Renal sodium reabsorption
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Renal reabsorption of sodium (Na+) is a part of renal physiology. 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 mmoles/day of sodium is filtered into the nephron, but only ~100 mmoles/day, or less than 0.4% remains in the final urine.
Proximal tubule
Most of the reabsorption (65%) occurs in the proximal tubule. In the latter part it is favoured by an electrochemical driving force, but initially it needs the cotransporter SGLT and the Na-H antiporter. Water is absorbed 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 absorption in the proximal tubule is isosmotic.
Loop of Henle
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.
Distal tubule
In the distal convoluted tubule sodium is transported against an electrochemical gradient by sodium-chloride symporters.
Collecting duct
The principal cells are the sodium-transporting cells in the collecting duct system.
Regulation
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.
Overview table
| 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 (mmoles/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 | by principal cells, stimulated by aldosterone | |||||||||
References
- ↑ http://www2.kumc.edu/ki/physiology/course/six/6_1.htm
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Walter F., PhD. Boron. Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. ISBN 1-4160-2328-3. Page 776
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 Walter F., PhD. Boron. Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. ISBN 1-4160-2328-3. Page 777
- ↑ 4.0 4.1 4.2 4.3 4.4 Walter F., PhD. Boron. Medical Physiology: A Cellular And Molecular Approaoch. Elsevier/Saunders. ISBN 1-4160-2328-3. Page 778
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Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .

