Importance of ultrafilterable plasma factors in maintaining tubular reabsorption

Maintaining K+ balance on the low-Na+, high-K+ diet

A low-Na⁺, high-K⁺ diet (LNaHK) is considered a healthier alternative to the "Western" high-Na⁺ diet. Because the mechanism for K⁺ secretion involves Na⁺ reabsorptive exchange for secreted K⁺ in the distal nephron, it is not understood how K⁺ is eliminated with such low Na⁺ intake. Animals on a LNaHK diet produce an alkaline load, high urinary flows, and markedly elevated plasma ANG II and aldosterone levels to maintain their K⁺ balance. Recent studies have revealed a potential mechanism involving the actions of alkalosis, urinary flow, elevated ANG II, and aldosterone on two types of K⁺ channels, renal outer medullary K⁺ and large-conductance K⁺ channels, located in principal and intercalated cells. Here, we review these recent advances.

Sodium transport inhibitor in proximal tubular urine during acute volume expansion

Harvested proximal tubular fluid from mannitolsaline expanded rats caused a 50% inhibition of transepithelial sodium concentration difference when compared to an artificially prepared test solution used in the same and nonexpanded animals. Because of the methodology employed, none of the usual factors known to affect sodium reabsorption by the kidney could have been responsible for these changes. The factor responsible acts from the luminal side, is an inhibitor and has a short duration of action.

Dependency of proximal tubular fluid transport on the load of glomerular filtrate

In hydropenic rats, the reabsorption of glomerular filtrate by the proximal convoluted tubules was measured before and after reduction of its intratubular flow rate. Three different protocols were used. (1) In 26 tubules (14 rats), nephron glomerular filtration rate (SNGFR) was varied from 37.2 +/- 7.3 to 20.4 +/- 7.1 nl/min by microperfusing their loops of Henle at 0 to 5 nl/min and 40 nl/min, respectively. This 43% reduction of SNGFR was followed by a 36.0 +/- 23.3% reduction of volume reabsorption rate (P less than 0.001). Between both parameters a linear regression line can be calculated, which is given by y = 0.92 chi + 0.0017. (2) In 17 tubules (14 rats), SNGFR was altered again by feedback from 46.0 +/- 9.7 to 28.8 +/- 9.3 nl/min. The volume resorption from the first half of the proximal convoluted tubule was compared with the reabsorption in its late proximal segments, which were microperfused with proximal tubular fluid at a rate of 20 nl/min. The 36.8% reduction of SNGFR was followed by only a 28.2% reduction of volume reabsorption rate in the first half of the tubule. In the microperfused segments, however, reabsorption remained unaltered. (3) In 29 tubules (21 rats), at the midpoint of proximal convolutions, some of the tubule fluid was removed by a suction pump, and volume reabsorption rate in the late segments was compared with that in the early parts of this tubule, when SNGFR remained stable. The reduction of intratubular flow from 27.7 +/- 8.5 to 14.7 +/- 5.8 nl/min, which is 53% of control, were followed by a reduction of volume reabsorption rate in the late segment to 60.6% control. Between both parameters a regression line was calculated, which is given by y = 0.76 chi +/- 0.01. We conclude that the rate of volume reabsorption by the proximal tubule depends on its intratubular load of glomerular filtrate and, further, that this dependency accounts predominantly for the maintenance of glomerular tubular balance under conditions of hydropenia.

Water reabsorption capacity of the proximal convoluted tubule: a microperfusion study on rat kidney

1. The differences in the water reabsorption capacity observed from one proximal tubule to another were investigated in vivo by continuous microperfusion. 2. Two to seven loops were punctured along the same tubule. The [3H]inulin, 22Na, [14C]glucose, sodium, chloride and magnesium concentrations as well as the osmolality of the collected samples were studied as a function of the perfused length. 3. With Ringer bicarbonate solution perfused in Saclay Wistar rats, the water reabsorption capacity ranged from 0 to 3 nl . min-1 . mm-1 depending on the tubule. This reabsorption rate was closely correlated with the unidirectional reabsorption flux of sodium, and with the rise in tubular chloride and magnesium concentrations. 4. In Munich Wistar rats with glomeruli accessible at the kidney surface, tubule perfusion with a Ringer bicarbonate solution showed that the highest water reabsorption rates per mm of tubule were found for the perfusion sites closest to the glomerulus; water fluxes were also positively correlated with glucose transport. 5. In a second series of experiments on Saclay rats, perfusion of a Ringer solution containing a high chloride concentration (137 m-equiv/l.) was unable to increase the water reabsorption rate compared to the control perfusion; here again, water fluxes were positively correlated with glucose transport.

Dependence of water movement on sodium transport in kidney proximal tubule: a microperfusion study substituting lithium for sodium

The relationship between water and sodium movements through the mammalian proximal convoluted tubule was investigated by substituting lithium for sodium. Proximal convoluted rat Kidney tubules were perfused in vivo with a Ringer solution containing 107 meq/liter lithium and 42 meq/liter sodium. Several micropunctures were made along the same nephron, and [3H] inulin, [14C] glucose, 22Na, osmolality, Na, Mg and Cl were determined on each sample. Measurements of 22Na showed that sodium and lithium diffusion rates were practically identical throughout the entire epithelium. A one- for-one exchange of sodium for lithium induced a negative transepithelial net flux of Na from plasma to lumen. However, despite this negative flux, a positive net water movement was measured from lumen to plasma. This movement was proportional both to glucose reabsorption and to the rise in the chloride concentration, two mechanisms known to be dependent on the transcellular movement of sodium. It was therefore concluded that the net water flux was a function of the unidirectional transcellular net flux of Na. Rabbit proximal convoluted tubules were perfused in vitro with solution containing 75 meq/liter Li and 75 meq/liter Na on both the luminal and peritubular sides. Under these conditions, the water reabsorption rate dropped to half its control value. Water movement was therefore a function of the external sodium concentration, which in turn probably regulates the intracellular Na concentration.

Volume reabsorption by the loop of Henle: a micropuncture study

The observed extension of glomerulo-tubular beyond the proximal tube is thought to be due either to flow dependent reabsorption by non-accessible proximal segments and pars recta, or to osmotic volume flow out of the descending limb of the loop of Henle.

Effect of flow rate and the extracellular fluid volume on proximal urate and water absorption

The in vivo microperfusion technique was used to examine the effect of variations in tubular flow rate and the extracellular fluid volume onf [2-14C]-urate and water absorption in the proximal tubule of the rat. In nondiuretic animals, fractional urate absorption was highest at the lowest perfusion rate examined and decreased as the rate of perfusion was increased. Increasing the initial concentration of urate in the perfusion solution had no effect on the fractional absorption of urate. Fractional water absorption was also inversely related to the rate of perfusion. Expansion of the extracellular fluid volume with isotonic saline resulted in rates of urate absorption similar to control values at any given microperfusion rate. Fractional water absorption showed the same flow rate dependency pattern observed in control animals, but at a significantly lower rate of absorption. These studies indicate that fractional urate absorption is dependent upon some parameter of tubular flow rate and that the relationship between urate absorption and perfusion rate is not related to the delivered load of urate per se and is not affected by the state of hydration of the extracellular fluid.

A micropuncture study of renal sodium retention in nephrotic syndrome in rats: evidence for increased resistance to tubular fluid flow

Micropuncture studies were carried out in surface nephrons of rats with nephrotoxic-serum (NTS)-induced nephrotic syndrome during a period of active sodium and water retention. It was found that hydrostatic pressure and tubular diameter were increased in the proximal tubules (13.4 +/- 0.2 vs. 10.4 +/- 0.2 mm Hg; 31.3 +/- 0.9 vs. 18.4 +/- 0.7 mu), whereas pressure and tubular diameter were normal in the distal tubules. Single nephron glomerular filtration rate (SNGFR) was decreased and fractional reabsorption of fluid was markedly increased in the proximal tubules (74.1 vs. 61.7%). The increased pressure gradient between the proximal and distal tubules suggests a condition of increased resistance to flow between the proximal and distal tubules. Microinfusion of proximal tubules with an isotonic "equilibrium" solution led to little or no rise in intratubular pressure in normal rats but it led to a significant rise in nephrotic rats. When proximal tubules of normal rats were infused with a solution containing 100 mg/100 ml albumin, pressure rose to levels observed in nephrotic rats. The mechanism of the increased resistance to flow appeared to be related, therfore, to the presence of protein in the tubular fluid. Sodium retention in the nephrotic animals might be attributed to the reduction in GFR. In other types of renal disease in animals and man with comparable or greater reductions in GFR, sodium retention does not occur, however, and fractional excretion of sodium in the urine is increased in proportion to the reduction in GFR. Thus, the rise in proximal fractional reabsorption secondary to impaired fluid flow could be an important factor in the sodium retention of this disease.

Single nephron filtration, luminal flow and tubular fluid reabsorption along the proximal convolution and the pars recta of the rat kidney as influenced by luminal pressure changes

Intratubular pressures were measured in free flow and after blockade of tubular flow at different distances from the glomerulum in the kidney of Wistar rats. Free flow pressure was ffp = 13.3 +/- 2.5 Torr and stop flow pressure sfp = 41.7 +/- 3.8 Torr. With increasing distance of the blockade from the glomerulum the intratubular pressure decreased being 22.4 +/- 2.1 Torr, when the tubule was blocked at the end of the pars recta. In a second series single nephron filtration rate (gfr) and late proximal flow rates (V) were measured at different intratubular pressures. Free flow gfrf was 26.5 +/- 5.9 nl/min and Vf = 14.7 +/- 4.0 nl/min. The difference of these flow rates divided by tubular length results in a local reabsorption rate of C = 2.9 +/- 0.9 nl/min-mm in the proximal convolution. In the pars recta local reabsorbtion rate was 1.0 +/- 0.3 nl/min-mm. In the proximal convolution C increased with increasing intratubular pressure: deltaC/deltaitp = (2.7 +/- 1.2)-10(-2) nl/min-mm-Torr. Filtration was in disequilibrium in these animals under all conditions examined, hydraulic filtration conductance was K = 1.2 +/- 0.4 nl/min-Torr. Modified methods have been used for intratubular pressure and for flow rate measurements in order to reduce experimental procedure. It is shown, that fractional reabsorption, calculated on the basis of pressure measurements, is a good approximation to results usually obtained by inulin measurements.

Effect of perfusion rate on the fluxes of water, sodium, chloride and urea across the proximal convoluted tubule

Studies were undertaken to examine the mechanism whereby changes in intraluminal flow rates after reabsorption in the isolated perfused proximal tubule of the rabbit. All protocols employed the technique of in vitro perfusion of isolated segments of the proximal convoluted tubule. Stepwise elimination of d-glucose and l-alanine from an artifical perfusate stimulating ultrafiltrate decreased the unidirectional flux of sodium, transtubular potential difference, and net water absorption. Using isosmolal ultrafiltrate as the perfusate, net fluid reabsorption and the unidirectional lumen-to-bath flux of sodium and chloride decreased with a decrease in flow rate below 11 nl/min, but neither net fluid reabsorption nor the unidirectional fluxes of sodium and chloride increased further as the perfusion rate was increased above 11 nl/min. The unidirectional flux of 14C-urea was not affected by changes of perfusion rate from 1.6 to 44 nl/min. The dependence of net fluid reabsorption and unidirectional fluxes of sodium and chloride on flow rate per se, and not on intraluminal hydrostatic pressure or geometry, was established by demonstrating their decrease despite a rise in intraluminal pressure and inside diameter produced by counterpressure at the collecting end of the tubule, while flow was decreased. Ouabain decreased net fluid reabsorption to near zero at all flow rates, but ouabain had no effect on the flow-dependency of unidirectional sodium anf sodium was eliminated with a decrease in bicarbonate concentration and removal of d-glucose and l-alanine from the perfusate. Thus, the present studies demonstrate that net water and unidirectional sodium and chloride fluxes are flow-dependent. At flow rates somewhere below 11 nl/min, unidirectional fluxes decreased with decreasing perfusion rates; however, at perfusion rates greater than 11 nl/min, there was no further effect of perfusion rate on either net water absorption or the unidirectional fluxes of sodium or chloride. These effects may be partly mediated through the flow-dependent changes in the intraluminal concentration of bicarbonate, d-glucose, and 1-alanine.

Effect of intraluminal bicarbonate and chloride on fluid absorption by the rat renal proximal tubule

In order to study mechanisms of fluid transport in the rat renal proximal convoluted tubule, the effects of large variations in intraluminal HCO3- and Cl- concentrations were measured by microperfusion techniques. No differences in rates of fluid transport were found when intraluminal HCO3- was varied from 4 to 30 mEq/liter and Cl- from 146 to 120 mEq/liter. Inhibition of H+ secretion with benzolamide had no effect on fluid absorption when little or no HCO3- was present in the lumen, but did reduce fluid transport when 25 mEq of HCO3- was present. If several different mechanisms are responsible for proximal fluid transport, such as nonelectrogenic active NaHCO3 transport, passive chloride diffusion and active sodium transport linked to H+ secretion, the above observations imply that they all operate at approximately the same rate, since the dominant driving force would have been different with each perfusion solution. The data seem more compatible with the view that active sodium transport is the major driving force for fluid absorption in the proximal tubule, that this is not linked to H+ secretion and that anions modify the rate of absorption only to the degree that they are able to accompany sodium across the epithelium. An additional observation was that absorption of isotonic NaCl was very slow in short segments of tubule, as compared to HCO3--containing perfusion solutions. Although the mechanism is uncertain, these data suggest that a finite amount of intraluminal HCO3- is necessary for optimal proximal fluid transport.