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Tubular reabsorption &


Of the 180 L glomerular filtrate formed
per day, about 1.5 L (less than 1%) per
day is excreted as urine.
The different segments of renal tubules
controls the composition, volume ,
osmolality & pH of ECF & ICF.
The final urine output is result of 3
processes glomerular filtration, tubular
reabsorption & secretion.

Processes concerned with urine

Three processes are involved: Glomerular filtration:-filtration of plasma
from glomerular capillaries into renal
Tubular reabsorption:-the return of needed
solutes & water from the tubules into the
Tubular secretion:-involves net movement
of water & unwanted solutes from blood to

General principles of renal tubular

Transport mechanism across cell
membrane: The water moves across the cell
membrane passively while the solute
movement occurs by both active &
passive processes.
Passive transport does not need
energy & occurs spontaneously down
an electrochemical gradient by: Diffusion, fascilitated diffusion &

Active transport
It requires direct input of energy & is
abolished if cell metabolism is
Active transport can occurs against
an electrochemical gradient.
Most of the active transports are
carrier mediated .
Endocytosis is also a type of active

Transepithelial transport
In the renal tubule a substance can be
reabsorbed or secreted by 3- pathways: Transcellular pathways:- refers to transport
through the cell.ex:-transcellular Na+
reabsorption by the proximal tubule.2step process: 1. movement of Na+ into the cells across
apical membrane down the elecrochemical
gradient establised by Na+K+ATPase.

Movement of Na+ into the ECF across the

basolateral membrane occurs against an
electrochemical gradient. Via Na+K+ATPase.
Tight junctions in between tubular cells
seprates the cell membrane proteins into
basolateral & apical.
But this tight junctions are not so tight in
proximal concoluted tubule & allows water &
small dissolved solutes to move through.

Sodium Reabsorption
Na+-K+ ATPase
located at the
basolateral membrane
of tubular cells
concentration gradient
for Na+ to diffuse into
the tubular cells from
tubular lumen
Keeps interstitial [Na+]
high creating
concentration gradient
for Na+ to diffuse into
blood (Bulk flow).

Paracellular pathway
Refers to transport between the cells
ex: Reabsorption of Ca+ & K+ across the
proximal tubule.
Some of the water reabsorbed across
the PCT.
Some solutes dissoved in the water
are carried along with the reabsorbed
fluid across the paracellular pathway
by solvent drag.

Patterns of renal handling of a

Urinary excretion = filtration
reabsorption + secretion.

Filtered load
It is the amount of solute transported across
the glomerular membrane per unit time.
FL= GFR x plasma conc. Of solute.
Excretion rate it is the amount of a substance
that appears in the urine per unit time.
ER = Urine flow rate (V) x urine conc. Of a
substance (Ux).
If the excretion rate exceeds the filtered load
net tubular secretion of that substance has

Renal tubular transport

Tm:- it refers to the maximum amount
of a given solute that can be
transported (reabsorbed or secreted)
per minute by the renal tubule.
The limit is due to saturation of the
specific transport systems involved.
The threshold concentration:- The
plasma conc. At which solute begins
to appear in urine.

Transport across different segments

of renal tubule
Transport across proximal tubule: The proximal tubule reabsorbs
approximately 67% of the filtered
water , Na+, Cl-, K+ & other
Almost all the amino acids & glucose
PCT does not reabsorbs inulin,
creatinine, sucrose & mannitol.
The PCT secretes H+,PAH,urate ,
pennicilin & creatinine.

Water reabsorption along

67% by osmosis in response to a
transtubular osmotic gradient
established by solute reabsorption.
2/3 rd through transcellular & 1/3rd
by paracellular pathways.
The osmotic water reabsorption is
called obligatory water reabsorption
as it cannot be changed according to
the need of the body.

Protein reabsorption
Normally only small amount of protein is
filtered by the glomerulus (40mg/L).
But because of high GFR the total amount of
protein filtered per day is significant : 180 L/day x 40 mg/L = 7.2 gm/day.
Normally this proteins are completely
endocytosed by PCT cells.
When amount of filtered protein inc. &
reabsorptive mechanism saturate =

Glucose Reabsorption
Na+-glucose co
transporter in
luminal membrane
called SGLT 2
Proteins involves in
facilitated diffusion
of glucose at
membrane is GLUT

Sodium Reabsorption
Na+-K+ ATPase
located at the
basolateral membrane
of tubular cells
concentration gradient
for Na+ to diffuse into
the tubular cells from
tubular lumen
Keeps interstitial [Na+]
high creating
concentration gradient
for Na+ to diffuse into
blood (Bulk flow).

Additional Examples of
Secondary Active Transport

These substances include some

amino acids, lactate, inorganic
phosphate (Pi), H+, and Cl-.

Mechanisms by which Water,

Chloride, and Urea Reabsorption
are Coupled with
Sodium Reabsorption

Figure 27-5;
Guyton and Hall

Reabsorption in the loop of Henle

Chemical composition of tubular fluid quite different
from filtrate

Glucose, amino acids and other nutrients

Osmolarity still close to that of blood

Reabsorption of water and solutes balanced

For the first time reabsorption of water is NOT
automatically coupled to reabsorption of solutes

Independent regulation of both volume and

osmolarity of body fluids
Na+-K+-2Cl- symporters function in Na+ and Clreabsorption promotes reabsorption of cations
Little or no water is reabsorbed in ascending limb
osmolarity decreases
Copyright 2009, John Wiley & Sons,

Na+K+-2Cl- symporter in the thick

ascending limb of the loop of Henle

Copyright 2009, John Wiley & Sons,


Reabsorption and secretion in the late

distale convoluted tubule and
collecting duct
Reabsorption on the early distal convoluted
Na+-Cl- symporters reabsorb Na+ and Cl Major site where parathyroid hormone stimulates
reabsorption of Ca+ depending on bodys needs

Reabsorption and secretion in the late distal

convoluted tubule and collecting duct
90-95% of filtered solutes and fluid have been
returned by now
Principal cells reabsorb Na+ and secrete K+
Intercalated cells reabsorb K+ and HCO3- and
secrete H+
Amount of water reabsorption and solute
2009, John Wiley
& Sons,
reabsorption and
on bodys

Hormonal regulation of tubular reabsorption and


Angiotensin II - when blood volume and

blood pressure decrease
Decreases GFR, enhances
reabsorption of Na+, Cl- and water in
Aldosterone - when blood volume and
blood pressure decrease
Stimulates principal cells in collecting
duct to reabsorb more Na+ and Cl- and
secrete more K+
2009, John Wiley & Sons,