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Na
+
K
+
Cl
Na
+
Na
+
Glucose
H
+
+ HCO
3
HCO
3
+ H
+
H
2
CO
3
H
2
O + CO
2
H
2
CO
3
CO
2
+ H
2
O
CA CA +
0 mV 10 mV
Angiotensin II
Thiazide diuretics
Cl channel diffusion
Ca
2+
Ca
2+
Cl
Lumen
urine
Distal
convoluted
tubule
Interstitium
blood
Na
+
Na
+
Cl
Na
+
K
+
R PTH
ATP
0 mV +7 mV
Loop diuretics
Diffusion down the
electrochemical
gradient
Lumen
urine
Thick ascending
limb
Interstitium
blood
Na
+
Na
+
K
+
K
+
K
+
K
+
Cl
2Cl
(+)
Potential
Mg
2+
, Ca
2+
ATP
0 mV 50 mV
K+ sparing diuretics
Cl
Lumen
urine
Collecting
tubule
Interstitium
blood
Na
+
K
+
Cl
Na
+
K
+
R
Aldosterone Principal cell
Water
channel
molecules
H
2
O
V
2 ADH
Intercalated cell
H
+
K
+
HCO
3
ATP
ATP
Early proximal tubulecontains brush
border. Reabsorbs all of the glucose and
amino acids and most of the bicarbonate,
sodium, chloride, and water. Isotonic
absorption. Generates and secretes
ammonia, which acts as a buffer for secreted
H
+
.
PTHinhibits Na
+
/phosphate cotransport
phosphate excretion.
AT IIstimulates Na
+
/H
+
exchange
Na
+
and H
2
O reabsorption (permitting
contraction alkalosis).
6580% Na reabsorbed.
Early distal convoluted tubuleactively
reabsorbs Na
+
, Cl
and indirectly
induces the paracellular reabsorption of
Mg
2+
and Ca
2+
. Impermeable to H
2
O.
Makes urine less concentrated as it ascends.
1020% Na reabsorbed.
Collecting tubulesreabsorb Na
+
in exchange for
secreting K
+
and H
+
(regulated by aldosterone).
Aldosteroneleads to insertion of Na
+
channel on
luminal side.
ADHacts at V
2
receptors insertion of aquaporin
H
2
O channels on luminal side.
35% Na reabsorbed.
FAS1_2012_17-Renal.indd 508 2/20/12 9:44 AM