Intrarenal urea and electrolyte concentrations as influenced by water diuresis and by hydrochlorothiazide

Active urea transport in lower vertebrates and mammals

Some unicellular organisms can take up urea from the surrounding fluids by an uphill pumping mechanism. Several active (energy-dependent) urea transporters (AUTs) have been cloned in these organisms. Functional studies show that active urea transport also occurs in elasmobranchs, amphibians, and mammals. In the two former groups, active urea transport may serve to conserve urea in body fluids in order to balance external high ambient osmolarity or prevent desiccation. In mammals, active urea transport may be associated with the need to either store and/or reuse nitrogen in the case of low nitrogen supply, or to excrete nitrogen efficiently in the case of excess nitrogen intake. There are probably two different families of AUTs, one with a high capacity able to establish only a relatively modest transepithelial concentration difference (renal tubule of some frogs, pars recta of the mammalian kidney, early inner medullary collecting duct in some mammals eating protein-poor diets) and others with a low capacity but able to maintain a high transepithelial concentration difference that has been created by another mechanism or in another organ (elasmobranch gills, ventral skin of some toads, and maybe mammalian urinary bladder). Functional characterization of these transporters shows that some are coupled to sodium (symports or antiports) while others are sodium-independent. In humans, only one genetic anomaly, with a mild phenotype (familial azotemia), is suspected to concern one of these transporters. In spite of abundant functional evidence for such transporters in higher organisms, none have been molecularly identified yet.

Urea and urine concentrating ability in mice lacking AQP1 and AQP3

Aquaporin-1 (AQP1) and aquaporin-3 (AQP3) water channels expressed in the kidney play a critical role in the urine concentrating mechanism. Mice with AQP1 or AQP3 deletion have a urinary concentrating defect. To better characterize this defect, we studied the influence of an acute urea load (300 mumol ip) in conscious AQP1-null, AQP3-null, and wild-type mice. Urine was collected and assayed every 2 h, from 2 h before (baseline) to 8 h after the urea load. Mice of all genotypes excreted the urea load in approximately 4 h with the same time course. Interestingly, despite their low baseline, the AQP3-null mice raised their urine osmolality and urea concentration progressively after the urea load to values almost equal to those in wild-type mice at 8 h. In contrast, urine non-urea solute concentration did not change. Urine volume fell in the last 4 h to about one-fourth of basal values. AQP1-null mice increased their urine flow rate much more than AQP3-null mice and showed no change in urine osmolality and urea concentration. The urea load strongly upregulated urea transporter UT-A3 expression in all three genotypes. These observations show that the lack of AQP3 does not interfere with the ability of the kidney to concentrate urea but impairs its ability to concentrate other solutes. This solute-selective response could result from the capacity of AQP3 to transport not only water but also urea. The results suggest a novel role for AQP3 in non-urea solute concentration in the urine.

Urea transport in proximal tubule and the descending limb of Henle

Urea transport in proximal convoluted tubule (PCT) and descending limb of Henle (DLH) was studied in perfused segments of rabbit nephrons in vitro. Active transport of urea was ruled out in a series of experiments in which net transport of fluid was zero. Under these conditions the collected urea concentration neither increased nor decreased when compared to the mean urea concentration in the perfusion fluid and the bath. Permeability coefficient for urea (P(urea)) was calculated from the disappearance of urea-(14)C added to perfusion fluid. Measurements were obtained under conditions of zero net fluid movement: DLH was perfused with isosmolal ultrafiltrate (UF) of the same rabbit serum as the bath, while PCT was perfused with equilibrium solution (UF diluted with raffinose solution for fluid [Na] = 127 mEq/liter). Under these conditions P(urea) per unit length was 3.3+/-0.4 x 10(-7) cm(2)/sec (5.3+/-0.6 x 10(-5) cm/sec assuming I.D. = 20mu) in PCT and 0.93+/-0.4 x 10(-7) cm(2)/sec (1.5+/-0.5 x 10(-5) cm/sec) in DLH. When compared to previously published results, these values show that the PCT is 2.5 times less permeable to urea than to Na, while the DLH is as impermeable to urea as to Na. These results further indicate that the DLH is less permeable to both Na and urea than the PCT. The reflection coefficient for urea, sigma(urea), was calculated as the ratio of induced solution efflux when 95 mOsm/liter of urea was added to the bath, as compared to net fluid movement induced by addition to the bath of equivalent amount of raffinose, sigma(urea) in DLH is 0.95+/-0.4 as compared to 0.91+/-0.05 in PCT. sigma(urea) in DLH is approximately equal to sigma(Na); however, sigma(urea) in PCT is higher than sigma(Na) (0.68). Several types of studies were conducted to examine the role of urea and urea plus sodium chloride in concentrating the fluid in the DLH. From the obtained results it was concluded that the intraluminal fluid of DLH is primarily concentrated by abstraction of water without significant net entry of solute. These results are discussed with respect to possible significance in the overall operation of the countercurrent system.

Influence of prehydration on the changes in renal tissue composition induced by water diuresis in the rat

1. The composition of renal tissue was determined in rats before and immediately after intravenous infusion of dextrose (2.5 g/100 ml.) in amounts sufficient to administer a positive fluid load of 4% body weight over 2 hr. The rats were classified into three groups, according to the preinfusion urine osmolality: hydropaenia, normal and moderately diuretic (over 2400, 800-1500 and below 800 mu-osmoles/g H(2)O, respectively).2. In non-infused rats, the steepness of the corticomedullary osmolal gradient varied, due to differences in both water and solute (sodium and urea) contents, and was related to urinary osmolality. Whereas differences in medullary and papillary solute contents occurred between all three groups, papillary water content was significantly higher only in the moderately diuretic animals.3. Dextrose infusion caused the induction of water diuresis, the lowest urinary osmolalities being produced in the previously moderately diuretic animals.4. Dextrose infusion caused a considerable reduction in the steepness of the corticomedullary osmolal gradient in all rats, particularly in the previously hydropaenic animals, due to changes in both solute (sodium and urea) and water contents. Whereas reductions in medullary and papillary solute contents occurred in all three groups, there was no further increase in papillary water content from the already high values seen in the noninfused diuretic animals.5. Thus, dextrose infusion largely abolished any previous differences in tissue water content, whereas significant, though small, differences in osmolal (particularly urea) content persisted.6. These data are discussed in terms of changes and differences in endogenous antidiuretic hormone (A.D.H.) release.7. Changes in the magnitude and direction of the urinary-papillary urea concentration difference are discussed in terms of passive transport, with probable A.D.H.-induced changes in nephron urea permeability.