47 Obligatory reabsorption and secretion in the proximal convoluted tubule Flashcards
Where does most of the recovery of ions, sugars, amino acids, peptides and a considerable amount of the total water occur?
First part of proximal tubule
What is the function of proximal tubule?
- Recovery of ions, sugars, amino acids, peptides and a considerable amount of the total water
- Actively secretes compounds for urinary excretion
- Metabolises amino acids
What are the two pathways molecules and ions might take across the tubule epithelium?
- Transcellular route (through the cell body)
2. Paracellular route (through the leaky ‘tight’ junctions between cell bodies)
What are the 5 forces involved in obligatory reabsorption from the proximal tubule?
- ION GRADIENTS across the basolateral membrane - active transport 3Na out 2K in
- This sets up an ELECTROCHEMICAL GRADIENT ~ -3mV (tubule lumen -ve; causes paracellular efflux of cations)
- OSMOTIC GRADIENT set up by pumping Na out of the cell into the interstitial space
- SOLVENT DRAG - water moving along the paracellular path due to osmotic pressure drags solutes along with it
- Chemical concentration of solutes left behind when water leaves the tubule facilitates a CHEMICAL GRADIENT
What occurs at ion gradients across the basolateral membrane?
Active transport 3Na out 2K in
What is the electrochemical gradient and what does is cause?
- 3mV
Tubule lumen -ve; auses paracellular efflux of cations
How is the osmotic gradient set up?
Pumping Na out of cell into the interstitial space
What is solvent drag?
Water moving along the paracellular path due to osmotic pressure drags solutes along with it
How is chemical gradient facilitated?
Chemical concentration of solutes left behind when water leaves the tubule
Different transport mechanisms at the proximal convoluted tubule cell?
- Sodium pump
- Co-transport
- Counter transport (exchange)
What does the sodium pump do?
- Active transport
- Sets up Na+ concentration gradient
- Gradient used by cell to transport other substances (secondary active transport)
What does co-transport with sodium do?
Moves substances into cell
What does counter transport (exchange) do with sodium do?
Moves substances out of cell
Movements of components occurring at the proximal convoluted tubule?
- The sodium pump decreases [Na+]i
- Sodium conc. gradient is used by the Na+/H+ exchanger to transport H+ OUT of the cell (against its conc. gradient)
- H+ combines with filtered bicarbonate to produce carbonic acid which breaks down to H2O and CO2
- H2O and CO2 diffuse into the cell
- H2O and CO2 produce H+ and bicarbonate
- H+ leaves cell (see note 2) into tubule lumen
- On basolateral membrane chloride, bicarbonate and potassium leave down their concentration gradients
- On basolateral membrane Ca2+ is exchanged for Na+. Ca2+ leaves the cell against its conc. gradient
- On apical membrane, Ca2+ enters through a Ca2+ channel. Also via paracellular route
- Entry of other solutes: coupled to Na+ entry on apical membrane; facilitated diffusion on the basolateral membrane.
- Solvent drag: Due to osmotic gradient from lumen to ISF. Movement of water (solvent) drags other ions through the paracellular route
What is “transport maximum”?
The limit of how much solute can be moved across the proximal convoluted tubule
(Tm or Tmax)
What is Tm/ Tmax measured in?
mg/min or mol/min (rate)
When can Tmax be exceeded?
• If blood conc. is high
-e.g. Glucose/ diabetes mellitus
• Increased plasma conc. or GFR
How does exceeding Tmax affect reabsorption and excretion?
Ion/component remains in fluid in tubule and is excreted in urine
Amount filtered (mg/min) =
Plasma conc. (mg/ml) x GFR (ml/min)
What is the threshold?
Point at which the amount filtered is equivalent to Tmax