COUNTERCURRENT MECHANISM

Presentation by 198. Aamir Mujtaba

199.Abdul Wadood
200.Abdullah Jahangir 201.Abdullah Khan

202.Adnan Basheer
Prepared By: ADNAN BASHEER

COUNTERCURRENT IS SIMPLY THE FLOW OF FLUID IN OPPOSITE DIRECTIONS IN TWO ADJACENT TUBULES

Countercurrent Multiplier
It is a mechanism involved in increasing the osmolarity of the interstitial fluid in the medulla of the kidney progressively to about 1200 to 1400 mOsm/L.

IMPORTANT CONCEPTS
1: The renal handling of salts and water are independent of each other. 2: The thin descending limb of Loop Of Henle is freely permeable to water and show a little permeability for salts. 3:Both the thin and thick portions of ascending limb of Loop Of Henle are impermeable to water but show a passive and active transport of salts respectively. 4:The active transport of salts in thick ascending LOH can maintain an osmolarity difference of 200mOsm/L between tubule and interstitium.

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 1
First, assume that the loop of Henle is filled with fluid with a concentration of 300 mOsm/L, the same as that leaving the proximal Tubule and blood plasma.

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 2
Next, the active pump of the thick ascending limb on the loop of Henle is turned on, reducing the concentration inside the tubule and raising the interstitial concentration; this pump establishes a 200mOsm/L concentration gradient.

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 3
Step 3 is that the tubular fluid in the descending limb of the loop of Henle and the interstitial fluid quickly reach osmotic equilibrium because of osmosis of water out of the descending limb.
NOTE:The interstitial osmolarity is maintained at 400 mOsm/L because of continued transport of ions out of the thick ascending loop of Henle.

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 4
Now the additional flow of fluid into the loop of Henle from the proximal tubule, which causes the hyperosmotic fluid in descending limb to flow into the ascending limb.

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 5
In the ascending limb, more ions are pumped into the interstitium, with water remaining behind,until a 200-mOsm/L osmotic gradient is established, with the interstitial fluid osmolarity rising to 500 mOsm/L .

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 6
Then, once again, the fluid in the descending limb reaches equilibrium with the hyper-osmotic medullary interstitial fluid

Steps Involved in Causing Hyperosmotic Renal Medullary Interstitium.

STEP 7
These steps are repeated over and over, with the net effect of adding more and more solute to the medulla in excess of water; with suf ficient time, this processgradually traps solutes in the medulla and multiplies the concentration gradient established by the active pumping of ions out of the thick ascending loop of Henle, eventually raising the interstitial fluid osmolarity to 1200 to 1400 mOsm/L .

Countercurrent Multiplier

ROLE OF UREA
1: Urea contributes to 40-50% of the osmolarity of medullary interstitium when kidney is forming maximally concentrated urine. 2:Urea is passively absorbed from inner medullary collecting ducts unlike the active re-absorption of NaCl from thick ascending limb. 3:Little absorption of urea in distal tubule and cortical collecting ducts as they are impermeable to urea. 4:Increased water re-absorption from cortical collecting tubule causes increased tubular urea level increased tubular urea level causes passive outflow of urea from tubule to medullary interstitium.(via UT-A1 and UT-A3 urea transporters) 5:Despite urea re-absorption, the simultaneous re-absorption of water maintains a high conc. of urea in urine. 6: Urea conc. in PCT rises because it is absorbed to less extent than water, rises in thin descending LOH due to UT-A2 transporters from medullary interstitium. 7: This urea goes gradually through the ascending LOH,DCT,collecting tubule and the cycle is repeated which contribute to hyper-osmolarity of renal medullary interstitium.

ROLE OF UREA

Countercurrent Exchange in the Vasa Recta

It is a process that Preserves Hyperosmolarity of the Renal Medullary Interstitium.

VASA RECTA
Peritubular capillary network that go along with the LOOP OF HENLE deep into the renel medulla is called VASA RECTA

Countercurrent Exchange in the Vasa Recta

Why it is needed?
1: Blood flow must be provided to the renal medulla to supply the metabolic needs of the cells in this part of the kidney. 2. Without a special medullary blood flow system, the solutes pumped into the renal medulla by the countercurrent multiplier system would be rapidly dissipated.

Countercurrent Exchange in the Vasa Recta

There are two special features of the renal medullary blood flow that contribute to the preservation of the high solute concentrations: 1. The medullary blood flow is low, accounting for less than 5 per cent of the total renal blood flow.This sluggish blood flow is suf ficient to supply the metabolic needs of the tissues but helps to minimize solute loss from the medullary interstitium. 2. The vasa recta serve as countercurrent exchangers, minimizing washout of solutes from the medullary interstitium.

Countercurrent Exchange in the Vasa Recta

1:As blood descends into the medulla toward the papillae, it becomes progressively more concentrated, partly by solute entry from the interstitium and partly by loss of water into the interstitium. 2: By the time the blood reaches the tips of the vasa recta, it has a con-centration of about 1200 mOsm/L, the same as that of the medullary interstitium. 3: As blood ascends back toward the cortex, it becomes progressively less concentrated as solutes diffuse back out into the medullary interstitium and as water moves into the vasa recta.

Countercurrent Exchange in the Vasa Recta

Counter current exchange mechanism which causes exchange of water and solutes between Vasa Recta and Renal Medullary Interstitium.

Countercurrent Exchange in the Vasa Recta RESULT OF COUNTERCURRENT EXCHANGE

Although there is a large amount of fluid and solute exchange across the vasa recta, there is little net dilution of the concentration of the interstitial fluid at each level of the renal medulla because of the U shape of the vasa recta capillaries, which act as countercurrent exchangers.

AND THATS ALL