The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology
Miriam Zacchia, Giovanna Capolongo, Luca Rinaldi, Giovambattista Capasso Division of Nephrology, Department of Cardio-Thoracic and Respiratory Sciences, Università della Campania “Luigi Vanvitelli”, Naples, Italy Abstract: The thick ascending limb (TAL) of Henle&rs...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2018-02-01
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| Series: | International Journal of Nephrology and Renovascular Disease |
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| Online Access: | https://www.dovepress.com/the-importance-of-the-thick-ascending-limb-of-henles-loop-in-renal-phy-peer-reviewed-article-IJNRD |
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| author | Zacchia M Capolongo G Rinaldi L Capasso G |
| author_facet | Zacchia M Capolongo G Rinaldi L Capasso G |
| author_sort | Zacchia M |
| collection | DOAJ |
| description | Miriam Zacchia, Giovanna Capolongo, Luca Rinaldi, Giovambattista Capasso Division of Nephrology, Department of Cardio-Thoracic and Respiratory Sciences, Università della Campania “Luigi Vanvitelli”, Naples, Italy Abstract: The thick ascending limb (TAL) of Henle’s loop is a crucial segment for many tasks of the nephron. Indeed, the TAL is not only a mainstay for reabsorption of sodium (Na+), potassium (K+), and divalent cations such as calcium (Ca2+) and magnesium (Mg2+) from the luminal fluid, but also has an important role in urine concentration, overall acid–base homeostasis, and ammonia cycle. Transcellular Na+ transport along the TAL is a prerequisite for Na+, K+, Ca2+, Mg2+ homeostasis, and water reabsorption, the latter through its contribution in the generation of the cortico-medullar osmotic gradient. The role of this nephron site in acid–base balance, via bicarbonate reabsorption and acid secretion, is sometimes misunderstood by clinicians. This review describes in detail these functions, reporting in addition to the well-known molecular mechanisms, some novel findings from the current literature; moreover, the pathophysiology and the clinical relevance of primary or acquired conditions caused by TAL dysfunction are discussed. Knowing the physiology of the TAL is fundamental for clinicians, for a better understanding and management of rare and common conditions, such as tubulopathies, hypertension, and loop diuretics abuse. Keywords: TAL, sodium handling, potassium handling, acid–base homeostasis, urine concentration |
| first_indexed | 2024-12-10T12:34:47Z |
| format | Article |
| id | doaj.art-ede1c0003d9149dc8c52a43c3494d6ac |
| institution | Directory Open Access Journal |
| issn | 1178-7058 |
| language | English |
| last_indexed | 2024-12-10T12:34:47Z |
| publishDate | 2018-02-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of Nephrology and Renovascular Disease |
| spelling | doaj.art-ede1c0003d9149dc8c52a43c3494d6ac2022-12-22T01:48:41ZengDove Medical PressInternational Journal of Nephrology and Renovascular Disease1178-70582018-02-01Volume 11819236805The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiologyZacchia MCapolongo GRinaldi LCapasso GMiriam Zacchia, Giovanna Capolongo, Luca Rinaldi, Giovambattista Capasso Division of Nephrology, Department of Cardio-Thoracic and Respiratory Sciences, Università della Campania “Luigi Vanvitelli”, Naples, Italy Abstract: The thick ascending limb (TAL) of Henle’s loop is a crucial segment for many tasks of the nephron. Indeed, the TAL is not only a mainstay for reabsorption of sodium (Na+), potassium (K+), and divalent cations such as calcium (Ca2+) and magnesium (Mg2+) from the luminal fluid, but also has an important role in urine concentration, overall acid–base homeostasis, and ammonia cycle. Transcellular Na+ transport along the TAL is a prerequisite for Na+, K+, Ca2+, Mg2+ homeostasis, and water reabsorption, the latter through its contribution in the generation of the cortico-medullar osmotic gradient. The role of this nephron site in acid–base balance, via bicarbonate reabsorption and acid secretion, is sometimes misunderstood by clinicians. This review describes in detail these functions, reporting in addition to the well-known molecular mechanisms, some novel findings from the current literature; moreover, the pathophysiology and the clinical relevance of primary or acquired conditions caused by TAL dysfunction are discussed. Knowing the physiology of the TAL is fundamental for clinicians, for a better understanding and management of rare and common conditions, such as tubulopathies, hypertension, and loop diuretics abuse. Keywords: TAL, sodium handling, potassium handling, acid–base homeostasis, urine concentration https://www.dovepress.com/the-importance-of-the-thick-ascending-limb-of-henles-loop-in-renal-phy-peer-reviewed-article-IJNRDthick ascending limbsodium handlingpotassium handlingacid-base homeostasisurine concentration |
| spellingShingle | Zacchia M Capolongo G Rinaldi L Capasso G The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology International Journal of Nephrology and Renovascular Disease thick ascending limb sodium handling potassium handling acid-base homeostasis urine concentration |
| title | The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology |
| title_full | The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology |
| title_fullStr | The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology |
| title_full_unstemmed | The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology |
| title_short | The importance of the thick ascending limb of Henle’s loop in renal physiology and pathophysiology |
| title_sort | importance of the thick ascending limb of henle rsquo s loop in renal physiology and pathophysiology |
| topic | thick ascending limb sodium handling potassium handling acid-base homeostasis urine concentration |
| url | https://www.dovepress.com/the-importance-of-the-thick-ascending-limb-of-henles-loop-in-renal-phy-peer-reviewed-article-IJNRD |
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