Atlas Of Diseases Of The Kidney by Robert W. Schrier

By Robert W. Schrier

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The DCT is impermeable to water. 11 Disorders of Sodium Balance Lumen – Na Interstitum + + Aldo receptor + Aldo + ~ K cAMP R + Na Na Na Na Na Na Na cGMP AR – ANP GC 2K+ 3Na+ + ↑GFR Gi PGE2 α – Lumen PGE2 ~ 2K+ 3Na+ AC H 2O Gs V2 ATP CCT AVP H 2O + V2 AVP – MCT + FIGURE 2-18 Principal cortical collecting tubule (CCT) cells. In these cells, sodium (Na) enters across the luminal membrane through Na channels (ENaC). The movement of cationic Na from lumen to cell depolarizes the luminal membrane, generating a transepithelial electrical gradient oriented with the lumen negative with respect to interstitium.

Because superficial and deep nephrons may differ in reabsorptive rates, these data would also be consistent with enhanced reabsorption by deep nephrons. Asterisk—data inferred from the difference between distal and urine samples. 19 FIGURE 2-39 Mechanisms of extracellular fluid (ECF) volume expansion in nephrotic syndrome. Nephrotic syndrome is characterized by hypoalbuminemia, which shifts the relation between blood and interstitial volume upward (dashed to solid lines in inset). As discussed in Figure 2-35, these effects of hypoalbuminemia are evident when serum albumin concentrations decrease by more than half.

31. : Identification and characterization of aquaporin-2 water channel mutations causing nephrogenic diabetes insipidus with partial vasopressin response. Hum Mol Genet 1997, 6(11):1865. Disorders of Sodium Balance David H. Ellison S odium is the predominant cation in extracellular fluid (ECF); the volume of ECF is directly proportional to the content of sodium in the body. Disorders of sodium balance, therefore, may be viewed as disorders of ECF volume. The body must maintain ECF volume within acceptable limits to maintain tissue perfusion because plasma volume is directly proportional to ECF volume.

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