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This chapter is devoted to the renal handling of sodium (Na), chloride (Cl), and water Sodium and chloride are crucial for the body because they are the two solutes of highest concentration in the extracellular fluids, while water is the solvent for all of the body s dissolved substances and constitutes the majority of the body s volume In terms of transport, the transport of water is the simplest As we pointed out in 4, water follows the osmoles Thus, much of the description for water transport really amounts to describing solute transport, taking into account the fact that in some regions of the kidney low-water permeability limits the amount of water that follows the osmoles Transport of chloride is a little more complicated, but is for the most part passive and, because of the constraints of electroneutrality, tied to the transport of sodium Sodium transport is clearly the most complicated, mostly because it is linked to the transport of so many other substances However, if we keep in mind the generalized model of epithelial transport developed in 4 (Figure 4 4) it is not difficult to grasp the key features of sodium transport The excretory rates of sodium, chloride, and water can vary over an extremely wide range For example, some persons may ingest 20 25 g of sodium chloride/ day, whereas a person on a low-salt diet may ingest only 005 g The normal kidney can readily alter its excretion of salt over this range Similarly, urinary water excretion can be varied physiologically from approximately 04 L/day to 25 L/day, depending on whether one is lost in the desert or participating in a beer-drinking contest Sodium, chloride, and water are all freely filterable at the renal corpuscle They all undergo considerable tubular reabsorption, usually more than 99%, but normally no tubular secretion Most of the considerable renal ATP energy expended every day is used to accomplish this enormous reabsorptive task The major tubular mechanisms for reabsorption of these substances can be summarized by 3 generalizations: 1 2 The reabsorption of sodium is mainly an active, transcellular process driven mostly by sodium-potassium-adenosine triphosphatase (Na-K-ATPase) The reabsorption of chloride is both passive (paracellular diffusion) and active (transcellular), but it is directly or indirectly coupled with the reabsorption of sodium, thus explaining why the reabsorption of the 2 ions usually occurs in parallel When describing the reabsorption of sodium, a parallel reabsorption of chloride is usually implied The reabsorption of water is by osmosis and is secondary to reabsorption of solutes, particularly sodium and substances whose reabsorption is dependent on sodium reabsorption (mostly chloride).

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The student understands the hemodynamics of renal blood flow Defines renal blood flow, renal plasma flow, glomerular filtration rate, and filtration fraction and gives normal values Y States the formula relating flow, pressure, and resistance in an organ Y Describes the relative resistances of the afferent arterioles and efferent arterioles Y Describes the effects of changes in afferent and efferent arteriolar resistances on renal blood flow The student understands how glomerular filtrate is formed and the forces that determine its rate of formation Y Describes how molecular size and electrical charge determine filterability of plasma solutes; states how protein binding of a low-molecular-weight substance influences its filterability Y States the formula for the determinants of glomerular filtration rate, and states,in qualitative terms, why the net filtration pressure is positive Y Defines filtration coefficient and states how mesangial cells might alter the filtration coefficient; states the reason why glomerular filtration rate is so large relative to filtration across other capillaries in the body Y Describes how arterial pressure, afferent arteriolar resistance, and efferent arteriolar resistance influence glomerular capillary pressure Y Describes how changes in renal plasma flow influence average glomerular capillary oncotic pressure The student understands the normal controls of renal blood flow and glomerular filtration rate Y States the Starling forces involved in capillary filtration Y States how changes in each Starling force affect glomerular filtration rate Y Defines autoregulation of renal blood flow and glomerular filtration rate Y Describes the myogenic and tubuloglomerular feedback mechanisms of autoregulation

know some students who always seem to ace the multiple-choice questions, and some students who would rather set themselves on fire than sit for another round of bubble trouble We hope that, with a little background and a few tips, you might improve your scores on this important component of the AP Chemistry exam First, the background Every multiple-choice question has three important parts: 1 The stem is the basis for the actual question Sometimes this comes in the form of a fill-in-the-blank statement, rather than a question

Source: Tim Kelly, Global Internet Connectivity and the Digital Divide, ITU, OECD Workshop on Internet, Traffic Exchange, Berlin, June 7 8, 2001

Renal Blood Flow and GlomeRulaR FiltRation / 25

and ________

US Internet backbone Other US public data networks US private-line data US local calls US local phone calls US local calls US intrastate toll US intrastate toll calls US intrastate toll calls US interstate toll US interstate toll US interstate toll US switched access minutes US international outbound US international inbound World telephony Late 2000 Late 1998 Late 1998 1995 1997 1998 1995 1997 1998 1995 1997 1998 1996 1997 1997 20,000 35,000 terabytes (TB)/month 1,000 TB/month 4,000 7,000 TB/month 2,228 GDEM 2,683 GDEM 2,986 GDEM (119,440 TB/month) 344 GDEM 404 GDEM 422 GDEM (16,880 TB/month) 451 GDEM 525 GDEM 555 GDEM (22,200 TB/month) 4688 GDEM 226 GDEM 91 GDEM 572 28 11 600 55 64 31 Network When Volume/Month Gbps

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