The Countercurrent Mechanism

Multiplier & Exchanger System

MECHANISM OF URINE
CONCENTRATION

Dr. Prince J. Samuel

PROFESSOR AND HEAD
DEPT. OF PHYSIOLOGY
OBJECTIVES
At the end of this class you should know
• Kidney conserves water ...By excreting
concentrated urine
• Obligatory urine output
• Requirements for excreting conc. Urine
• Counter-current mechanism
• Applied aspects
Kidney conserves water ...By
excreting concentrated urine
 WATER BALANCE – a projection
• Rainy day pass more urine

• Sunny day in a desert Therefore,

can’t afford to lose water even as urine ....

• So how does body prevent loss of water

in urine ???
Why 1400 ml urine output and not
180,000 ml????
• Human kidney can produce a maximal
urine concentration of 1200 – 1400
mOsm/L, four to five times the
osmolarity of plasma.

• Desert animals can concentrate urine

upto 10,000 mOsm/L while aquatic
animals like beaver can only concentrate
urine upto 500 mOsm/L.
Obligatory Urine Output
 Obligatory Urine Output
• A normal 70 kg adult must excrete about
600 mOsm of solute each day [urea, SO4,
PO4,other wastes,non-waste ions(Na+, K+)]

• Maximal urine concentrating ability is 1200

mOsm/L i.e. 4 times that of Plasma.

• Therefore, minimal urine volume that must

be excreted, called the Obligatory Urine
Output = 600 mOsm / day = 0.5 L / day
1200 mOsm / L
 Obligatory Urine Output

• As long as the kidneys are functioning, this

volume will be excreted, even if there is no
H2O intake → urinate to death !!!.
 Obligatory Urine Output
• You are shipwrecked !!! There is no water
to drink !!! You are extremely thirsty !!!
You drink seawater .. .. .. What will
happen to you ??????
 Obligatory Urine Output
• Sea water has 3% NaCl and an osmolarity
of 2000 – 2400 mOsm/L.

• If you drink 1 litre of sea water then you

ingest 2400 mOsm of solutes.
 Obligatory Urine Output
• Kidney’s maximal concentrating capacity
= 1200 mOsm/L

• To remove 2400 mOsm of solutes .... you

will have to produce 2 litres of
concentrated urine.

• So for every litre you drink you land up

passing 2 litres of urine .... Rapid
dehydration.
Requirements for excreting
concentrated urine
Concentrating Urine:
•Water absorption
•Controller for water absorption
•Channels to transport water
•Osmotic gradient for movement of
water
 Requirements for excreting
concentrated urine
–High ADH levels
–High osmolarity of renal medullary
interstitium
•Production of hyperosmolar
interstitium
•Maintenance of hyperosmolar
interstitium
 Requirements for excreting
concentrated urine
– High ADH levels .. .. To be discussed later

– High osmolarity of renal medullary

interstitium
• Production
Due to
Countercurrent
• Maintenance
Mechanism
Countercurrent Mechanism
 Countercurrent Mechanism

Depends on special anatomical

arrangement of :
1. Loop of Henle - Countercurrent
Multiplier
2. Vasa Recta - Countercurrent
Exchanger
 Countercurrent Mechanism

High osmolarity of renal medullary interstitium

is due to :
• Production of hyperosmolar interstitium
–Loop Of Henle
• Maintenance of hyperosmolar interstitium
–Vasa Recta
Countercurrent Multiplier
Loop of Henle
 75%

25%

300mOsm
600mOsm
900mOsm
1200mOsm
CORTICAL & JUXTA-MEDULLARY NEPHRONS
 Countercurrent Multiplier
Major Factors that contribute to hyperosmolarity:
1. Thick portion of Asc. limb of LOH – active
transport of Na ions and cotransport of K,
Cl, other ions – contributes 200 mOsm /L
 Countercurrent Multiplier
Less Major Factors that contribute :
1. Collecting Ducts – active transport of ions
2. Inner medullary Collecting Ducts – passive
diffusion of urea
3. Medullary
tubules -
Diffusion of
small amounts
of water
relative to reabsorption of solutes
 Countercurrent Multiplier
Production of hyperosmolar
interstitium
The Steps
 FACTS TO REMEMBER

IN THE PROXIMAL TUBULE

• All the solute movements are accompanied
by equivalent H2O movements

• The fluid that leaves the proximal tubule is

isosmotic with plasma ie 300 mOsmoles/l.
AN OVERVIEW OF FUNCTIONS OF NEPHRON
 BASICS OF CC MULTIPLIER

Ascending limb is only permeable to NaCl, so

interstitial fluid becomes HYPEROSMOTIC
compared to fluid in ascending limb – upto a
limiting gradient of 200 mOsm
BASICS OF CC MULTIPLIER

Descending limb is permeable to H2O only

which moves into interstitium until
osmolarities are now equal. Interstitial
hyperosmolarity maintained - Asc. limb still
pumps NaCl & H2O is absorbed by vasa
MECHANISM OF URINE CONCENTRATION –
HYPEROSMOLARITY PRODUCTION
MECHANISM OF URINE CONCENTRATION –
HYPEROSMOLARITY PRODUCTION
MECHANISM OF URINE CONCENTRATION –
HYPEROSMOLARITY PRODUCTION
 MECHANISM
OF URINE
CONCENTRATION
300mOsm

600mOsm

900mOsm

1200mOsm

Permeable Impermeable To H2O

Only To H2O Only active transport of NaCl
 Countercurrent Mechanism

•Fluid flows down the descending limb

and up the ascending limb- this is
counter current flow

•The repeated pumping of Nacl into the

interstitium causes its conc. to be
multiplied in the renal interstitium- hence
the term countercurrent multiplier for
the loop of henle
Role of Urea in producing
hyperosmotic interstitium
MECHANISM
MECHANISM OF
AN OVERVIEW URINE
OF
OF CONCENTRATION
URINE CONCENTRATION
FUNCTIONS –
OF NEPHRON
HYPEROSMOLARITY PRODUCTION

RELATIVELY IMPERMEABLE
TO UREA – ITS CONC. RISES

PERMEABLE
TO UREA
ANOTHER
MECHANISM
MECHANISM OF CONCENTRATION
MECHANISM OF URINE URINE –
CONCENTRATIONPRODUCTION
HYPEROSMOLARITY
ANOTHER MECHANISM

RELATIVELY IMPERMEABLE
TO UREA – ITS CONC. RISES

PERMEABLE TO UREA
Urea’s contribution:
• Urea contributes about 40 % of the
osmolarity (500 mOsm/L) of the renal
medullary interstitium.

• Malnutrition is associated with a low

urea concentration in medullary
interstitium and considerable
impairment in urine concentrating
ability.
Role of Distal tubules & Collecting
Ducts in excreting concentrated
urine
MECHANISM OF URINE CONCENTRATION

50mOsm

300mOsm 100mOsm
NO 300mOsm

600mOsm

900mOsm

50-100mOsm 1200mOsm
MECHANISM OF URINE CONCENTRATION

50mOsm

300mOsm 100mOsm
HIGH 300mOsm

600mOsm

900mOsm

1200mOsm
1200mOsm
Countercurrent Exchanger
Vasa Recta
 THUS WE SEE:
2 main contributors to the renal inner
medullary interstitial hyperosmolarity
• NaCl
• UREA
But this should ideally be washed away by
the renal blood flow as metabolic wastes
are washed away anywhere in the body -
but this doesn’t happen. Why?
Answer to Why?
• Two special features of the renal
medullary blood flow that contribute to
preservation of high solute
concentrations:
1. Medullary blood flow is low .. .. Only 1-2
% of renal flow .. .. Sluugish blood flow
is enough to supply metabolic needs but
helps to minimize solute loss from
interstitium.
2. Serves as countercurrent exchanger,
minimizing washout of solutes.
 PERI-TUBULAR CAPILLARIES

CORTICAL JUXTAMEDULLARY
VASA RECTA
-A counter
current system
-This allows
exchange of
solutes & water
within its limbs –
COUNTER
CURRENT
EXCHANGER
-this prevents
any change in
the medullary
osmolarity
Highlight

• Even with maximal levels of ADH, urine

concentrating ability will be reduced if
medullary blood flow increases enough to
reduce the hyperosmolarity in the renal
medulla.
Countercurrent Mechanism
The Conclusion
The counter current mechanism
OBJECTIVES
At the end of this class you should know
• Kidney conserves water ...By excreting
concentrated urine
• Obligatory urine output
• Requirements for excreting conc. Urine
• Counter-current mechanism
• Applied aspects
Thank you
CCM
• Need for concentrated urine
• Obligatory urine output
• Requirements for excreting conc. Urine
• Counter-current mechanism
– Parts
– Multiplier
• production of hyperosmolar interstitium
– Steps
– Role of Urea
– Exchanger
• Maintenance of hyperosmolar interstitium
– Special features
• Applied aspects – malnutrition, diabetes insipidus (2 types)