05/01/2011

Water and Solute Movement

1. Ion and Water Transport in the nephron.

Proximal Convoluted Tubule:

1) Returns water and dissolved chemicals to the bloodstream,
permeable to water and moderately permeable to most dissolved substances
including urea.
2) Na+ and glucose are co-transported across the cells of the proximal
tubule into the blood, thus returning large amounts of glucose to the
bloodstream.

Proximal
The descending part of the Loop of Henle is very permeable to water
and thus water diffuses into the interstitial fluid, concentrating the still dilute
filtrate, as the filtrate passes down the tubule.
Most of the water moves into the interstitial fluid at the start because
the filtrate is most dilute there and diffusion depends upon the difference in
water concentration between the filtrate (high water conc.) and the
interstitial fluid (lower water concentration).
-As urine moves deeper in the descending tubule, water movement
from the tubule is less, but not zero. The filtrate becomes more
concentrated, but the interstitial fluid is also more concentrated than at the
top of the tubule. Water still diffuses from the filtrate to the interstitial fluid.

The ascending portion of the Loop of Henle is quite impermeable to

water, becoming particularly so in the upper portion with a thickened wall.
-Sodium and chloride passively move out of the filtrate in the thin
portion of the ascending tubule and actively in the thick portion and the
distal tubule and into the interstitial fluid surrounding the nephron. The
water is left behind, making the filtrate more dilute again, even more dilute
than when it entered the descending tubule but with MUCH LESS VOLUME.
 The gradient of osmolarity in the interstitial fluid is produced
by the "vasa recta" capillary network. (Blood flow enters the glomerulus
from the afferent arteriole and leaves via the efferent arteriole, and finally
goes into the "vasa recta" network of capillaries which twist and branch
around the ascending and descending tubules. The blood enters the
network at the ascending tubule and leaves from the descending
tubule, thus the blood moves in the OPPOSITE DIRECTION TO THE
URINE.)

Sodium ions pumped out of the ascending tubule enter the blood
stream, thus increasing the concentration of sodium in the blood. When the
blood reaches the inner medulla, sodium concentration in the blood is high,
causing sodium to flow out of the blood and into the interstitial fluid. Since
the inner medullary portion of the Loop of Henle is impermeable to sodium,
sodium stays in the interstitial fluid and creates the gradient of high
osmolarity in the medullary portion of the interstitial fluid and lower
osmolarity in the outer medullary and cortex regions of interstitial fluid.
Now we have set up a gradient of interstitial fluid osmolarity as a
result of the asymmetry in water permeability and sodium chloride
movement between descending and ascending tubules.

Now, the collecting duct goes "down" again, water progressively

diffuses out of the collecting duct into the more "concentrated" interstitial
fluid and the result is concentrated urine with low volume. (Eckert, Fig. 14-
34)
3. Renin-Angiotensin-Aldosterone System.

This system is helps maintain arterial blood pressure when blood

volume decreases, for example if there is blood loss.

The afferent arteriole acts as a pressure receptor, causing secretion of

renin when blood flow is low.
 Low salt concentrations detected by the macula densa also cause renin
secretion. This leads to a complicated chain of events, including Angiotensin
II causing arteriolar vasoconstriction and increased blood pressure. The
adrenal gland releases Aldosterone, causing reduction in excretion of sodium
chloride and thus a decrease in water excretion. (You should know what the
following do: Macula densa, Renin, Angiotensin I and II, ACE, Aldosterone,
ADH.)

3. Diuretics cause increased output of urine, sometimes by preventing

sodium transport from the tubules.