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It uses Na-H antiport, Na-glucose symport, sodium ion channels (minor). [1] It is stimulated by angiotensin II and aldosterone, and inhibited by atrial natriuretic peptide. It is very efficient, since more than 25,000 mmol/day of sodium is filtered into the nephron, but only ~100 mmol/day, or less than 0.4% remains in the final urine.
ANP acts on the kidney to increase sodium and water excretion (natriuresis) in the following ways: [23] [24] The medullary collecting duct is the main site of ANP regulation of sodium excretion. [25] ANP effects sodium channels at both the apical and basolateral sides. [25]
Although the kidney cannot directly sense blood, long-term regulation of blood pressure predominantly depends upon the kidney. This primarily occurs through maintenance of the extracellular fluid compartment, the size of which depends on the plasma sodium concentration.
The functions of the kidney include maintenance of acid-base balance; regulation of fluid balance; regulation of sodium, potassium, and other electrolytes; clearance of toxins; absorption of glucose, amino acids, and other small molecules; regulation of blood pressure; production of various hormones, such as erythropoietin; and activation of vitamin D.
The fractional excretion of sodium (FE Na) is the percentage of the sodium filtered by the kidney which is excreted in the urine.It is measured in terms of plasma and urine sodium, rather than by the interpretation of urinary sodium concentration alone, as urinary sodium concentrations can vary with water reabsorption.
In respiratory acidosis, the kidney produces and excretes ammonium (NH 4 +) and monophosphate, generating bicarbonate in the process while clearing acid. There is also an excretion of Cl- and a reabsorption of sodium, resulting in a negative urinary anion gap. [5] In respiratory alkalosis, less bicarbonate (HCO 3 −) is reabsorbed, thus ...
This decreases the washout of NaCl and urea in the kidney medullary space. Thus, higher concentrations of NaCl and urea in the medulla facilitate increased absorption of tubular fluid. Furthermore, increased reabsorption of fluid into the medulla will increase passive reabsorption of sodium along the thick ascending limb of the Loop of Henle.
Acute kidney injuries can be present on top of chronic kidney disease, a condition called acute-on-chronic kidney failure (AoCRF). The acute part of AoCRF may be reversible, and the goal of treatment, as with AKI, is to return the person to baseline kidney function, typically measured by serum creatinine .
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