In renal physiology, renal sodium reabsorption refers to the process by which the kidneys, having filtered out waste products from the blood to be excreted as urine, re-absorb sodium ions (Na2+) from the waste. It uses Na-H antiport, Na-glucose symport, sodium ion channels (minor). [1] It is stimulated by angiotensin II and aldosterone, and inhibited by atrial natriuretic peptide.
It is very efficient, since more than 25,000 mmol/day of sodium is filtered into the nephron, but only ~100 mmol/day, or less than 0.4% remains in the final urine.
Most of the reabsorption (65%) occurs in the proximal tubule. In the latter part it is favored by an electrochemical driving force, but initially it needs the cotransporter SGLT and the Na-H antiporter. Sodium passes along an electrochemical gradient (passive transport) from the lumen into the tubular cell, together with water and chloride which also diffuse passively. Water is reabsorbed to the same degree, resulting in the concentration in the end of the proximal tubule being the same as in the beginning. In other words, the reabsorption in the proximal tubule is isosmotic.[ citation needed ]
Sodium is reabsorbed in the thick ascending limb of loop of Henle, by Na-K-2Cl symporter and Na-H antiporter. It goes against its chemical driving force, but the high electrical driving force renders the overall electrochemical driving force positive anyway, availing some sodium to diffuse passively either the transcellular or paracellular way.[ citation needed ]
In the distal convoluted tubule sodium is transported against an electrochemical gradient by sodium-chloride symporters.[ citation needed ]
The principal cells are the sodium-transporting cells in the collecting duct system.[ citation needed ]
Although only a fragment of total reabsorption happens here, it is the main part of intervention. This is e.g. done by endogenous production of aldosterone, increasing reabsorption. Since the normal excretion rate of sodium is ~100mmoles/day, then a regulation of the absorption of still more than 1000 mmoles/day entering the collecting duct system has a substantial influence of the total sodium excreted.[ citation needed ]
Characteristic | Proximal tubule | Loop of Henle | Distal convoluted tubule | Collecting duct system | |||||||
---|---|---|---|---|---|---|---|---|---|---|---|
S1 | S2 | S3 | Descending limb | Thin ascending limb | Thick ascending limb | Connecting tubule | Initial collecting tubule | Cortical collecting ducts | Medullary collecting ducts | ||
Reabsorption (%) | 67% [2] | 25% [2] | 5% [2] | 3% [2] | |||||||
Reabsorption (mmol/day) | ~17,000 [2] | ~6,400 [2] | ~1,300 [2] | ~700 [2] | |||||||
Concentration (mM) | 142 [3] | 142 [3] | 100 [3] | 70 [3] | 40 [3] | ||||||
Electrical driving force (mV) | -3 [3] | +3 [3] | +15 [3] | -5 to +5 [3] | -40 [3] | ||||||
Chemical driving force (mV) | 0 [3] | 0 [3] | -9 [3] | -19 [3] | -34 [3] | ||||||
Electrochemical driving force (mV) | -3 [3] | +3 [3] | +6 [3] | -24 to -14 [3] | -74 [3] | ||||||
Apical transport proteins | SGLT, Na-H antiporter [4] | (Passively) | Na-K-2Cl symporter (Na-H antiporter [4] and passively) | Sodium-chloride symporter [4] | ENaC [4] | ||||||
Basolateral transport proteins | Na+/K+-ATPase [4] | ||||||||||
Other reabsorption features | Isosmotic | Principal cells, stimulated by aldosterone | |||||||||
The nephron is the minute or microscopic structural and functional unit of the kidney. It is composed of a renal corpuscle and a renal tubule. The renal corpuscle consists of a tuft of capillaries called a glomerulus and a cup-shaped structure called Bowman's capsule. The renal tubule extends from the capsule. The capsule and tubule are connected and are composed of epithelial cells with a lumen. A healthy adult has 1 to 1.5 million nephrons in each kidney. Blood is filtered as it passes through three layers: the endothelial cells of the capillary wall, its basement membrane, and between the podocyte foot processes of the lining of the capsule. The tubule has adjacent peritubular capillaries that run between the descending and ascending portions of the tubule. As the fluid from the capsule flows down into the tubule, it is processed by the epithelial cells lining the tubule: water is reabsorbed and substances are exchanged ; first with the interstitial fluid outside the tubules, and then into the plasma in the adjacent peritubular capillaries through the endothelial cells lining that capillary. This process regulates the volume of body fluid as well as levels of many body substances. At the end of the tubule, the remaining fluid—urine—exits: it is composed of water, metabolic waste, and toxins.
The renin-angiotensin system (RAS), or renin-angiotensin-aldosterone system (RAAS), is a hormone system that regulates blood pressure, fluid, and electrolyte balance, and systemic vascular resistance.
The collecting duct system of the kidney consists of a series of tubules and ducts that physically connect nephrons to a minor calyx or directly to the renal pelvis. The collecting duct participates in electrolyte and fluid balance through reabsorption and excretion, processes regulated by the hormones aldosterone and vasopressin.
The distal convoluted tubule (DCT) is a portion of kidney nephron between the loop of Henle and the collecting tubule.
Renal physiology is the study of the physiology of the kidney. This encompasses all functions of the kidney, including maintenance of acid-base balance; regulation of fluid balance; regulation of sodium, potassium, and other electrolytes; clearance of toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D.
The proximal tubule is the segment of the nephron in kidneys which begins from the renal pole of the Bowman's capsule to the beginning of loop of Henle. At this location, the glomerular parietal epithelial cells (PECs) lining bowman’s capsule abruptly transition to proximal tubule epithelial cells (PTECs). The proximal tubule can be further classified into the proximal convoluted tubule (PCT) and the proximal straight tubule (PST).
In the kidney, the loop of Henle is the portion of a nephron that leads from the proximal convoluted tubule to the distal convoluted tubule. Named after its discoverer, the German anatomist Friedrich Gustav Jakob Henle, the loop of Henle's main function is to create a concentration gradient in the medulla of the kidney.
The renal medulla is the innermost part of the kidney. The renal medulla is split up into a number of sections, known as the renal pyramids. Blood enters into the kidney via the renal artery, which then splits up to form the segmental arteries which then branch to form interlobar arteries. The interlobar arteries each in turn branch into arcuate arteries, which in turn branch to form interlobular arteries, and these finally reach the glomeruli. At the glomerulus the blood reaches a highly disfavourable pressure gradient and a large exchange surface area, which forces the serum portion of the blood out of the vessel and into the renal tubules. Flow continues through the renal tubules, including the proximal tubule, the loop of Henle, through the distal tubule and finally leaves the kidney by means of the collecting duct, leading to the renal pelvis, the dilated portion of the ureter.
Sodium-dependent glucose cotransporters are a family of glucose transporter found in the intestinal mucosa (enterocytes) of the small intestine (SGLT1) and the proximal tubule of the nephron. They contribute to renal glucose reabsorption. In the kidneys, 100% of the filtered glucose in the glomerulus has to be reabsorbed along the nephron. If the plasma glucose concentration is too high (hyperglycemia), glucose passes into the urine (glucosuria) because SGLT are saturated with the filtered glucose.
Sodium–hydrogen antiporter 3 also known as sodium–hydrogen exchanger 3 (NHE3) or solute carrier family 9 member 3 (SLC9A3) is a protein that in humans is encoded by the SLC9A3 gene.
Tubular fluid is the fluid in the tubules of the kidney. It starts as a renal ultrafiltrate in the glomerulus, changes composition through the nephron, and ends up as urine leaving through the ureters.
In renal physiology, renal chloride reabsorption refers to the process by which the kidneys, having filtered out waste products from the blood to be excreted as urine, re-absorb chloride ions from the waste.
The chloride potassium symporter is a membrane transport protein of the solute carrier family 12 that is present in the S3-segment of the renal proximal tubule and in the neuron. It functions in renal chloride reabsorption to transport chloride across the basolateral membrane. Chloride potassium symporter can lower intracellular chloride concentrations below the electrochemical equilibrium potential.
Solvent drag, also known as bulk transport, refers to solutes in the ultrafiltrate that are transported back from the renal tubule by the flow of water rather than specifically by ion pumps or other membrane transport proteins. This is a phenomenon primarily in renal physiology, but it also occurs in gastrointestinal physiology.
Renal urea handling is the part of renal physiology that deals with the reabsorption and secretion of urea. Movement of large amounts of urea across cell membranes is made possible by urea transporter proteins.
Renal glucose reabsorption is the part of kidney (renal) physiology that deals with the retrieval of filtered glucose, preventing it from disappearing from the body through the urine.
Renal oligopeptide reabsorption is the part of renal physiology that deals with the retrieval of filtered oligopeptides, preventing them from disappearing from the body through the urine.
Renal protein reabsorption is the part of renal physiology that deals with the retrieval of filtered proteins, preventing them from disappearing from the body through the urine.
A carboxylate transporter is a membrane transport protein that transports carboxylate.
In physiology, aldosterone escape is a term that has been used to refer to two distinct phenomena involving aldosterone that are exactly opposite each other: