENaC, nothing happens In the presence of ENaC, sodium will not flow into the cells. Aldosterone present: Hypovolaemia Aldosterone absent: Hypoaldosteronism, etc.

ENaC

GNa Positive
N a N a

ENaC present: Na will flow in and depolarize membrane Potassium will flow out
Hypokalaemia Diuretics, Congenital tubular diseases

ENaC

ENaC absent: Sodium cannot flow in No potassium leak out

No hypokalaemia High salt intake Volume loaded persons