Describe the renal handling of water including the modulation of water excretion.
This question required a brief introduction of the role the kidney plays in water balance; a more detailed description of how water is handled as it passes through the various segments of the nephron (glomerulus, PCT, Loop of Henle, DCT and Collecting Duct); the modulation of water excretion by the kidney due to ADH (vasopressin) and how this operates; and the stimuli (osmotic and non-osmotic) for ADH secretion. Although worth mentioning in the context of the effect they have on water movement through the kidney, detailed explanations of Starling's forces in the glomerulus, and of the operation and maintenance of the counter-current mechanism, were not required. More important was describing the control of water reabsorption in the collecting ducts (and thus modulation of water excretion by the kidney) under the influence of ADH.
Segment | What happens to water | Regulatory mechanisms |
Glomerulus |
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Main mechanism is to influence glomerular blood flow:
|
Proximal convoluted tubule |
|
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Descending thin limb |
|
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Ascending thin and thick limbs |
|
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Distal convoluted tubule |
|
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Connecting tubule and collecting duct |
Variable:
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