IV: Urine-Concentrating Mechanism in the Inner Medulla Flashcards
Lack of water effects on plasma osmolarity, ADH and concentration of urine
Increased plasma osmolarity
Increase ADH
Concentrated urine = less volume
Excess water effect on plasma osmolarity, ADH, and urine concentration
Decreased plasma osmolarity
Decreased ADH
More diluted urine
ADH stimulates
Water reabsorption
Why is it dangerous to drink high V of water
Because of decreased plasma osmolarity
How do you prevent peeing overnight
There is ADH increase (increase in water reabsorption)
What occurs to ADH during dehydration, vomiting, diahrrea
Increase in plasma osmolarity
Increase in ADH
Function of Loop of Henle in concentrating/diluting urine
It generates + maintains an intersticial osmotic gradient
Osmotic gradient at renal cortex
290mOsm/Kg
Osmotic gradient at tip of medulla
1200 mOsm/kg
What does an increase in interstitial osmolarity do to the movement of H2O
It pulls the remaining H2O from descending structures
At loop of Henle 20% of H2O is reabsorbed
Descending limb is permeable/impermeable to H2O
Permeable
Ascending limb is permeable/impermeable to H2O
Impermeable
Concentration of tubular fluid as it descends limb
It becomes more concentrated as it loses H2O
Concentration of tubular fluid as it ascends the limb
It gets more diluted as it loses solutes
Where is the maximum osmotic gradient in loop of henle
At tip of medulla
Low osmotic gradient on ascending limb because
Na+ is diffusing out and due to impermeability no H2O can get in
Countercurrent multiplication used to
Generate an osmotic gradient to reabsorb H2O from descending tube and concentrate urine
Single effect in generating osmotic gradient
NaCl- are reabsorbed in descending loop = hyperosmolarized interstitium
This causes H2O in descending limb to passively diffuse into interstitium
Countercurrent multiplication, reabsorption of H2O is all
ADH DEPENDENT
Urea is produced by the
Liver
From what is urea formed
NH4+
How is urea filtrated in glomerulus
Freely filtrates
Where is part of urine reabsorbed
In proximal tubule
In thin limb of loop of henle, urea is
Secreted from interstitium to renal tubule
What transporter is used for urea to get to loop of henle
UT-A2
What part is impermeable to urea
Thick ascending loop of henle
UT-A1 and UT-A3 location and function
At medullary collecting duct and allow PASSIVE reabsorption of urea into interstitium
Urea reabsoprtion is ADH dependent?
Yes
% of urea contribution to osmolarity of medullary interstitium
40-50%
Is urea reabsorbed along with H2O in distal tubule and cortical collecting duct?
No
How does interstitial osmolarity reach 1200mOsm/KL at tip of medulla?
Due to urea recycling
Blood flow of vasa recta
Opposite to tubular flow
Function of vasa recta
Prevent absorbed H2O from diluting the interstitium
H2O passes directly to vasa recta
Another reason, H2O related, of why medullary osmolarity reaches 1200mOsm/KL
Because H2O directly crosses to vasa recta so it does not dilute the interstitium
Where is ADH synthesized
In hypothalamo
When is ADH synthetised
Increase plasma osmolarity (decreased H2O concentration)
Decreased blood pressure (Dehydration, hemorrhage)
Which receptors and organs sense changes in plasma osmolarity and blood pressure
V1 and V2 receptors in vascular smooth muscle
And kidney
Where are V2 receptors located
In kidney in basolateral membrane of principal cells
What allows reabsorption of H2O
AQP2 which are driven by increase in interstitial osmolarity (decrease of water)
What does ADH stimulate in thick ascending limb
Urea reabsorption (UT-A2) Na+ transport
W/ ADH Urea: Volume: H2O: Osmolarity:
Less urea
Decreased volume
Decreased H2O
Higher osmolarity
W/O ADH Urea: Volume: H2O: Osmolarity:
Increased urea
Increased volume
Increased H2O
Decreased osmolarity
ADH Control: increase in osmolarity (sensor receptor)
Increase in osmolarity = decreased H2O (we need more ADH)
OSMORECEPTORS in hypothalamus
ADH Control: Decreased blood pressure
We need more ADH
Baroceptors in atrium and carotid arch
Water loss tightly regulated by
ADH
How much do adults eliminate from catabolism
600mOsm/d
Maximum concentration of urine
1200mOsm/d
0.5L/d
Mechanism to ensure that we lose a min. amount of liquid a day
Thirst mechanism
Main mechanism to control [Na+] and osmolarity
ADH and thirst