Mechanisms of intercellular hypertonicity and isotonic fluid absorption in proximal tubules of mammalian kidneys

The main purpose of this theoretical analysis (second of two articles) is to examine whether transjunctional diffusion of NaCl causes intercellular hypertonicity, which permits transcellular water transport across solute-impermeable lateral cell membranes until osmotic equilibration. In the S2 segment with tubular NaCl concentration 140 mM, the calculated apical intercellular NaCl concentration is c0 approximately 132 mM, which exceeds peritubular NaCl concentration by 12 mM or 22 mOsm kg-1. Variations in volume flow, junctional reflection coefficient (sigmaNaCl = 0.25-0.50), gap distance (g = 6-8 A), junctional depth (d = 18-100 A), intercellular diffusion coefficient (DLIS=500-1500 microm2 s-1) and hypothetical active NaCl transport alter c0 only by a fraction of 1 mM. However, dilution and back-leakage of NaHCO3 lower apical intercellular hyperosmolality to approximately 18 mOsm kg-1. Water transport through solute-impermeable lateral cell membranes continues until intercellular and cellular osmolalities are equal. Transcellular and transjunctional volume flow are of similar magnitude (2 nL min-1 mm-1 tubule length) in the S2 segment. Thus, diffusion ensures isotonic absorption of NaCl. Two-thirds of NaHCO3 and other actively transported sodium salts are extruded into the last third of the exponentially widening intercellular space where the exposure time is only 0.9 s. Osmotic equilibration is dependent on aquaporins in the cell membranes. If permeability to water is low, transcellular water transport stops; tubular fluid becomes hypotonic; NaCl diffusion diminishes, but transjunctional water transport remains unaltered as long as transcellular transport of NaHCO3 and other solutes provides the osmotic force.     

Regulation of phosphate transport in proximal tubules

Homeostasis of inorganic phosphate (P_i) is primarily an affair of the kidneys. Reabsorption of the bulk of filtered P_i occurs along the renal proximal tubule and is initiated by apically localized Na⁺-dependent P_i cotransporters. Tubular P_i reabsorption and therefore renal excretion of P_i is controlled by a number of hormones, including phosphatonins, and metabolic factors. In most cases, regulation of P_i reabsorption is achieved by changing the apical abundance of Na⁺/Pi cotransporters. The regulatory mechanisms involve various signaling pathways and a number of proteins that interact with Na⁺/P_i cotransporters.     

Secretion of tetraethylammonium by proximal tubules of rabbit kidneys

The secretory transport of tetraethylammonium (TEA) was investigated in perfused and nonperfused isolated S1, S2, and S3 segments of proximal tubules from rabbit kidneys. In the perfused tubules the transepithelial net secretory flux and in nonperfused tubules the TEA cellular uptake were saturable (Km = 67 microM, Vmax = 2,480 fmol X min-1 X mm-1 in perfused S2 segments), energy dependent, and inhibited by mepiperphenidol. The net secretory flux of TEA (J b leads to j TEA) at a bath TEA concentration of 40 microM differed for the three segments and decreased in the order S1 greater than S2 greater than S3. The concentration of TEA in the perfusate leaving the tubule was approximately twice as great and the intracellular TEA concentration approximately 40 times as great as that in the bath. In nonperfused segments (40 microM TEA in the incubation medium) the TEA tissue water-to-medium ratio reached 100. In the three segments the ability to accumulate TEA across the peritubular membrane, thus, was similar, but the transepithelial secretory flux differed significantly. The differences in secretory rate between the three segments presumably result from differences in the luminal membrane permeability.     

Lack of solvent drag of NaCl and NaHCO3 in rabbit proximal tubules

Using in vitro microperfusion of rabbit nephron segments we measured the effects of osmotically induced water flow on net transport of HCO3 and Cl. Measurements were made in superficial and juxtamedullary proximal convolutions and in superficial pars recta. In addition, measurements were taken in the presence and absence (hypothermia) of active transport. Using osmotic gradients of 25 mM raffinose in superficial and 50 mM in juxtamedullary segments, we observed increases in water flow equal to or greater than the normal rates of volume reabsorption observed in these tubule segments. However, there were no significant changes in HCO3 and Cl flux. This lack of significant solvent drag was seen both when osmotic water flow was in the lumen-to-bath direction and when osmotic flow was in the bath-to-lumen direction. The results of these studies suggest that solvent drag does not contribute significantly to NaCl and NaHCO3 reabsorption in proximal tubules. The lack of significant solvent drag of these salts can be interpreted as indicating either that osmotically induced transepithelial water flow in proximal tubules almost exclusively traverses transcellular pathways or that proximal tubule tight junction reflection coefficients for these salts are close to unity.     

Basolateral choline transport in isolated rabbit renal proximal tubules

 Choline can undergo both net secretion and net reabsorption by renal proximal tubules, but at physiological plasma levels net reabsorption occurs. During this process, choline enters the cells at the luminal side down an electrochemical gradient via a specific transporter with a high affinity for choline. It appeared likely that choline was then transported out of the cells against an electrochemical gradient at the basolateral membrane by countertransport for another organic cation. This possibility was examined by studying net transepithelial reabsorption and basolateral uptake and efflux of [¹⁴C]choline in isolated S2 segments of rabbit renal proximal tubules. Basolateral uptake, which was inhibited by other organic cations such as tetraethylammonium (TEA), appeared to occur by the standard organic cation transport pathway. However, the addition of TEA to the bathing medium not only failed to trans-stimulate net transepithelial reabsorption and basolateral efflux of [¹⁴C]choline but it actually inhibited transepithelial reabsorption by @60%. The results do not support the presence of a countertransport step for choline against an electrochemical gradient at the basolateral membrane. Instead, they suggest that choline crosses this membrane by some form of carrier-mediated diffusion even during the reabsorptive process. Received: 24 March 1998 / Received after Revision: 15 June 1998 / Accepted: 2 July 1998     

Analysis of reabsorbate concentrations in the proximal tubules of dog kidneys during osmotic diuresis

To examine to what extent the reabsorbate concentrations, calculated as the flux ratios between solutes and water, represent the fluid composition in the lateral intercellular space (LIS) in the proximal tubules, reabsorption was stimulated by elevating PCO2 from 5 to 13 kPa before and during infusion of mannitol to a plasma concentration of 70 mM in volume-expanded dogs receiving ethacrynic acid. The reabsorbate concentration of NaHCO3 increased by 50 mM during mannitol infusion. The real concentration of NaHCO3 in LIS could not, however, be elevated by this amount, since the driving forces for fluid reabsorption then would have increased during osmotic diuresis due to diffusion of mannitol into LIS from plasma. A model analysis of diffusion in LIS showed that transcellular transport can only lead to trivial increases of LIS concentrations compared to plasma, whereas diffusion across tight junctions can increase LIS concentrations by several mM. NaCl diffusion and coupled transcellular water transport may therefore represent a significant contribution to total bicarbonate-dependent NaCl and water reabsorption in the proximal tubules.     

Energy source for transepithelial sodium transport in rat renal proximal tubules

Summary The effects of various metabolic inhibitors on isotonic fluid absorption (J _V ) in rat proximal tubules and on the Na⁺–K⁺-ATPase of isolated cell membranes of rat kidney cortex were investigated by the shrinking split oil droplet technique and biochemical methods respectively.Both Oligomycin (5×10^–5 M, 10^–4 M) and Antimycin A (10^–5 M, 10^–4 M) inhibited isotonic fluid absorption by 80% when applied intratubularly but only in conjunction with bovine serum albumin. At these concentrations they inhibited a Na⁺–K⁺ activated adenosine triphosphate phosphohydrolase (Na⁺–K⁺ ATPase E.C. 3.6.1.3.) of cell membranes isolated from rat kidney cortex by 77%, 82% and 55%, 95%, respectively.Sodium phosphoenolpyruvate (PEP) 5×10^–3 M could partially reverse the inhibition of the isotonic fluid absorption but only with 10^–5 M Antimycin A when the Na⁺–K⁺ ATPase inhibition was apparently small.The uncoupler, carbonyl cyanide m-chlorophenyl hydrazone (CCCP) (10^–3 M), as well as sodium cyanide (5×10^–3 M) inhibitedJ _V 100%, but only when applied through peritubular blood capillary perfusion.From these findings it was concluded thatall proximal tubular isotonic fluid absorption is supported by energy fromoxidative processes, and that in a least 80% of this sodium reabsorption, ATP from oxidative phosphorylation is directly involved, while, for the remaining 20% non ATP energy is responsible.C. J. Martin Fellow of the National Health and Medical Research Council of Australia.     

Giant mitochondria in the epithelial cells of the proximal convoluted tubules of diseased human kidneys.

Electron microscopy of 100 renal biopsies obtained at random from patients with various renal disorders revealed gigantic mitochondria in the cytoplasm of the epithelial cells of the proximal tubules in 36 cases (36 per cent). These giant mitochondria are usually round, ovoid, spindle-shaped or rod-shaped often reaching the size of the cell nucleus, and appear singularly and sporadically in the epithelial cell lining of the tubules. Once recognized by electron microscopy they are easily identified in routine histologic preparations and show the same staining characteristics as other mitochondria. In electron microscopy, giant mitochondria have a double limiting membrane, abundant matrical substance, and few remnants or cristae. In addition, they are characterized by (1) intramatrical irregularly branching fibrils approximately 35 A thick, (2) intramatrical bundles of straight filaments approximately 60 to 70 A thick, (3) intramatrical electron-opaque globules up to 0.6 mum., and (4) helical filaments in focally dilated spaces of the outer compartment. The significance of such a remarkable morphologic change of tubular mitochondria and the nature of the unusual components are at present unknown, but an abnormal metabolic condition is considered in its pathogenesis. Nothing specific has yet been found in the relationship between the positive appearance of giant mitochondria and types of renal disorders or clinical and laboratory data. It may be postulated from the present study that "giant mitochondrial tubulopathy" is a rather common, characteristic, and noteworthy change in the histopathology of renal tubule.     

Electrochemical forces for chloride transport in the proximal tubules of the rat kidney

The electrochemical forces for chloride transport in the proximal tubule of the rat kidney were studied using micropuncture techniques. Electrical transmembrane potentials were recorded in randomly punctured tubules with Ling-Gerhard electrodes. Chloride activities in the luminal, cellular and interstitial compartments were measured with ion selective micro-electrodes. Electrical potential measurements between cell to interstitium and lumen to interstitium were -72.1 ± 2.6 mVand ± 0.5±1.4mV(mean ± S.D.)respectively. The calculated chloride concentrations for lumen, cell and interstitium were 133.0±10.3 mM, 8.5±1.0 mM and 99.1 ± 3.2 mM (mean ± S.D.) respectively. The net electrochemical forces, qualitatively, offer a passive chloride ion pathway through the tubular wall and a chloride equilibrium over the luminal membrane seems to exist.     

Effects of CO2 and acetazolamide on bicarbonate and fluid transport in rabbit proximal tubules

Early superficial (SF) and juxtamedullary (JM) proximal convolutions of the rabbit kidney were perfused in vitro to determine the effects of carbonic anhydrase inhibition (10(-4) M acetazolamide) and acute changes in PCO2 (decreases to approximately equal to 15 and increases to approximately equal to 74 mmHg) on potential differences (PD in mV), volume reabsorption (Jv in nl x mm-1 x min-1), and bicarbonate reabsorption (JCO2 in pmol x mm-1 x min-1). At PCO2 37 mmHg early JM exhibited a more lumen-negative PD (-7.5 vs. -5.3), greater Jv (1.13 vs. 0.82), and greater JCO2 (86.7 vs. 44.4) than early Sf. Sf and JM had similar responses to acetazolamide: PD became more negative (-5.2 to -5.9 in SF; -8.8 to -10.1 in JM), Jv decreased (0.92 to 0.68 in SF; 1.11 to 0.76 in JM), and JCO2 decreased (35.7 to 7.7 in SF; 99.2 to 27.4 in JM). Increasing PCO2 to approximately equal to 74 mmHg decreased lumen-negative PD, increased Jv, and increased JCO2 in SF and JM (-5.5 to -4.8, 0.72 to 0.95, and 47.6 to 80.4 in SF; -6.6 to -5.7, 1.19 to 1.47, and 78.0 to 111.3 in JM). Decreasing PCO2 to approximately equal to 15 mmHg increased lumen-negative PD, decreased JCO2, but had no effect on Jv in both segments (-4.9 to -5.8, 51.3 to 6.3, and 0.80 to 0.79 in SF; -7.0 to -7.9, 75.3 to 19.6, and 1.34 to 1.41 in JM). It is concluded that 1) early SF and JM display quantitative heterogeneity, 2) PCO2 changes within the physiologic range produce large changes in HCO3 absorption in early proximal tubules and 3) large changes in HCO3- reabsorption are dissociated from changes in volume reabsorption during hypocapnia.