Mechanisms of Kidney


Source: OpenStax Anatomy and Physiology

OpenStax Anatomy and Physiology

Mechanisms by which substances move across membranes for reabsorption or secretion include active transport, diffusion, facilitated diffusion, secondary active transport, and osmosis.

Active transport utilizes energy, usually the energy found in a phosphate bond of ATP, to move a substance across a membrane from a low to a high concentration. It is very specific and must have an appropriately shaped receptor for the substance to be transported. An example would be the active transport of Na+ out of a cell and K+ into a cell by the Na+ /K+ pump. Both ions are moved in opposite directions from a lower to a higher concentration.

Simple diffusion moves a substance from a higher to a lower concentration down its concentration gradient. It requires no energy and only needs to be soluble.

Facilitated diffusion is similar to diffusion in that it moves a substance down its concentration gradient. The difference is that it requires specific membrane receptors or channel proteins for movement. The movement of glucose and, in certain situations, Na+ ions, is an example of facilitated diffusion. In some cases of mediated transport, two different substances share the same channel protein port; these mechanisms are described by the terms symport and antiport.

Symport mechanisms move two or more substances in the same direction at the same time, whereas antiport mechanisms move two or more substances in opposite directions across the cell membrane. Both mechanisms may utilize concentration gradients maintained by ATP pumps. As described previously, when active transport powers the transport of another substance in this way, it is called “secondary active transport.” Glucose reabsorption in the kidneys is by secondary active transport. Na+ /K+ ATPases on the basal membrane of a tubular cell constantly pump Na+ out of the cell, maintaining a strong electrochemical gradient for Na+ to move into the cell from the tubular lumen. On the luminal (apical) surface, a Na+ /glucose symport protein assists both Na+ and glucose movement into the cell. The cotransporter moves glucose into the cell against its concentration gradient as Na+ moves down the electrochemical gradient created by the basal membranes Na+ /K+ ATPases. The glucose molecule then diffuses across the basal membrane by facilitated diffusion into the interstitial space and from there into peritubular capillaries.

Most of the Ca++, Na+ , glucose, and amino acids must be reabsorbed by the nephron to maintain homeostatic plasma concentrations. Other substances, such as urea, K+ , ammonia (NH3), creatinine, and some drugs are secreted into the filtrate as waste products. Acid–base balance is maintained through actions of the lungs and kidneys: The lungs rid the body of H+ , whereas the kidneys secrete or reabsorb H+ and HCO3 –. In the case of urea, about 50 percent is passively reabsorbed by the PCT. More is recovered by in the collecting ducts as needed. ADH induces the insertion of urea transporters and aquaporin channel proteins.


Betts, J. G., Young, K. A., Wise, J. A., Johnson, E., Poe, B., Kruse, D. H., … DeSaix, P. (n.d.). Anatomy and Physiology. Houston, Texas: OpenStax. Access for free at:


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