Reabsorption of sodium along the tubule Flashcards

1
Q

Where is glucose reabsorbed?

A
  • All glucose is reabsorbed at proximal convoluted tubule
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2
Q

How is glucose reabsorbed?

A
  • Secondary active transport
  • Driven by energy released from Na+ down its concentration gradient
  • Na+/K+ ATPase creates a low conc of Na+ within the cells
  • More Na+ therefore diffuses into cell
  • Glucose is transported alongside Na+
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3
Q

What is Tm?

A
  • Maximum tubular resorptive capacity for a solute
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4
Q

Why does glycosuria develop?

A
  • There is a limited number of Na+/glucose carriers, so resorption of glucose is limited
  • When plasma glucose rises above 10mmol/L, there are not enough transporters to remove all the glucose from the filtrate
  • This results in glycosuria
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5
Q

Which demographic is glycosuria common in?

A
  • Pregnant women
  • Tm for glucose falls and glucose is excreted into urine
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6
Q

How are amino acids reabsorbed?

A
  • Filter easily through glomerulus
  • Reabsorbed in PCT by secondary active transport
  • Symport with Na+ (driven by Na+/K+ ATPase)
  • Tm limited process
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7
Q

Outline how sodium is reabsorbed in the PCT

A
  • Na+/K+ ATPase - 3Na+ is pumped into blood and 2 K+ brought into cell
  • Lots of mitochondria generate energy for ATPase
  • Co-transport with glucose, amino acids, phosphates, carboxylic acids
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8
Q

What ions are reabsorbed at the PCT?

A
  • Na+
  • Cl- diffuses via Cl-/base exchanger
  • HCO3- and H+
  • Water moves through aquaporins
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9
Q

Outline how HCO3- is reabsorbed at the PCT

A
  • HCO3- combines with H+ to form H2CO3
  • H2CO3 splits to form CO2 and H2O
  • CO2 and H2O diffuse into cell
  • Carbonic anhydrase converts them back to H2CO3
  • H2CO3 dissociates back to H+ and HCO3-
  • HCO3- resorption into blood is coupled with Na+
  • Na+ is removed to balance charge of H+
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10
Q

What transporters are present in the cells surrounding the loop of Henle?

A
  • Na+/K+/2Cl- co-transporter - bring these ions out of lumen and into cell
  • Na+/K+ ATPase
  • ROMK
  • Cl- channels
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11
Q

What is the function of the ROMK channels in the loop of Henle?

A
  • Allow some K+ to trickle back into loop of Henle
  • This allows K+ to still be used in the Na+/K+/2Cl- transporter
  • Required because K+ has a lower conc than the other 2 ions
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12
Q

What allows electrolytes such as Mg+ and Ca2+ to be reabsorbed from the loop of Henle?

A
  • Transport of Na+, K+ and 2Cl- makes lumen of loop of Henle more positive
  • Positively charged ions are repelled out of the lumen and between tight junctions
  • They are then reabsorbed
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13
Q

Outline the movement of ions at the distal convoluted tubule

A
  • Na+/Cl- transporter moves ions out of DCT
  • ENac channels allow active resorption of Na+
    -Ca2+ resorbed
  • Na+/K+ ATPase on basolateral membrane
  • ROMK moves K+ into blood
  • Cl- channels allow Cl- into blood
  • Ca2+ moved into blood and exchanged for Na+
  • NO WATER REABSORBED
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14
Q

What is the function of aldosterone?

A
  • Upregulate the number of ENac channels in the cell membrane
  • Upregulates number of ROMK channels in cell membrane
  • Inhibited by ANP
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15
Q

Outline the channels found in the collecting duct cells and their functions

A
  • Aquaporins allow H2O through - ADH binding to V2 receptor upregulates number of aquaporins in the membrane
  • ROMK allows K+ back into collecting duct
  • ENac brings Na+ into cell
  • Na+/K+ ATPase on basolateral membrane
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16
Q

What causes central diabetes insipidus?

A

Damage to hypothalamus or pituitary gland due to:
- Brain injury e.g. fracture to base of skull
- Tumour
- Sarcoidosis or tuberculosis
- Aneurysm
- Some forms of encephalitis or meningitis

17
Q

What is central diabetes insipidus?

A
  • Impaired ADH secretion by the hypothalamus
  • Water is inadequately resorbed from collecting ducts
  • Large quantities of urine produced
18
Q

How is central diabetes insipidus managed?

A
  • ADH injection s or ADH nasal spray treatments
19
Q

What is nephrogenic diabetes insipidus?

A
  • Acquired insensitivity of kidney to ADH
  • Plasma ADH levels are normal
  • Water inadequately reabsorbed from collecting ducts
  • Large quantity of urine produced
20
Q

How is nephrogenic diabetes insipidus managed?

A
  • Low-salt, low protein diet reduces urine output
  • No current treatment to correct deficit
21
Q

What are the causes of nephrogenic diabetes insipidus?

A
  • Mutation in gene coding for V2 receptors
  • Chronic pyelonephritis
  • Polycystic kidneys
  • Drugs such as lithium
22
Q

What are the causes of nephrogenic diabetes insipidus?

A
  • Mutation in gene coding for V2 receptors
  • Chronic pyelonephritis
  • Polycystic kidneys
  • Drugs such as lithium
23
Q

What characterises Syndrome of Inappropriate Antidiuretic Hormone secretion (SIADH)?

A
  • Excessive release of ADH from posterior pituitary gland
  • Dilutional hyponatraemia
  • Plasma Na+ conc lowered
  • Total body fluid increased