Renal Physiology and Hydrosaline Metabolism

Description

This volume discusses renal function and the mechanisms by which the kidney regulates the composition and volume of the extracellular fluid. It also highlights the role of the kidney in the development and progression of arterial hypertension. Most textbooks of renal physiology are based in mammalians physiology and mostly human physiology of the kidney, but the authors considered that this book should also include other species to include the broad spectrum of students and researchers in the life and biomedical sciences. In this sense, we included chapters such as comparative osmoregulation in non-mammalian vertebrates and we emphasize that in vertebrates like fish, reptiles, amphibians and birds, the kidneys and extrarenal organs are vital to maintain fluid homeostasis. The purpose of the book is to provide a concise frame of knowledge in a clear and direct language, of the renal function to medical and biological sciences students. In the context of normal renal function, we provide pathophysiological basis for chronic renal diseases and hypertension with the participation of renal vasoactive hormones. This book is used as textbook in several physiology courses for medical, nursing and biological sciences students at the Pontifical Catholic University of Chile, Finis Terrae University, Universidad San Sebastian as well as other universities. Preface to the Second Edition Acknowledgments Contents About the Authors 1: General Kidney Functions 1.1 Excretion of Nitrogenous Metabolites 1.2 Conservation of Organic Solutes That Are Valuable to the Body 1.3 Regulation of Plasma Osmolality 1.4 Regulation of the Effective Circulating Volume 1.5 Regulation of the Acid-Base Balance 1.6 Regulation of Potassium Balance 1.7 Regulation of Calcium and Phosphate Balance 1.8 Endocrine Function 1.9 Extrarenal Organs in the Maintenance of the Hydrosaline Balance 1.10 Nomenclature of Solute Carriers, Water, and Ion Channels 1.11 Conclusions Bibliography 2: Functional Anatomy of the Kidney 2.1 General Structure of the Kidney 2.2 Nephron Structure 2.2.1 Renal Corpuscle 2.2.1.1 Juxtaglomerular Apparatus (JGA) 2.2.2 Renal Tubule 2.3 Proximal Tubule 2.4 Loop of Henle 2.5 Distal Nephron 2.5.1 Distal Convoluted Tubule 2.5.2 Connecting Tubule 2.5.3 Cortical Collecting Duct (CCD) 2.5.4 Medullary Collecting Duct (MCD) 2.6 Renal Circulation 2.7 Conclusions Bibliography 3: Glomerular Filtration and Renal Blood Flow 3.1 Composition of Glomerular Filtrate 3.2 Dynamics of Glomerular Filtration 3.3 Renal Blood Flow 3.3.1 Autoregulation of Renal Blood Flow 3.3.2 Neurohumoral Regulation of Renal Blood Flow 3.4 Measurement of Glomerular Filtration Rate 3.4.1 Concept of Renal Clearance 3.4.2 Measuring Renal Plasma Flow (RPF) 3.5 Conclusions Bibliography 4: Transport of NaCl, Organic Solutes, and Water in the Renal Tubule 4.1 Renal Function and Tubular Reabsorption 4.2 General Concepts of Transepithelial Transport 4.3 Bioenergetics of Sodium Transport and the Na+, K+-ATPase 4.4 Tubular Processes in Urine Formation 4.4.1 Proximal Tubule 4.5 Glucose Reabsorption 4.6 Amino Acids and Proteins 4.7 Bicarbonate Reabsorption 4.8 Chloride Reabsorption 4.9 Secretion of Organic Anions and Cations 4.10 Coupling of Water Reabsorption with Solutes 4.11 Loop of Henle 4.12 Distal Nephron 4.13 Regulation of NaCl and Water Reabsorption Along the Nephron 4.13.1 Physical Factors: Starling Forces 4.13.2 Glomerulotubular Balance 4.13.3 Regulation by Neurotransmitters and Hormones: General Concepts 4.14 Conclusions Bibliography 5: Water Balance and the Regulation of Plasma Osmolality 5.1 Physical Basis of Water Transport 5.2 Water Pathways in the Cell Membrane and Regulation of Cell Volume 5.3 Distribution of Water in the Body 5.4 Whole Organism Water Balance 5.5 Determinants of Effective Plasma Osmolality 5.6 Biology of Arginine-Vasopressin 5.7 Regulation of Plasma Osmolality 5.8 Mechanism of Urinary Concentration and Dilution 5.8.1 Hypertonic Urine Formation 5.8.2 Hypoosmotic Urine Formation 5.8.3 Role of Vasa Recta Capillaries 5.9 Renal Handling of Urea 5.10 Quantification of the Kidney´s Ability to Concentrate and Dilute Urine 5.11 Survival of Cells in High-Salinity Environments 5.12 Conclusions Bibliography 6: Osmoregulation in Non-mammalian Vertebrates 6.1 Fish 6.1.1 Teleosts 6.2 Elasmobranchs 6.3 Amphibians 6.4 Birds and Reptiles 6.5 Energy Cost of Osmoregulation in Aquatic Environments 6.6 Conclusions Bibliography 7: Regulation of the Effective Circulating Volume and the Sodium Balance 7.1 Concept and Determinants of the Circulating Volume 7.2 Sodium Balance and Its Relationship to Circulating Volume 7.3 Detection of Changes in Circulating Volume 7.4 Signals Generated from the Volume Receptors 7.4.1 Sympathetic Renal Innervation 7.4.2 Renin-Angiotensin II-Aldosterone Axis 7.4.3 Atriopeptin 7.4.4 Arginine-Vasopressin 7.5 Control of Renal Sodium Excretion Under Euvolemic Conditions 7.6 Control of Renal Sodium Excretion in Hypovolemia 7.7 Control of Renal Sodium Excretion Under Conditions of Hypervolemia 7.8 Edema 7.9 Conclusions Bibliography 8: Renal Regulation of Acid-Base Balance 8.1 Body Acid-Base Balance 8.2 Buffers in the Body 8.3 Physiology of the CO2-Bicarbonate Buffer 8.4 Renal Regulation of Acid-Base Balance 8.4.1 Bicarbonate Reabsorption Along the Nephron 8.4.2 Bicarbonate Regeneration 8.5 Regulation of Acid-Base Transport by the State of the Acid-Base Balance 8.6 Primary Acid-Base Balance Disorders 8.6.1 Metabolic Acidosis 8.6.2 Metabolic Alkalosis 8.6.3 Respiratory Acidosis 8.6.4 Respiratory Alkalosis 8.7 Conclusions Bibliography 9: Potassium Balance Regulation 9.1 Distribution of the K+ in the Body 9.2 Transmembrane Distribution of K+ 9.3 Internal Balance 9.4 External Balance 9.5 Adaptation to Potassium 9.6 Conclusions Bibliography 10: Tubular Transport of Calcium, Phosphate, and Magnesium 10.1 Role of the Ca++ and Phosphate in the Body 10.2 Components of Total Calcium and Phosphate in Plasma 10.3 Tubular Transport of Calcium 10.4 Endocrine Regulation of Tubular Calcium Transport 10.5 Phosphate Tubular Transport 10.6 Endocrine Regulation of Phosphate Tubular Reabsorption 10.7 Conclusions Bibliography 11: Kidney Hormones and Their Action 11.1 Renin-Angiotensin System 11.1.1 Function 11.1.2 Renal Location of RAS Components 11.1.3 Renin 11.1.4 Angiotensin I-Converting Enzyme (ACE), ACE2, and NEP 24.11 11.1.5 Angiotensinogen 11.1.6 AT1 and AT2 Receptors 11.1.7 Mas Receptor 11.1.8 Pro-Renin Receptor 11.1.9 Ontogenia 11.2 Kallikrein-Kinin System 11.2.1 Functions 11.2.2 Renal Location of KKS Components 11.2.2.1 Kallikrein 11.2.2.2 Kininogens 11.2.2.3 B1 and B2 Receptors 11.2.3 KKS Ontogeny 11.3 Prostaglandins 11.3.1 Distribution of COX-1 in the Kidney 11.3.2 Distribution of COX-2 in the Kidney 11.4 Nitric Oxide 11.4.1 Distribution of NOS Isoforms in the Kidney 11.5 Erythropoietin 11.5.1 Location 11.5.2 Ontogeny 11.6 Conclusions Bibliography 12: Pathophysiology of Hypertension or High Blood Pressure 12.1 Sodium-Sensitive Hypertension and Kidney Hormones 12.2 Imbalance Between Vasoactive Hormones as a Mechanism of Renal Damage: Increase in ACE and Decrease in Kallikrein Alters t... 12.2.1 Local Induction of ACE and Progression of Kidney Disease 12.2.1.1 Importance of Tubulointerstitial Space 12.2.1.2 Is There a Common Mechanism for the Induction of ACE in Kidney Damage? 12.2.2 Deficiency of the Kallikrein-Kinin System and Kidney Damage 12.3 Regulation of Kallikrein Synthesis, Regulatory effect of Dietary Potassium 12.4 Importance of an Adequate Diet in Potassium and Its Natriuretic Effect 12.5 Sodium and Potassium in the Diet and Salt-Sensitive (Sodium) Hypertension 12.6 Importance of Renal Medullary Circulation in Sodium and Blood Pressure Regulation 12.7 Cyclooxygenase-2 12.8 Conclusions Bibliography 13: Genetic Alterations of Tubular Transport of NaCl and Water 13.1 Bartter Syndrome 13.2 Gitelman Syndrome 13.3 Liddle Syndrome 13.4 Apparent Excess of Mineralocorticoid (AME) 13.5 Genetic Alterations of the Tubular Transport of Water 13.6 Diabetes Insipidus 13.7 Conclusions Bibliography 14: Answers to Chapter Questions Index