Procesamiento Tubular Renal contracorriente

7/24/2019 Procesamiento Tubular Renal contracorriente

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Copyright 2006 by Elsevier, Inc.

Tubular Reabsorption

Figure 27-1;Guyton and Hall


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Primary Active Transport of Na +



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Mechanisms ofSecondary

Active Transport


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Glucose TransportMaximum



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Interstitial Fluid

TubularLumen

Tubular Cells

Reasorption of Water and Solutes isCoupled to Na + Reabsorption

Na +

+ATP

Na +

+ATP Na +

! " m#$ mv

%&$

Cl !

'rea

Na+

% +

(lucose) amino acidsNa +

! *$ m#



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Mechanisms by which Water, Chloride,and Urea Reabsorption are Coupled withSodium Reabsorption


7/43Copyright 2006 by Elsevier, Inc.

Figure 27-6; Guyton and Hall

Cellular Ultrastructure and PrimaryTransport Characteristics of ProximalTubule




Cellular Ultrastructure and TransportCharacteristics of Thin and Thick Loopof Henle

not permea leto H 2!"

#ery permea leto H 2!"



Figure 27-$;Guyton and Hall

Sodium Chloride and Potassium Transport inThick Ascending Loop of Henle




Countercurrent Multiplier Systemin the Loop of Henle



Countercurrent multiplier animation
http://www.colorado.edu/intphys/Class/IPHY3430-200/countercurrent_ct.htmlhttp://www.colorado.edu/intphys/Class/IPHY3430-200/countercurrent_ct.html




Recirculation of Urea Absorbed from MedullaryCollecting Duct into Interstitial Fluid



Net Effects ofCountercurrent Multiplier

1% &ore 'olute t(an )ater i' added to t(e renal medulla*i%e%+ 'olute' are ,trapped in t(e renal medulla"%

2% Fluid in t(e a'.ending loop i' diluted%

3% Hori/ontal gradient o0 'olute .on.entration e'ta li'(ed y t(e a.ti#e pumping o0 a l i' ,multiplied y.ounter.urrent 0lo) o0 0luid%



T(e #a'a re.ta 'er#e a' .ounter.urrent

e .(anger'

The Vasa Recta PreserveHyperosmolarity of Renal Medulla

a'a re.ta lood 0lo) i' lo) *only 1-2 o0

total renal lood 0lo)"




Figure 27-1 ;Guyton and Hall

Sodium Chloride Transport inEarly Distal Tubule


16/43Copyright 2006 by Elsevier, Inc.Figure 27-11; Guyton and Hall

Cellular Ultrastructure and TransportCharacteristics of Early and Late Distal Tubulesand Collecting Tubules

not permea le to H 2! not #ery

permea le tourea

permea ility to H 2! depend' on A H not #ery

permea le tourea




Sodium Chloride Reabsorption and PotassiumSecretion in Collecting Tubule Principal Cells



Tu ular 9umenTu ular ell'

a :ATP

l - :

H :ATP

Cortical Collectin( TubulesIntercalated Cells

H2 *depend' on

A H"

H :ATP

:ATP

ATP

:





Cellular Ultrastructure and TransportCharacteristics of Medullary Collecting Tubules



Normal Renal Tubular Na + Reabsorption

%6

*15 mday"

*16+614 mday"

65

*63$ md"*617 mday"2%4

25+56md

25

*178$ md"

7




Summary of Water Reabsorption andsmolarity in ,ifferent Parts of t-e Tubule

Pro imal Tu ule? 65 rea 'orption+ i'o'moti.

e'.% loop? 15-2 rea 'orption+ o'molarity in.rea'e'

A'.% loop? rea 'orption+ o'molarity de.rea'e'



Concentration and,ilution of t-e 'rine

&a imal urine .on.entration @ 12 - 14 m!'m > 9

*'pe.i0i. gra#ity 1% 3 "

&inimal urine .on.entration

@ 5 - 7 m!'m > 9*'pe.i0i. gra#ity 1% 3"



Obligatory Urine Volume

T(e minimum urine #olume in )(i.( t(e e .reted'olute .an e di''ol#ed and e .reted%

< ample?B0 t(e ma % urine o'molarity i' 12 m!'m>9+and 6 m!'m o0 'olute mu't e e .reted ea.(day to maintain ele.trolyte alan.e+ t(eo ligatory urine #olume i'?

6 m!'m>d 12 m!'m>9

. %5 9>day



Maximum Urine Concentration ofDifferent Animals

Animal /a01 'rine Conc1 2m sm 3L4

Cea#er 5

Pig 1+1Human 1+4og 2+4

D(ite Eat 3+

angaroo &ou'e 6+Au'tralian Hopping Mouse 1 +



Late ,istal) Cortical and /edullaryCollectin( Tubules

Tu ular 9umenPrin.ipal ell'

l -

H2 *)>o A H"

Aldo'terone

:

a :ATP :

ATP

a :




< .e'' aldo'terone - onn ' 'yndrome a : retention+ (ypo alemia+ al alo'i'+(yperten'ion

Abnormal Aldosterone Production

Aldo'terone de0i.ien.y - Addi'on ' di'ea'e a : )a'ting+ (yper alemia+ (ypoten'ion+deat( i0 untreated


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Bnter'titial Fluid

Tu ular ell' Tu ular 9umen

a :

H :

aATP

:

:

An( II Increases Tubular Na + Transport

Ang BBAng BB



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5ffect of An(iotensin II onPeritubular Capillary ,ynamics

Peritu ular apillary

Glomerular apillary

Ea EeArterialPre''ure

Ang BB Ee P. * peritu ular .ap% pre''%"

renal lood 0lo) FF

.


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An( II Constriction of 5fferent Arterioles Causes Na +

Retention and /aintains 50cretion of Waste Products

a:

depletion

Ee'i'tan.e e00erent arteriole'

Ang BB

Glom% .ap% pre''

Pre#ent' de.rea'ein GFE andretention o0

)a'te produ.t'

Eenal lood 0lo) Peritu % ap% Pre''%

Filt% Fra.tion

a : and H 2! Eea '%Copyright 2006 by Elsevier, Inc.


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Angiotensin II Blockade Decreases Na + Reabsorption and Blood Pressure

A < in(i itor' *.aptopril+ ena/ipril+ ramipril" Ang BB antagoni't' *lo'artan+ .ande'artin+ ir e'artan"

de.rea'e aldo'terone dire.tly in(i it a : rea 'orption de.rea'e e00erent arteriolar re'i'tan.e

atriure'i' and iure'i' : Clood Pre''ure


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Formation of a Dilute UrineFormation of a Dilute Urine

ontinue ele.trolyterea 'orption

e.rea'e )aterrea 'orption

/ec-anism6de.rea'ed A Hrelea'e and redu.ed)ater permea ilityin di'tal and.olle.ting tu ule'


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Formation of a Concentrated 'rine

ontinue ele.trolyte rea 'orption Bn.rea'e )ater rea 'orption

&e.(ani'm? Bn.rea'ed A H relea'e )(i.( in.rea'e' )ater

permea ility in di'tal and .olle.ting tu ule' Hig( o'molarity o0 renal medulla ounter.urrent 0lo) o0 tu ular 0luid


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Formation of a Concentrated Urine whenAntidiuretic Hormone (ADH) Levels are High


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Osmoreceptorantidiuretic hormone (ADH)

feedback mechanism forregulating extracellular

fluid osmolarity


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ADH synthesis in theneurons of hypothalamus,

release by the posteriorpituitary, and action on

the kidneys


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Factors t-at ,ecreaseA,% Secretion

e.rea'ed o'molarity Bn.rea'ed lood #olume *.ardiopulmonary re0le e'"

Bn.rea'ed lood pre''ure *arterial arore.eptor'" !t(er 0a.tor'?

- al.o(ol- (aloperidol *antip'y.(oti.+ ti.'+Tourette '"


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Stimuli for T-irst

Bn.rea'ed o'molarity e.rea'ed lood #olume

*.ardiopulmonary re0le e'" e.rea'ed lood pre''ure

*arterial arore.eptor'"

Bn.rea'ed angioten'in BB !t(er 'timuli?- dryne'' o0 mout(


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Factors t-at ,ecrease T-irst

e.rea'ed o'molarity Bn.rea'ed lood #olume

*.ardiopulmonary re0le e'" Bn.rea'ed lood pre''ure

*arterial arore.eptor'" e.rea'ed angioten'in BB !t(er 'timuli?

-Ga'tri. di'tention


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Atrial Natriuretic Peptide (ANP)

Clood #olume

Eenal a : and H 2! rea 'orption

Eenin relea'e aldo'terone GFE

Ang BB

a : and H 2! e .retion

A P


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Tu ular 9umenTu ular ell'

Late ,istal and Collectin( Tubules

H2 *depend'on A H"

A,% .A&P

H2

A=uaporin-2A=uaporin-3H2

e'i.le

A=uaporin'

#& receptor



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Sodium Chloride and Potassium Transport inThick Ascending Loop of Henle


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Figure 27-1 ;

Guyton and Hall

Sodium Chloride Transport inEarly Distal Tubule


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Figure 27-12;

Sodium Chloride Reabsorption and PotassiumSecretion in Collecting Tubule Principal Cells

Procesamiento Tubular Renal contracorriente

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