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Department of Physiology and Biophysics, Weill Medical College of Cornell University, New York, New York 10021
Mathematical models of renal
tubular function, with detail at the cellular level, have been
developed for most nephron segments, and these have generally been
successful at capturing the overall bookkeeping of solute and water
transport. Nevertheless, considerable uncertainty remains about
important transport events along the nephron. The examples presented
include the role of proximal tubule tight junctions in water transport
and in regulation of Na+ transport, the mechanism by which
axial flow in proximal tubule modulates solute reabsorption, the effect
of formate on proximal Cl
transport, the assessment of
potassium transport along collecting duct segments inaccessible to
micropuncture, the assignment of pathways for peritubular
Cl
exit in outer medullary collecting duct, and the
interaction of carbonic anhydrase-sensitive and -insensitive pathways
for base exit from inner medullary collecting duct. Some of these uncertainties have had intense experimental interest well before they
were cast as modeling problems. Indeed, many of the renal tubular
models have been developed based on data acquired over two or three
decades. Nevertheless, some uncertainties have been delineated as the
result of model exploration and represent communications from the
modelers back to the experimental community that certain issues should
not be considered closed. With respect to model refinement,
incorporating more biophysical detail about individual transporters
will certainly enhance model reliability, but ultimate confidence in
tubular models will still be contingent on experimental development of
critical information at the tubular level.
proximal tubule; distal tubule; collecting duct; sodium; potassium; chloride; acid/base
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