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CONC AND DILUTE URINE

The document explains the mechanisms of controlling extracellular fluid (ECF) osmolality and sodium concentration through urine concentration and dilution. It details the processes involved in excreting dilute and concentrated urine, including the roles of ADH, the counter-current mechanism, and osmolar clearance. Normal ECF sodium concentration is noted as 142 mEq/L and osmolality as 300 mOsm/L, with osmoreceptors playing a key role in regulating ADH secretion.

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3 views2 pages

CONC AND DILUTE URINE

The document explains the mechanisms of controlling extracellular fluid (ECF) osmolality and sodium concentration through urine concentration and dilution. It details the processes involved in excreting dilute and concentrated urine, including the roles of ADH, the counter-current mechanism, and osmolar clearance. Normal ECF sodium concentration is noted as 142 mEq/L and osmolality as 300 mOsm/L, with osmoreceptors playing a key role in regulating ADH secretion.

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dr.fatimajavaid107
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1/2/25, 8:33 AM ChatGPT

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Control of ECF Osmolality & Na Conc.

Excreting Dilute Urine: When ECF osmolality decreases, ADH secretion decreases. This reduces water
reabsorption in the late distal tubule, cortical collecting tubule, and collecting duct, leading to more water
being excreted as dilute urine, increasing ECF osmolality back to normal.

Excreting Concentrated Urine (Counter-Current Mechanism):

1. Creating Hyperosmolality in Medullary Interstitium:

Active transport of Na and Cl from the thick ascending limb of the loop of Henle and collecting duct
into the medullary interstitium.

In the presence of ADH, water is reabsorbed from the collecting duct, increasing urea concentration.
Urea then diffuses into the medullary interstitium due to the concentration gradient.

2. Maintaining Hyperosmolality:

Slow medullary blood flow minimizes solute removal.

The vasa recta acts as a counter-current exchange mechanism, where blood flowing down absorbs
solutes from the interstitium, and blood flowing up releases solutes back, maintaining
hyperosmolality.

3. Enhancing Medullary Hyperosmolality:

Na and Cl from the thick ascending limb diffuse into the medullary interstitium.

Na and Cl from the interstitium diffuse into the descending limb of the loop of Henle and vasa recta,
traveling to the papilla.

Much of Na and Cl diffuse into the papillary interstitium, further increasing osmolality.

The cycle repeats, enhancing the concentration in the medullary interstitium.

4. Formation of Concentrated Urine:

In the presence of ADH, the late distal tubule, cortical collecting tubule, and collecting duct become
permeable to water. Water is reabsorbed due to hyperosmolality in the interstitium, making the urine
more concentrated.

Osmolar Clearance: The volume of plasma cleared per minute of osmoles is called osmolar clearance.

Free Water Clearance: The volume of plasma cleared per minute of free water is called free water clearance.

Normal ECF Na Conc. & Osmolality:

Normal ECF Na Conc.: 142 mEq/L

Normal ECF Osmolality: 300 mOsm/L

Note: Na regulates over 90% of ECF osmolality, so they are controlled together.

Osmoreceptors: These neuronal cells are located near the "AV region" and supraoptic nuclei. They shrink when
ECF osmolality (or Na concentration) increases, triggering increased ADH secretion from the posterior
pituitary.

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