Download Contemporary Nephrology: Volume 2 by James A. Schafer (auth.), Saulo Klahr M. D., Shaul G. Massry PDF

By James A. Schafer (auth.), Saulo Klahr M. D., Shaul G. Massry M. D. (eds.)

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K + conductance. but, in the collecting segment, the Na + conductance dominates. These obsenatiollS point again to the importam:e of the specialized transport properties of the luminal membrane in determining the rate and direction of transcpithelial ion movements. By allowing for a luminalmembrane K + conductance, an epithelium that is otherwise identical tu the toad bladder is also made capable of net K + secretion. The presence of an apical membrane K + conductance also leads to diflerences in the transepithelial \oltage.

Lt becomes difficult to establish which of these changes is the initiating or dominant effeet of the aldosterone and it is likely that al! of the changes are direct actions of the hormone that pro\'ide for a coordinated change in apicall\:a + entry, l\'a,K-ATPase acti\'ity, ancl the energv supplv für the pump. 1. Effect of Aldosterone on Metabolism Earh suggestions of an effeet of aldosterone via changes in the metabolie activity of the tel! Jolism anc! that a large fraction of the basal energv turn()\'er in that tissue was in\'()I\'ed with the transport process.

16:1 The possibility that aldosterone action is exerted through an enhanced energy supply for the Na,K-ATPase is also compromised by the lack of any evidence that ATP levels are rate limiting to pump activity in the presence or absence of the hormone, or that aldosterone increases the ATP pool available to the Na,K-ATPase. In addition, Handler et al. 164 observed that aldosterone stimulation of Na + transport in the lOad bladder markedly reduced phosphocreatine with a corresponding increase in creatine.

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