RENAL TRANSPORT MECHANISM

NaCL AND WATER REABSORPTION ALONG THE NEPHRON

OBJECTIVE 1.Explain the three processes involved in the production of urine a. filtration b. reabsorption c. secretion.. 2.Describe the magnitude of the processes of filtration and reabsorption by the nephron. 3.Describe the composition of normal urine. 4.explain the basic transport mechanisms present in each nephron segment. 5.Describe how water reabsorption is coupled to Na+ reabsorp tion in the proximal tubule. 6.Explain how solutes, but not water , are reabsorbed by the thick ascending limb of Henles loop.

OBJECTIVE - COUNT.
7. Describe how Starling forces regulate solute and water reabsorption across the proximal tubule. 8. Explain glomerulotubular balance and its physiological significance . 9. Identify the major hormones that regulate NaCl and water reabsorption by its nephron segment

COMPOSITION OF URINE SUBSTANCE CONCENTRATION

Na+ K+ NH4Ca++ Mg++ Cl PO4 Urea Kreatinin pH Osmolality others

50 - 150 meq/l 20 - 70 meq/l 30 - 50 meq/l 5 - 12 meq/l 2 - 18 meq/l 50 - 130 meq/l 20 - 40 meq/l 200 400 mM 6 - 20 mM 5 - 7 500 - 800 mOsm/Kg H2O 0

MECHANISMS OF SOLUTETRANSPORT

PASSIVE . Spontaneous , down an electrochemical gradient no energy requirement. Diffusion Facilitated diffusion ion channel Uniport Coupled transport Antiport Symport

ACTIVE Against an electrochemical gradient, requires direct input of energy Active transport Endocytosis.

Tubuler fluid
Paracelluler pathway Lateral intercellular space

blood

Transcelluler pathway

Tight junction

Na+
ATP

Na+ K+
ATP Apical cell membrane ATP

Na+
Basolateral membrane

Capillary Basement membrane

Tubular fluid

blood

Na+ X Na+ H+
CA

ATP K+
X

Na+

HCO3

CO2 + H2O

First half of proximal tubule

Tubular fluid

0rganics

Na+ Clblood

NaCl H2O

Na+
Clorga nics

org anic

Na+ ClH2O

organics

H2O

Na+ Cl-

Tubular fluid

Second half of proximal tubule blood

CLNa+ Na+ Na+ H base ClK+ ClNa+ ATP

H+ Hbase Base
Cl-

K+

ClNa+

Some organic secreted by the proximal tubule

Endogenous anions cAMP Bile salts Hippurate(PAH) Oxalate Prostaglandins Urate Drug acetazolamide chlorothiazide furosemide penicillin probenecid salicylate(aspirin) hidrochlorthiazide bumetanide

Some organic cations secreted by the proximal tubule

Endogenous cations Creatinine Dopamine Epinephrine Norepinephrine Drugs atropine isoproterenol cimetidine morphine quinine amiloride

Tubular fluid

BLOOD

Na+ APAH OAK+

Na+ Di/tri carboxylase

ATP

Di/tri carboxylase

PAH(OA-)

HENLES LOOP

-Reabsorbs approimately 20 % of filtered Na+, Cl and K+ -Ca+, HCO3- and Mg++ -Exclusively in the thick ascending limb -The ascending thin limb and descending thin limb does not reabsorbs. -water is reabsorbed exclusively in the descending thin limb -The ascending limb is impermiable to water

Tubulalar fluid

blood

Na+ 2ClK+ Na+

ClK+ K+ H+ CA
CO2 + H2O

ATP
K+
HCO3

Na+

+
Na+ K+ Ca++ MG++ Paracellular diffusion

DISTAL TUBULE AND COLLECTING DUCT

Reabsorb approximately 12 % of the filtered Na+ and ClSecrete variable amount of K+ and H+ The first segment: reabsorbs Na+.Cl- and Ca++ and its impermiable to water. The last segment of distal tubule and collecting duct: reabsorb ed Na+ and water and secrete K+(princial cell) Intercalated cell secrete H+ and reabsorb HCO3- and K+

Tubular fluid

EARLY SEGMENT OF THE DISTAL TUBULE blood

Na+
Cl-

Na+
ATP ClK+

H2O

DISTAL TUBULE AND COLLECTING DUCT

Tubular fluid
Na+ Principal cell ATP K+ Na+

blood

K+

Tubular fluid
Intercalated cell ATP H+ CA HCO3

blood

CO2 + H2O

REGULATION OF NaCL AND WATER REABSORPTION

Tubular fluid
Interstitial space

blood

3 2 1 P is IIcap P cap

II is

Basement membrane

1. STARLING FORCES 2. GLOMERULOTUBULAR BALANCE 3. HORMONES 4. SYMPHATIC NERVOUSN SYSTEM

HORMONES that regulate NaCl and water reabsorption

SEGMENT Prox.tubule Thick Asc. limb HORMONE angiotensin II glucocorticoids Aldosteron vasopressin EFFECTS NaCl NaCl NaCl NaCl H2O H2O

Distal Tub./ Collecting Duct

aldosteron atrial natriuretic Pep. prostaglandin bradikynin vasopressin

NaCl NaCl NaCl NaCl NaCl

H2O H2O

H2O