Reabsorption I: The Proximal

Tubules
With Thad Wilson

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 Epithelial Transport in the Nephron
Basolateral Apical Filtration
Interstitium and membrane membrane
blood vessels Lumen
Epithelial cells
Bulk flow
Blood side Paracellular path
Transcellular path
Channels and
transporters assist Urine side
ATP
passage across the 2 Active
membranes.
Passive Solutes
(diffusion)
Reabsorption Excretion
Osmosis H2 O

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 Overview of Proximal Tubule Transport
Apical Basolateral
Na+ gradient H2O

Water osmosis
HIGH Na+-K+ ATPase Solvent
[Na+] Na+
LOW
drag
[Na+]
K+ H2O

Ions, small molecules

Water
Voltage Na+ reabsorption
gradient

3 mV Solutes

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 Proximal Tubule Transport by Solute

2.0 Inulin

Tubule fluid concentration/plasma

Inulin is not reabsorbed.

ultrafiltrate concentration
Cl
Na+ is flat as it is being reabsorbed Na+ K+
at a similar rate as water. 1.0
Osmolality

Under most circumstances

a. a. and glucose are totally HCO3
reabsorbed in the PT. Amino acids
0 Glucose
0 50 100
Distance along proximal tubule (%)

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 Proximal Tubule Structure

Proximal convoluted
tubule (PCT)

Proximal
straight
tubule (PST)

Tubule lumen is lined with a

brush border comprising
thousands of villi.

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 Glucose Transport

Apical Basolateral Apical Basolateral

Flow

Na+-K+ ATPase Na+-K+ ATPase

Na+ Na+

Na+ K+ 2 Na+ K+
Glucose Glucose

SGLT2 To blood SGLT1 To blood

Glucose Glucose
Glucose
GLUT2 GLUT1

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 Peptide Transport
Early segments Late segments
Apical Basolateral
Flow

Dipeptide
Amino acid transporter Amino acid transporter

PepT1
PepT2
H+ H+
Peptide Peptide

Tripeptide
Protease Protein
Amino
Peptidase acids Endocytotic vacuole
Na+-K+ ATPase Na+-K+ ATPase

Megalin and cubilin endocytotic receptors

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 Amino Acid Transport in PT

Apical Membrane
• Anionic (acidic) a. a. (amino acid) transport various ion exchanges

• Cationic (basic) a. a. transport often for a neutral a. a.

• Neutral a. a. transport via Na+ or H+ cotransport

Basolateral Membrane
• Cationic and Neutral a. a. transport via Na+ cotransport

• Aromatic a. a. via facilitated diffusion

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 Phosphate Transport Within the PT

Parathyroid hormone (PTH) inhibits Pi transporters are inserted into the apical
phosphate (Pi) reabsorption. membrane when plasma Pi levels are low.
Apical Basolateral Apical Basolateral
Unknown Pi transporter
Na+-Pi IIc
Pi 3 Na+
Pi

Pi PTH PTH
2 Na+
Pi

Endocytotic vesicles Na+-Pi IIc

PTH receptor

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 Phosphate Transport Within the PT

Parathyroid hormone (PTH) inhibits Parathyroid Hormone (PTH)

phosphate (Pi) reabsorption.
Apical Basolateral

Pi

Pi PTH

Endocytotic vesicles
PTH receptor

Openstax, Thyroid Gland

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 Phosphate Transport Within the PT

Parathyroid hormone (PTH) inhibits Parathyroid hormone

phosphate (Pi) reabsorption.
Apical Basolateral

Pi
Bone Kidney Kidney
Bone Ca2+ PO43
resorption reabsorption reabsorption
Pi PTH

Plasma Ca2+
Endocytotic vesicles
PTH receptor

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 Transport Maximums

Glucose = 375 mg/min

Amino acids = 1.5 mM/min

Proteins = 30 mg/min

Phosphate = 0.1 mM/min

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 Effect of Transport Maximum on Excretion
However, if the amount filtered
is > than the capacity to reabsorbed,
the solute will be left in the tubule

Solute concentration filtered,

reabsorbed, or excreted
lumen (i. e., excreted)
Filtered

A limited transport capacity (Tm)

limits how much solute can be
Reabsorbed
recovered from the tubule lumen. Tm
Splay
Excreted
Some nephrons reach (Tm) before
others, causing the titration curve
to splay. Plasma solute concentration

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 Sodium Transport in the PT
Na+-K+ ATPase establishes a Na+ gradient across the
surface membrane. Na+ gradient powers uptake of
Na+ in association with various organic compounds.
The bulk transcellular flow Apical Basolateral
is derived from all the co-
Na+-K+ ATPase
transport across the apical
membrane. The Na+ is the
Na+ cotransporters Na+
driving force for the
movement of these other
K+
molecules. Na+

Na+
Water also follows the Glucose
sodium and is reabsorbed. Na+ Amino acids
Organic acids
Phosphate Trans-
Na+
cellular
flow

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 Chloride Transport in the PT

Cl- is reabsorbed paracellularly, driven by the

electrical gradient created by Na+ reabsorption.
Na+ leaks backwards by the same pathway.

Large amounts of Cl- are

also transported, primarily 3 mV Na+
via the paracellular route.
Not shown on the apical
membrane are Cl-base Na+-K+ ATPase
exchanger (CFEX) in the
late PT for transcellular
reabsorption. Paracellular flow

Cl-

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 Calcium and Magnesium Transport in the PT

• Early PT transport is via solvent drag

• Later PT transport is via transepithelial voltage

• Ca2+ reabsorbed is ~65 % of filtered load

• Mg2+ reabsorbed is ~15 % of filtered load

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 K+ Transport
Apical Basolateral

Similar to Ca2+, and Mg2+,

H2O
K+ is reabsorbed by the
same 2 mechanisms. H2O Solvent drag
However, a greater % of
filtered load i. e., 80 % - H2O
Na+
is reabsorbed in the PT. Na+-K+ ATPase
Potassium K+
K+is reabsorbed passively, ions
carried along with water.
K+
K+ reabsorption in the later K+ channel
regions is favored by the
transepithelial voltage
gradient.
Tight junction
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 Peritubular Starling Forces
Interstitium Fluid is absorbed across the length of the capillary.
Arteriole Plasma colloid osmotic
35 35
pressure (pPC)
PC

Pressure (mm Hg)

30
Pressure (mm Hg)

25 25 Peritubular capillary

Fluid reabsorption
20

15 15
Lymphatic Venule Capillary hydrostatic To renal vein
capillary pressure (PPC)

Small amount of filtration Large amount of reabsorption

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