Obligatory Reabsorption and Secretion in PCT Flashcards

1
Q

Describe the transport of urea

A
  • filtered out in glomerulus
  • 50-60% reabsorbed in PCT
  • rest is recycled through more distal tubule segments
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2
Q

Describe the transport of lipid soluble substances

A

simple diffusion through membrane

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3
Q

Describe the transport of phosphate/sulphate

A
  • sodium-linked transport in proximal tubule

- regulated by parathyroid hormone

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4
Q

Describe the transport of proteins/peptides

A
  • almost all is reabsorbed and degraded in proximal tubule

- rest digested to amino acids within tubule and taken up by tubular epithelial cells

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5
Q

How much of each solute is obligatorily reabsorbed in the proximal tubule?

A
  • glucose, amino acids, lactate = 100%
  • water = 65%
  • HCO3- = 90%
  • Cl- = 50%
  • K+ = 55%
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6
Q

What are the different pathways ions can travel to go across proximal tubule epithelium?

A
  • transcellular (through cell body)

- paracellular (through leaky tight junctions between cell bodies)

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7
Q

What are the forces involved in the obligatory reabsorption from the proximal tubule?

A
  • electrochemical gradient across apical and basolateral membranes
  • sodium gradient across apical membrane
  • early proximal tubule has transepithelial potential (-3mV)
  • osmotic gradient from pumping sodium into interstitial space and glucose/amino acids/carboxylic acids moving down concentration gradient
  • solvent drag
  • chemical gradients for other solutes generated by chemical concentration of solutes left behind after water leaves
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8
Q

What is solvent drag?

A

when water moves along osmotic gradient along paracellular path and drags solutes along with it

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9
Q

How is the electrochemical gradient established?

A
  • active transport through Ma/K-ATPase
  • K+ efflux across basolateral membrane
  • creates membrane potential
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10
Q

What is the sodium gradient used to power?

A

active uptake of filtered glucose, amino acids, phosphate, sulphate and carboxylic acids (electrogenic)

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11
Q

Describe the cells found in the proximal tubule (S1)

A
  • columnar cells joined by leaky tight junctions
  • brush border of microvilli on apical membrane
  • infoldings on basolateral membrane
    ^ both increase surface area for absorption and secretion
  • asymmetrical distribution of proteins between apical and basolateral membrane
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12
Q

Describe the movement of solutes into and out of the cell at apical membrane

A
  • sodium pump decreases intracellular Na
  • Na/H exhanger uses sodium concentration gradient to transport H+ out of cell
  • H+ binds with filtered bicarbonate to produce carbonic acid which breaks down into H20 and CO2
  • both diffuse into cell and dissociate into H+ and bicarbonate
  • H+ leaves cell into tubule lumen
  • Ca2+ enter through Ca2+ channel
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13
Q

Describe the movement of solutes into and out of cell at basolateral membrane

A
  • chloride, bicarbonate and potassium leave down concentration gradients
  • Ca2+ is exchanged for Na+
  • Ca2+ leaves cell against concentration gradient but driven by electrochemical gradient
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14
Q

How are additional solutes transported into and out of the cell?

A

Entry:

  • at apical membrane: coupled to Na+ entry
  • at basolateral membrane: facilitated diffusion
  • their own transporters and channels
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15
Q

What is transport maximum?

A
  • the point where increasing the concentration of a substance does not increase movement of it across the cell membrane
  • measured in mg/min or mmol/min
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16
Q

When can Tmax be exceeded?

A
  • in blood concentration is high

- eg. glucose in diabetes

17
Q

What is renal threshold and what happens when a substance exceeds its threshold?

A
  • threshold is the point a which the amount filtered is close to Tmax
  • above it the substance appears in urine
  • above it concentration of substance is proportional to plasma concentration
18
Q

how is amount filtered calculated and what happens if any factor increases?

A
  • plasma concentration (mg/ml) x GFR (ml/min)

- if either increases, Tmax may be exceeded as reabsorption cannot cope

19
Q

What is clearance and its range?

A
  • virtual volume of plasma entering the kidneys that has been totally cleared of the substance per unit time (ml/min)
    (theoretical volume as can’t be completely cleared)
  • ranges from zero to renal plasma flow
  • zero = fully reabsorbed/never filtered
  • renal plasma flow: all of substance delivered to kidney in blood ends up in urine
20
Q

What 3 renal processes determine and modify composition of urine?

A
  • glomerular filtration
  • tubular reabsorption
  • tubular secretion
21
Q

What are clearance ratios used for and explain what the different results can mean

A
  • used to determine whether renal transport mechanism is net reabsorption or net secretion
  • done by comparing proportions in urine and plasma to that of inulin
  • if = 1: neither secreted or reabsorbed
  • if >1: substance secreted
  • if <1: substance reabsorbed
22
Q

How do you calculate filtration fraction?

A

GFR/RPF