Proximal tubule function and response to acidosis

Clinical Journal of the American Society of Nephrology : CJASN
Norman P Curthoys, Orson W Moe

Abstract

The human kidneys produce approximately 160-170 L of ultrafiltrate per day. The proximal tubule contributes to fluid, electrolyte, and nutrient homeostasis by reabsorbing approximately 60%-70% of the water and NaCl, a greater proportion of the NaHCO3, and nearly all of the nutrients in the ultrafiltrate. The proximal tubule is also the site of active solute secretion, hormone production, and many of the metabolic functions of the kidney. This review discusses the transport of NaCl, NaHCO3, glucose, amino acids, and two clinically important anions, citrate and phosphate. NaCl and the accompanying water are reabsorbed in an isotonic fashion. The energy that drives this process is generated largely by the basolateral Na(+)/K(+)-ATPase, which creates an inward negative membrane potential and Na(+)-gradient. Various Na(+)-dependent countertransporters and cotransporters use the energy of this gradient to promote the uptake of HCO3 (-) and various solutes, respectively. A Na(+)-dependent cotransporter mediates the movement of HCO3 (-) across the basolateral membrane, whereas various Na(+)-independent passive transporters accomplish the export of various other solutes. To illustrate its homeostatic feat, the proximal tubule alters its...Continue Reading

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Related Concepts

Renal Tubular Acidosis, Type II
Kidney Tubules, Proximal
Orthophosphate
Sodium Chloride, (24)NaCl
Sodium Bicarbonate
Acidosis
Acids
Na(+)-K(+)-Exchanging ATPase
Ammonium
Bicarbonates

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