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Renal Phys 6

WVSOM -- Renal Phys -- Renal tranport of Na, Cl, and water

QuestionAnswer
What is the primary anion with Na and Cl and water movement? bicarb
Why is the fate of Na important? Na contributes to the lion’s share of the total body osmosis, so wehre Na goes, water goes.
How much of Na, Cl and water are reabsorbed? nearly 99%
Describe Na uptake. primarily an active, transcellular process; but there is reabsorption by paracellular too
Describe Cl uptate. beoth paracellular and transellular and directly coupled with Na reabsorpotion
Describe water reabsorption. is by osmosis and secondary to the reabsorption of solutes, especially Na and solutes whose reabsorption is dependent on Na reaborption
What is the key to Na reabsorption? Na/K?ATPase at the basolateral membrane
What are the luminal membrane transporters? Na/H antiporters, Na chennels, Na-nutrient symporter (glucose, amonio acids, etc)
Describe NaCl absorption in the loop of henle. NaCl gets reabsorbed in the ascending limbs wehre water cannot follow. In the thick ascending there is active transcellular and passive paracellular. There is passive paracellular transport in thin ascending limb
What is permeability of Na in descending limb of loop of henle? low
Describe the action of Na in the distal tubule. reabsorb a small amount of Na and respond to ADH and aldosterone.
Describe the action of ADH on Na. will increase Na reabsoorption… remember WATER FOLLOWS SALT
How is water reabsorbed? in the proximal tubule by transcellular and paracellular pathways. Also reabsorbed in the descending loop of Henle
What special channels are in the proximal tubule to allow water reabsorption? aquaporins
Water permeability is low in the thick ascending lime of Loop of Henle and in downstream segments unless ___ is present. ADH
Is Na and water reabsorbed in the collecting duct system? Yes
Which parts of the nephron have high water permeability? PT, descending loop of henle
Which parts of the nephron have a low permeability to water? DCT and ascending loop of henle
What happens on the luminal side of the proximal tuble with sodium? antiport with protons, co-transport with nutrient and co transport with phosphate or sulate
What happens on the basolateral side of the proximal tuble in regards to Na? Na/K ATPase and Na/HCO3 co transport (secondary active absorption of HCO3
What reaction is inside of the PT cell? carbonic anhydrase reaction
What elements does the carbonic anhydrase reaction in the PT provide? HCO3
Where is a major site for HCO3 reabsorption? proximal tuble
If solute X exists in high concentration in the glomerular filtrate and is not reabsorbed, what happens to water? retards the tendency for water to follow the reabsorbed Na, and you will have more water in the tubule lumen. And Na will be lower so there will be less diffusion of Na. Osmotic dieresis
Osmotic dieresis can occur in people with Diabetes mellitus because the filtered load of glucose exceeds the ______________. threshold
What is the anatomical separation in the loop? between Na and water absorption, NaCl gets reabsorbed more than water in the loop but happens on ascending side. Water only on descending side
What is the sequence of events in loop of henle with NaCl/Water? descdning limb water gets reabsorbed and only a tiny bit of NaCl. NaCl gets concentrated in the tuble and thin in thin ascending limb, Na is reabsorbed passively. Water is not permeable. Na/K/2CL symporter is key in thick ascending limb
What is the target of loop diuretics? The Na/K/2 Cl symporters in the thick ascending loop of henle
Why is lasix potassium wasting? it targets the Na/K/ 2Cl symporter so not only is NaCl affected but also potassium
What is the diluting segment of the loop of Henle? Thick ascending limb where NaCl is rebasobrebed passively and actively leaving water in the tubule
Describe K activitiy in the thick ascending limb of the loop of henle. K enters in equal amounts of Na, however the luminak K channels let K leak back out into the lumin
Is the fluid entering the collecting duct system hyposmotic or hyperosmotic? hypoosmotic
Describe the major elemtent of the distal convoluted tubule. Na/Cl co-transporter
What diuretics are the target of thiazide diuretics? Na/Cl co-transpoerters of the DCT
What do amelioride diuretics work on? Na channels in the cortical collection tubule
What channels are in the cortical collecting tubule? Na channels in, Potassium channels out, Na/K ATPase, and aquaporin channel
What NA channel is regulated in the Cortical collecting tubule by aldosterone? the Na/K ATPase
Without ADH water permeability is _____________. low
With ADH, water permeability is ___________ high
What happens in the cortical collecting system with ADH? water flows out of tube to the isometotic iterstitium of the cortex
What happens in the medullary collecting system with ADH? water flows out of the tube to the hyperosmotic interstiium
What is urine like that enters the ureters with ADH? Urine is concentrated
What is the mechanism of ADH? ADH makes aquaporin channels for reabsorption
What is Diabetes insipisous…. Too much or too little ADH? too little
What is SIADH? too much ADH
Created by: tjamrose