Session 4: Control of Volume Flashcards
Why does Na+ excretory rates vary?
Because our diet changes from day to day
Why would you not simply add or remove water to or from the plasma to increase ECF volumes?
Because that would change the plasma osmolarity and not necessarily the volume. I.e. concentration would go down and that means that water would move from the ECF to another more concentrated medium via osmosis.
What kind of fluid can you add to ECF to increase volume?
Isosmotic solution that mimics the solutes of the plasma.
What two modes of transport are the prominent ones in kidney reabsorption and secretion?
Paracellular reabsorption/secretion and transcellular reabsorption/secretion.
What are the two membranes concerned with kidney reabsorption and secretion?
Luminal/apical membrane (lumen to tubular cells) Basal/basolateral membrane (tubular cells to lateral intercellular space)
Main sodium transporters in the proximal convoluted tubule. Where can they be found?
Na-H antiporter Na-Glucose symporter Na-AA co-transporter Na-Pi Found on the apical membrane
What other important sodium transporter can be found in the PCT?
3Na/2K-ATPase NaHCO3- Both can be found on the basolateral side
Main sodium transporters in the loop of Henle.
NaKCC symporter
Main sodium transporters in the early distal convoluted tubule.
NaCl symporter
Main sodium transporters in the late DCT and collecting duct.
ENaC
Explain what happens in S1 of PCT.
The Na-glucose cotransporter move 3Na+ as well as glucose from the lumen to the tubular cells. As the glucose lvls decrease in the lumen it will have to be actively transported via this transporter. Na/K-ATPase moves 3Na+ into capillary and 2K+ is transported into tubular cells. Glucose moves into capillaries. Almost 100% of the glucose is reabsorbed here as well as the amino acids and carboxylic acids. There is also co-transport with phosphate through NaPi channels which are sensitive to PTH. Aquaporin allows movement of water.
What increases in concentrations in S1 of PCT?
Urea and Cl- concentrations. This is to compensate for the losses of glucose. The increase in Cl- concentrations create a concentration gradient for chloride reabsorption in S2-S3 of PCT.
Explain what transport maximum is.
The glucose transporters are only so many and can only work at a certain rate. If the glucose concentrations exceed this level then the reabsorption will not be able to keep up with the filtration and there will be glucose excreted. As plasma glucose increases filtration will increase linearly. But reabsorption won’t be able to keep up and excretion will happen.
Give examples of drugs that can act on S1 of PCT.
Amiloride
Explain how amiloride acts on S1 of PCT.
Amiloride is a diuretic and blocks the Na+/H+ antiporter in PCT. It also inhibits AgII on the secretion of H+ in PCT.
Amiloride has other functions in the kidneys as well.
Explain what happens in S2 and S3 of PCT.
Apical Na+ is reabsorbed via Na-H exchange.
Also Cl- begins to be transported out of the lumen via a chloride-anion antiporter.
Also chloride ions and sodium ions are transported paracellularly out of the lumen as well. This is due to a positive transepithelial charge due to the movement of Cl- transcellularly.
Water also moves out of the lumen via aquaporin.
Amino acids are also reabsorbed via sodium dependent amino acid transporters.
Give a summary of what is being reabsorbed in the PCT and how much.
65% water
100% glucose and AA
67% Na+
Give forces that cause reabsorption of water in the PCT.
Osmotic force due to sodium and glucose.
Hydrostatic force in interstitium
Oncotic force in peritubular capillary since it lost 20% of its filtrate at the glomerulus but the proteins are still left in the blood (higher conc.)
What happens to transporters when renal artery BP increases?
Reduced number of Na-H antiporters and reduced activity of Na-K/ATPase