Renal medullary concentrating process: an integrative hypothesis. 1980

J V Bonventre, and C Lechene

The inability to demonstrate adequate active transport in the ascending thin limb of the mammalian kidney has led to the development of models of concentration with only passive transport in the inner medullary loop of Henle. These models depend on very limited solute entry into the descending thin limb, an assumption counter to much of the experimental in vivo data. In addition, these models have not incorporated the vascular-tubular relationships in the renal medulla. We hypothesize that fluid enters the inner medulla in the descending thin limb slightly hyperosmotic to the fluid leaving the inner medulla in the interstitial-vasa recta compartment. We illustrate the hypothesis with a steady-state model of the medullary concentration process with no active transport in the inner medullary loop of Henle and with tubular permeability properties and solute concentrations consistent with experimental data. A difference of 33 mosmol/kg between descending thin limb and fluid leaving the inner medulla in the interstitial-vasa recta compartment results in an increase in formative urine osmolality from 530 mosmol/kg in the collecting duct at the outer-inner medullary boundary to 2,200 mosmol/kg in the ureteral urine. The hypothesis incorporates anatomical and physiological properties of the vascular and tubular structures in the outer medulla.

UI MeSH Term Description Entries
D007671 Kidney Concentrating Ability The ability of the kidney to excrete in the urine high concentrations of solutes from the blood plasma. Urine Concentrating Ability,Abilities, Kidney Concentrating,Abilities, Urine Concentrating,Ability, Kidney Concentrating,Ability, Urine Concentrating,Concentrating Abilities, Kidney,Concentrating Abilities, Urine,Concentrating Ability, Kidney,Concentrating Ability, Urine,Kidney Concentrating Abilities,Urine Concentrating Abilities
D007679 Kidney Medulla The internal portion of the kidney, consisting of striated conical masses, the renal pyramids, whose bases are adjacent to the cortex and whose apices form prominent papillae projecting into the lumen of the minor calyces. Kidney Papilla,Kidney Medullas,Kidney Papillas,Medulla, Kidney,Medullas, Kidney,Papilla, Kidney,Papillas, Kidney
D008138 Loop of Henle The U-shaped portion of the renal tubule in the KIDNEY MEDULLA, consisting of a descending limb and an ascending limb. It is situated between the PROXIMAL KIDNEY TUBULE and the DISTAL KIDNEY TUBULE. Ascending Limb of Loop of Henle,Descending Limb of Loop of Henle,Henle Loop
D008954 Models, Biological Theoretical representations that simulate the behavior or activity of biological processes or diseases. For disease models in living animals, DISEASE MODELS, ANIMAL is available. Biological models include the use of mathematical equations, computers, and other electronic equipment. Biological Model,Biological Models,Model, Biological,Models, Biologic,Biologic Model,Biologic Models,Model, Biologic
D009997 Osmotic Pressure The pressure required to prevent the passage of solvent through a semipermeable membrane that separates a pure solvent from a solution of the solvent and solute or that separates different concentrations of a solution. It is proportional to the osmolality of the solution. Osmotic Shock,Hypertonic Shock,Hypertonic Stress,Hypotonic Shock,Hypotonic Stress,Osmotic Stress,Hypertonic Shocks,Hypertonic Stresses,Hypotonic Shocks,Hypotonic Stresses,Osmotic Pressures,Osmotic Shocks,Osmotic Stresses,Pressure, Osmotic,Pressures, Osmotic,Shock, Hypertonic,Shock, Hypotonic,Shock, Osmotic,Shocks, Hypertonic,Shocks, Hypotonic,Shocks, Osmotic,Stress, Hypertonic,Stress, Hypotonic,Stress, Osmotic,Stresses, Hypertonic,Stresses, Hypotonic,Stresses, Osmotic
D002463 Cell Membrane Permeability A quality of cell membranes which permits the passage of solvents and solutes into and out of cells. Permeability, Cell Membrane
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D014508 Urea A compound formed in the liver from ammonia produced by the deamination of amino acids. It is the principal end product of protein catabolism and constitutes about one half of the total urinary solids. Basodexan,Carbamide,Carmol

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