Robert J. Alpern,* Gerhard Giebisch,t and Donald W. Seldin*
* Department of Internal Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas 75235; and 'Department of Cellular and Molecular Physiology, Yale University, New Haven, Connecticut 06510
In this chapter we review how the kidney transports electrolytes and water, and how these processes are regulated. The chapter will then form the basis for an understanding of the multiplicity of diuretic effects, many potentially therapeutic, some responsible for unwanted side effects. The nephron is divided into a number of functional segments, shown in Fig. 1. We begin by discussing the mechanisms of renal Na+, CI ", H+, HC03", and K+ transport. Sections addressing the transport of NH4+, Ca2+, Mg2+, and phosphate follow. We conclude with a discussion of water transport, urinary concentration and dilution, and transport of diuretics.
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