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Urolithiasis
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Crystallogenesis in the free-flowing solution within nephrons is debatable.Occurs in the most supersaturated urine—at the end of the descending Loop of Henle.
Insights into the Recent Scientific Evidences of Natural Therapeutic Treasures as Diuretic Agents
Published in Debarshi Kar Mahapatra, Cristóbal Noé Aguilar, A. K. Haghi, Applied Pharmaceutical Practice and Nutraceuticals, 2021
Vaibhav Shende, Sameer Hedaoo, Debarshi Kar Mahapatra
The diuretics play a crucial role with the management of dropsy and high blood pressure.13 This process operates the rise in negative water and substance balance.14 The proximal convoluted tube-shaped structure reabsorbs the fluid by both active and passive processes.15 The skinny descending loop of Henle permits the diffusion water abstraction is impermeable to the solutes and play pivotal role in reducing water absorption from the descendent limb in overall increased symptomatic condition (Fig. 4.1).16 The skinny ascending limb of loop of Henle is rubberized to water and extremely permeable to chloride and sodium diuretics which show no pronounced effects on that.17
Functions of the Kidneys and Functional Anatomy
Published in Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal, Principles of Physiology for the Anaesthetist, 2020
Peter Kam, Ian Power, Michael J. Cousins, Philip J. Siddal
The loop of Henle consists of a thin limb, which descends into the medulla, followed by a hairpin bend and an ascending limb, which returns to the cortex (Figure 40.1). In nephrons with short loops, the ascending limb is thick. In nephrons with long loops that course through the medulla to the tips of papillae, the ascending limb is at first thin and becomes thickened as it passes through the outer medulla back to the cortex. The purpose of the loop of Henle is to create an increasing interstitial osmotic gradient in the medulla, permitting the reabsorption of water from the collecting ducts and the production of concentrated urine (up to 1400 mOsm/kg) in the presence of antidiuretic hormone (ADH). The descending limb of the loop of Henle reabsorbs water. The thick, ascending limb reabsorbs sodium, potassium, chloride and bicarbonate and secretes hydrogen ions.
Current concepts and advances in biomarkers of acute kidney injury
Published in Critical Reviews in Clinical Laboratory Sciences, 2021
Osteopontin (OPN) is an extracellular matrix protein that serves as a transient proinflammatory cytokine for monocyte/macrophage recruitment. It is located mostly in the loop of Henle and the distal tubule in normal kidney tissue, but can be upregulated in all tubular and glomerular segments following injury [68]. It is therefore considered a more general marker of tubular injury [69]. OPN also has protective roles in tubular injury via decreasing cell apoptosis, participating in adaptive repair, decreasing nitric oxide synthase, and promoting cell survival during hypoxia [68]. It has also been demonstrated to predict AKI in neonates with low birthweight, in adult patients with transplant rejection or drug-induced nephrotoxicity, and in critically ill patients on KRT [69–72].
The furosemide stress test: current use and future potential
Published in Renal Failure, 2021
Blaithin A. McMahon, Lakhmir S. Chawla
Once a loop diuretic is secreted into the tubular fluid it then reaches its site of activity at the NKCC-2 at the thick ascending limb of the loop of Henle. The tubular concentration of furosemide determines its natriuretic effect, and the urine concentration of furosemide has been used as a surrogate for the tubular concentration [10]. Once at the NKCC-2 site, furosemide binds within the translocation ion pocket embedded in the chloride-binding site (portions of the transmembrane domains 11 and 12) resulting in obstruction and subsequent inhibition of the NKCC-2 transporter (Figure 1). Expression of Na-K-2Cl is also evident in cytoplasmic vesicles, suggesting a reservoir of transporters for insertion into the membrane [14], a process that can be modified by vasopressin and PGE2 [18,19]. At least half of an administered furosemide dose is excreted unchanged into the urine, a process that is prolonged in kidney failure (half-life of furosemide increases) [5] and the other half undergoes renal conjugation to glucuronic acid.
Advances in understanding vertebrate nephrogenesis
Published in Tissue Barriers, 2020
Joseph M. Chambers, Rebecca A. Wingert
By the time the nephron is fully developed, it will contain a number of unique cell-types that each need to have the appropriate gene expression to complete their vital functions (Figure 1). The nephron begins with the blood filter, or renal corpuscle encompassing the glomerulus and Bowman’s capsule. This contains a number of cell types including capillaries, mesangium, podocytes, and parietal cells. Next, the tubule contains the proximal convoluted tubule, proximal straight tubule, the Loop of Henle (including descending limb, thin ascending limb, thick ascending limb), distal convoluted tubule, and connecting tubule. The proximal tubule functions in absorption and secretion in an effort to regulate pH of the filtrate. Largely, the Loop of Henle functions to concentrate the filtrate by reabsorbing water. The distal tubule ensures proper ion transport occurs to fine-tune the filtrate by regulating potassium, sodium, and calcium levels. Each unique segment is needed to maintain blood homeostasis by completing these functions. Nephron cells must acquire a number of features to be generally considered terminally differentiated, including proper epithelization, cilia formation, and expression of functional proteins such as tight junctions and solute transporters.