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Counter current mechanism

Formation of concentration urine
Counter current mean, a current flowing in an opposite direction to one another.
The mechanism that the kidneys use to concentrate urine is called the countercurrent

In order to understand countercurrent mechanism, first we have to understand how a

countercurrent multiplier works.

Let us say there are 2 tubes, through which a solution of the same substance is flowing. There
is a free exchange of the solution between the two tubes. There can be two kinds of flow through
these tubes.

Concurrent flow: Here, the solutions in the two tubes flow in the same direction. If at one end,

one of them starts at 0% concentration and the other starts at 100% concentration. By the time
they reach the other end of the tubes, the concentrations in each tube will be roughly 50%, as
shown in the figure.

Countercurrent flow: Here the solutions in the two tubes flow in opposite directions. In one
tube 0% concentration of the solution starts to flow from one end, and in the other tube, 100%
concentration of the solution starts to flow from the opposite end. Due to the free exchange of the
substances between the two tubes, by the time the solutions reach the end of the tube, it will have

acquired a concentration equal to the other tube at that end. This will become clear from the figure.
Medullary hyper osmolality: The osmolality of renal cortical intersitium is same (300 mL
osmol/litre) as in other tissues, but that of the interstitium of renal medulla is hypertnic with a
gradient of hyper-osmolality from renal cortex to the tips of medullary papillae. Under the

conditions in which a concentrated urine is to be produced the hyper-osmolality of medullary

interstitium near the tips of the papillae is as high as 1200 to 1400 mL osmol/litre.

Countercurrent mechanism to maintain medullary hyperosmolality: The gradient of increasing

hypersomolality of medullary interstitium is maintained by a peculiar countercuurent mechanism
operated by the Henles loops of juxtamedullary nephons and vasa recta. About 15% to 20% of the

nephorns in mammalian kidneys are situated at the level where cortex and medulla meet and, hence

called juxtamedullary nephrons. The henles loops of these nephorns are thin and long and extend

almost upto the tips of medullary papillae. The peritubular capillaries associated with these Henles
loops are also very thin and in the form of thin loops extending almost upto the tips of medullary

papillae. These capillary loops are called vasa recta. A countercurrent can be defined as the flow of a
fluid in opposite directions in the two arms of a U-tube if the arms are rather very close together.

Thus, the Henles loops of juxtamedullary nephrons and vasa recta are anatomically ideal for the

operation of countercurrent mechanism. There are two aspects of this mechanism,

(1) Countercurrent multiplication and (The Henles loops play the role of contercurrent multipliers.)

(2) Countercurrent exchange. (The vasa recta plays the role of countercurrent exchanger.)


Your kidneys have a remarkable mechanism for reabsorbing water from the tubular fluid, called

countercurrent multiplication.

Countercurrent multiplication in the kidneys is the process of using energy to generate

an osmotic gradient that enables you to reabsorb water from the tubular fluid and produce
concentrated urine. This mechanism prevents you from producing litres and litres of dilute
urine every day, and is the reason why you dont need to be continually drinking in order to


countercurrent multiplication in the loops of Henle of juxtamedullary nephrons is largely responsible

for developing the osmotic gradients that are needed to concentrate urine.
Although the loops of Henle are essential for concentrating urine, they do not work alone. The
specialized blood capillary network (the vasa recta) that surrounds the loops are equally important.

The vasa recta capillaries are long, hairpin-shaped blood vessels that run parallel to the loops of
Henle. The hairpin turns slow the rate of blood flow, which helps maintain the osmotic gradient
required for water reabsorption.
How does countercurrent multiplication work?

The three segments of the loops of Henle have different characteristics that enable countercurrent multiplication.
The thin descending limb is passively permeable to both water and small solutes such as sodium chloride and
urea. As active reabsorption of solutes from the ascending limb of the loop of Henle increases the concentration
of solutes within the interstitial space (space between cells), water and solutes move down their concentration

gradients until their concentrations within the descending tubule and the interstitial space have equilibrated. As
such, water moves out of the tubular fluid and solutes to move in. This means, the tubular fluid becomes steadily
more concentrated or hyperosmotic (compared to blood) as it travels down the thin descending limb of the
tubule. The thin ascending limb is passively permeable to small solutes, but impermeable to water, which means
water cannot escape from this part of the loop. As a result, solutes move out of the tubular fluid, but water is
retained and the tubular fluid becomes steadily more dilute or hyposmotic as it moves up the ascending limb of

the tubule. The thick ascending limb actively reabsorbs sodium, potassium and chloride. this segment is also
impermeable to water, which again means that water cannot escape from this part of the loop. This segment is
sometimes called the diluting segment. Countercurrent multiplication moves sodium chloride from the tubular
fluid into the interstitial space deep within the kidneys. Although in reality it is a continual process, the way the
countercurrent multiplication process builds up an osmotic gradient in the interstitial fluid can be thought of in
two steps:

1. The single effect. The single effect is driven by active transport of sodium chloride out of the tubular

fluid in the thick ascending limb into the interstitial fluid, which becomes hyperosmotic. As a result, water moves
passively down its concentration gradient out of the tubular fluid in the descending limb into the interstitial
space, until it reaches equilibrium.

2. Fluid flow. As urine is continually being produced, new tubular fluid enters the descending limb,
which pushes the fluid at higher osmolarity down the tube and an osmotic gradient begins to develop. As the
fluid continues to move through the loop of Henle, these two steps are repeated over and over, causing the
osmotic gradient to steadily multiply until it reaches a steady state. The length of the loop of Henle determines
the size of the gradient - the longer the loop, the greater the osmotic gradient.

Absorbed water is returned to the circulatory system via the vasa recta, which surrounds the tips of the
loops of Henle. Because the blood flow through these capillaries is very slow, any solutes that are reabsorbed

into the bloodstream have time to diffuse back into the interstitial fluid, which maintains the solute concentration
gradient in the medulla. This passive process is known as countercurrent exchange.

The concentration of urine is controlled by antidiuretic hormone, which helps the kidneys to conserve
water. Its main effects in the renal tubules is to increase water permeability in the late distal tubule and collecting
ducts, increase active transport of sodium chloride in the thick ascending limb of the loop of Henle, and enhance
countercurrent multiplication and urea recycling, all of which increase the size of the osmotic gradient.
Countercurrent Exchange:

Remember 3 things:

1. Vasa recta is freely permeable to both solute and water throughout the length. Water diffuses along
the osmotic gradient and NaCl diffuses along its concentration gradient.
2. Blood entering the descending limb of vasa recta is ~ 300mOsm/L and Blood leaving the ascending
limb of vasa recta is ~ 325mOsm/L. Only slight increase in the solute content of the blood going out
of the medulla shows that the medullary concentration gradient is maintained as most of the solute is
left in the interstitium.

3. Urine osmolarity is inversely related to medullary (vasa recta) blood flow. Faster the blood flows, there

is less time for equilibration and increased solute leave blood leading to decreased medullary
concentration gradient.


1. As the blood descends through the descending limb of vasa recta, water diffuses out and NaCl diffuses

in to equilibrate with the increasing osmolarity of medullary interstitial fluid (ISF) from top to bottom
established by countercurrent multiplier.

2. As the blood ascends through the ascending limb of vasa recta, water diffuses in and NaCl diffuses
out to equilibrate with the decreasing osmolarity of medullary interstitial fluid (ISF) from bottom to top.

3. The process continues and the equilibrium is never reached.

Urea recycling

Urea recycling in the inner medulla also contributes to the osmotic gradient generated by the loops of Henle.

Antidiuretic hormone increases water permeability, but not urea permeability in the cortical and outer medullary
collecting ducts, causing urea to concentrate in the tubular fluid in this segment. In the inner medullary collecting
ducts it increases both water and urea permeability, which allows urea to flow passively down its concentration
gradient into the interstitial fluid. This adds to the osmotic gradient and helps drive water reabsorption.

Ques: Why drinking sea water leads to dehydration?

Ans: This is due to limited ability of human kidney to concentrate the urine to maximal concentration of 1200
mOsm/L. Osmolarity of sea water is ~ 1200 mOsm/L. Hencer for each litre of sea water drunk, 1L of water is
required to excrete 1200 mOsm of sodium. But still dehydration occurs. This is because of requirement to excrete
other substances as well. At maximal concentration ability, urea contributes 600 mOsm/L. Hence meximum
concentration of NaCl that can be excreted by kidney is 600 mOsm/L. Hence, for every 1L of sea water drunk, 2L
of fluid loss occurs

Qus: How the nephron loop makes the medulla of the kidney hyper tonic and how this helps the collecting duct
to produce concentrated urine?