procesamiento tubular renal contracorriente
TRANSCRIPT
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Tubular Reabsorption
Figure 27-1;Guyton and Hall
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Primary Active Transport of Na +
Figure 27-2;Guyton and Hall
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Figure 27-3;Guyton and Hall
Mechanisms ofSecondary
Active Transport
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Glucose TransportMaximum
Figure 27-4;Guyton and Hall
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Interstitial Fluid
TubularLumen
Tubular Cells
Reasorption of Water and Solutes isCoupled to Na + Reabsorption
Na +
+ATP
Na +
+ATP Na +
! " m#$ mv
%&$
Cl !
'rea
Na+
% +
(lucose) amino acidsNa +
! *$ m#
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Figure 27-5;Guyton and Hall
Mechanisms by which Water, Chloride,and Urea Reabsorption are Coupled withSodium Reabsorption
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Figure 27-6; Guyton and Hall
Cellular Ultrastructure and PrimaryTransport Characteristics of ProximalTubule
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Figure 27-8;Guyton and Hall
Cellular Ultrastructure and TransportCharacteristics of Thin and Thick Loopof Henle
not permea leto H 2!"
#ery permea leto H 2!"
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Figure 27-$;Guyton and Hall
Sodium Chloride and Potassium Transport inThick Ascending Loop of Henle
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Figure 28-3; Guyton and Hall
Countercurrent Multiplier Systemin the Loop of Henle
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Countercurrent multiplier animation
http://www.colorado.edu/intphys/Class/IPHY3430-200/countercurrent_ct.htmlhttp://www.colorado.edu/intphys/Class/IPHY3430-200/countercurrent_ct.html -
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Figure 28-5; Guyton and Hall
Recirculation of Urea Absorbed from MedullaryCollecting Duct into Interstitial Fluid
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Net Effects ofCountercurrent Multiplier
1% &ore 'olute t(an )ater i' added to t(e renal medulla*i%e%+ 'olute' are ,trapped in t(e renal medulla"%
2% Fluid in t(e a'.ending loop i' diluted%
3% Hori/ontal gradient o0 'olute .on.entration e'ta li'(ed y t(e a.ti#e pumping o0 a l i' ,multiplied y.ounter.urrent 0lo) o0 0luid%
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T(e #a'a re.ta 'er#e a' .ounter.urrent
e .(anger'
The Vasa Recta PreserveHyperosmolarity of Renal Medulla
a'a re.ta lood 0lo) i' lo) *only 1-2 o0
total renal lood 0lo)"
Figure 28-3; Guyton and Hall
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Figure 27-1 ;Guyton and Hall
Sodium Chloride Transport inEarly Distal Tubule
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Cellular Ultrastructure and TransportCharacteristics of Early and Late Distal Tubulesand Collecting Tubules
not permea le to H 2! not #ery
permea le tourea
permea ility to H 2! depend' on A H not #ery
permea le tourea
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Figure 27-12;Guyton and Hall
Sodium Chloride Reabsorption and PotassiumSecretion in Collecting Tubule Principal Cells
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Tu ular 9umenTu ular ell'
a :ATP
l - :
H :ATP
Cortical Collectin( TubulesIntercalated Cells
H2 *depend' on
A H"
H :ATP
:ATP
ATP
:
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Figure 27-13; Guyton and Hall
Cellular Ultrastructure and TransportCharacteristics of Medullary Collecting Tubules
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Normal Renal Tubular Na + Reabsorption
%6
*15 mday"
*16+614 mday"
65
*63$ md"*617 mday"2%4
25+56md
25
*178$ md"
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Summary of Water Reabsorption andsmolarity in ,ifferent Parts of t-e Tubule
Pro imal Tu ule? 65 rea 'orption+ i'o'moti.
e'.% loop? 15-2 rea 'orption+ o'molarity in.rea'e'
A'.% loop? rea 'orption+ o'molarity de.rea'e'
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Concentration and,ilution of t-e 'rine
&a imal urine .on.entration @ 12 - 14 m!'m > 9
*'pe.i0i. gra#ity 1% 3 "
&inimal urine .on.entration
@ 5 - 7 m!'m > 9*'pe.i0i. gra#ity 1% 3"
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Obligatory Urine Volume
T(e minimum urine #olume in )(i.( t(e e .reted'olute .an e di''ol#ed and e .reted%
< ample?B0 t(e ma % urine o'molarity i' 12 m!'m>9+and 6 m!'m o0 'olute mu't e e .reted ea.(day to maintain ele.trolyte alan.e+ t(eo ligatory urine #olume i'?
6 m!'m>d 12 m!'m>9
. %5 9>day
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Maximum Urine Concentration ofDifferent Animals
Animal /a01 'rine Conc1 2m sm 3L4
Cea#er 5
Pig 1+1Human 1+4og 2+4
D(ite Eat 3+
angaroo &ou'e 6+Au'tralian Hopping Mouse 1 +
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Late ,istal) Cortical and /edullaryCollectin( Tubules
Tu ular 9umenPrin.ipal ell'
l -
H2 *)>o A H"
Aldo'terone
:
a :ATP :
ATP
a :
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< .e'' aldo'terone - onn ' 'yndrome a : retention+ (ypo alemia+ al alo'i'+(yperten'ion
Abnormal Aldosterone Production
Aldo'terone de0i.ien.y - Addi'on ' di'ea'e a : )a'ting+ (yper alemia+ (ypoten'ion+deat( i0 untreated
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Bnter'titial Fluid
Tu ular ell' Tu ular 9umen
a :
H :
aATP
:
:
An( II Increases Tubular Na + Transport
Ang BBAng BB
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5ffect of An(iotensin II onPeritubular Capillary ,ynamics
Peritu ular apillary
Glomerular apillary
Ea EeArterialPre''ure
Ang BB Ee P. * peritu ular .ap% pre''%"
renal lood 0lo) FF
.
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An( II Constriction of 5fferent Arterioles Causes Na +
Retention and /aintains 50cretion of Waste Products
a:
depletion
Ee'i'tan.e e00erent arteriole'
Ang BB
Glom% .ap% pre''
Pre#ent' de.rea'ein GFE andretention o0
)a'te produ.t'
Eenal lood 0lo) Peritu % ap% Pre''%
Filt% Fra.tion
a : and H 2! Eea '%Copyright 2006 by Elsevier, Inc.
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Angiotensin II Blockade Decreases Na + Reabsorption and Blood Pressure
A < in(i itor' *.aptopril+ ena/ipril+ ramipril" Ang BB antagoni't' *lo'artan+ .ande'artin+ ir e'artan"
de.rea'e aldo'terone dire.tly in(i it a : rea 'orption de.rea'e e00erent arteriolar re'i'tan.e
atriure'i' and iure'i' : Clood Pre''ure
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Figure 28-1; Guyton and Hall
Formation of a Dilute UrineFormation of a Dilute Urine
ontinue ele.trolyterea 'orption
e.rea'e )aterrea 'orption
/ec-anism6de.rea'ed A Hrelea'e and redu.ed)ater permea ilityin di'tal and.olle.ting tu ule'
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Formation of a Concentrated 'rine
ontinue ele.trolyte rea 'orption Bn.rea'e )ater rea 'orption
&e.(ani'm? Bn.rea'ed A H relea'e )(i.( in.rea'e' )ater
permea ility in di'tal and .olle.ting tu ule' Hig( o'molarity o0 renal medulla ounter.urrent 0lo) o0 tu ular 0luid
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Figure 28-4; Guyton and Hall
Formation of a Concentrated Urine whenAntidiuretic Hormone (ADH) Levels are High
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Figure 28-8;Guyton and Hall
Osmoreceptorantidiuretic hormone (ADH)
feedback mechanism forregulating extracellular
fluid osmolarity
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Figure 28-$;Guyton and Hall
ADH synthesis in theneurons of hypothalamus,
release by the posteriorpituitary, and action on
the kidneys
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Factors t-at ,ecreaseA,% Secretion
e.rea'ed o'molarity Bn.rea'ed lood #olume *.ardiopulmonary re0le e'"
Bn.rea'ed lood pre''ure *arterial arore.eptor'" !t(er 0a.tor'?
- al.o(ol- (aloperidol *antip'y.(oti.+ ti.'+Tourette '"
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Stimuli for T-irst
Bn.rea'ed o'molarity e.rea'ed lood #olume
*.ardiopulmonary re0le e'" e.rea'ed lood pre''ure
*arterial arore.eptor'"
Bn.rea'ed angioten'in BB !t(er 'timuli?- dryne'' o0 mout(
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Factors t-at ,ecrease T-irst
e.rea'ed o'molarity Bn.rea'ed lood #olume
*.ardiopulmonary re0le e'" Bn.rea'ed lood pre''ure
*arterial arore.eptor'" e.rea'ed angioten'in BB !t(er 'timuli?
-Ga'tri. di'tention
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Atrial Natriuretic Peptide (ANP)
Clood #olume
Eenal a : and H 2! rea 'orption
Eenin relea'e aldo'terone GFE
Ang BB
a : and H 2! e .retion
A P
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Tu ular 9umenTu ular ell'
Late ,istal and Collectin( Tubules
H2 *depend'on A H"
A,% .A&P
H2
A=uaporin-2A=uaporin-3H2
e'i.le
A=uaporin'
#& receptor
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Figure 27-$;Guyton and Hall
Sodium Chloride and Potassium Transport inThick Ascending Loop of Henle
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Figure 27-1 ;
Guyton and Hall
Sodium Chloride Transport inEarly Distal Tubule
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Figure 27-12;
Sodium Chloride Reabsorption and PotassiumSecretion in Collecting Tubule Principal Cells