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Reabsorption of sodium and water. S pecific learning objectives. Renal handling of sodium Reabsorption of sodium at different levels of nephron Applied aspects Reabsorption of water Applied aspects. Na + Reabsorption.
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Specific learning objectives • Renal handling of sodium • Reabsorption of sodium at different levels of nephron • Applied aspects • Reabsorption of water • Applied aspects
Na+ Reabsorption • The reabsorption of Na+ and Cl– plays a major role in body electrolyte and water homeostasis. H+ Amino acids Organic acids Glucose Na+ transport Co-transport Phosphate Other electrolytes
60% 30% 7% 3% ( Aldosterone)
Na+ Reabsorption Passive Transport Active Transport
1. Facilitated diffusion : Sodium diffuses across the apical membrane into the cell down an electrochemical gradient established by the sodium-potassium ATPase pump on the basolateral side of the membrane. 2. Active transport : Sodium is transported across the basolateral membrane against an electrochemical gradient by the sodium-potassium ATPase pump. 3. Solvent drag :Sodium, water, and other substances are reabsorbed from the interstitial fluid into the peritubular capillaries by ultrafiltration, a passive process driven by the hydrostatic and colloid osmotic pressure gradients.
Regulation of Na+ Excretion • Na+ in the body is a prime determinant of the ECF volume. • Depends on • changes in GFR • changes in tubular reabsorption (primarily in the 3% of filtered Na+ that reaches the collecting ducts).
Regulation of Na+ Excretion • The factors affecting include • Tubuloglomerular feedback • Circulating level of aldosterone and other adrenocortical hormones • The circulating level of ANP and other natriuretic hormones • The rate of tubular secretion of H+ and K+.
Types of water Reabsorption- In nephron, • Obligatory water reabsorption • Facilitatoryor Facultative water reabsorption
Obligatory water reabsorption • “Water reabsorption takes place as a result of solute reabsorption” • Takes place in PCT
Obligatory water reabsorption PCT, epithelial cell membrane is permeable to water; because • Leaky tight junction – solvent drag • Aquoporin-1—water channels of luminal surface • In PCT, 65% solutes are reabsorbed • Hence equal volume of (65%) water reabsorbed
Facilitatory water reabsorption • In CT; reabsorption of water is facilitated (aided) by some external agents; hence called Facilitatory water reabsorption. • Absorption determined by body’s need • Facilitatory agents are –ADH (Vasopressin) & Aldosterone
Mechanism of action of ADH • Water reabsorption aided by ADH: • Water channels in CT is aquoporin-2 • Aquoporin-2 synthesized is stored in vesicles in epithelial cells of CT . • Water channels incorporated into luminal membrane only in the presence of ADH
VASOPRESSIN (ADH) Aquaporin is stored in vesicles in the cytoplasm of principal cells. Vasopressin V2 receptor Cyclic adenosine 5-monophosphate Insertion of these vesicles into the apical membrane of cells. Protein kinase A. Increased permeability of collecting duct to water
Action of ADH (Vasopressin) • ADH through V2 receptor increase cAMP activate protein kinase remove aquoporin-2 (water channels) molecules from vesicles and incorporates into the luminal epithelial membrane • Incorporation of aquoporin-2 (water channels) into cell membrane increase water permeability and cause water reabsorption
ADH Osmoreceptor- ADH feedback mechanism for regulating extracellular fluid osmolarity
References • Comprehensive Textbook of Medical physiology (Vol 2, 1stedition) G K Pal • Text book of medical physiology (Vol 2, 6thedition) A K Jain • Essentials of medical physiology (6thedition) K Sembulingam and PremaSembulingam • https://www.drawittoknowit.com/course/physiology/glossary/physiological-process/sodium-reabsorption-in-neprhon • http://www.austincc.edu/apreview/PhysText/Renal.html