230 Chapter 12
aDH Antidiuretic hormone;
it stimulates nephrons to
reabsorb water.
aldosterone A hormone
that concentrates urine by
reducing the amount of
water leaving distal tubules.
juxtaglomerular apparatus
The region where efferent
arterioles lie close to a
nephron’s distal tubules.
sodium is actively transported out of the ascending limb—
but water can’t move with it.
The filtrate now moves into the distal tubule. Its cells
continue to remove salt but don’t also let water escape.
Hence, a dilute urine moves on into the collecting duct.
Naturally, as salt leaves the filtrate moving through a
nephron tubule, the concentration of solutes rises outside
the tubule and falls inside it. This steep gradient helps
drive the reabsorption of valuable solutes, which move
into peritubular capillaries. It also draws water out of the
descending limb by osmosis.
Urea boosts the gradient. As water is reabsorbed, urea
left in the filtrate becomes concentrated. Some of it will be
excreted in urine, but when filtrate enters the final portion
of the collecting duct, some urea also will diffuse out—
so the concentration of solutes in the inner medulla rises
even more.
Drink a large glass of water and the next time you “go,”
your urine may be pale and dilute. If you sleep 8 hours
without a break, your urine will be concentrated and
darker yellow. As described next, hormones control how
much water the kidneys add to urine. These controls also
adjust blood pressure.
Hormones control whether kidneys make
urine that is concentrated or dilute
When you don’t take in as much water as your body
loses, the salt concentration in your blood rises. In the
brain, receptors sense this change and trigger the release
of antidiuretic hormone, or aDH. It acts on cells in distal
tubules and collecting ducts so that more water moves out
of them and is reabsorbed into the blood (Figure 12.8). As
a result, the urine becomes more concentrated. Gradually
the additional water in blood reduces the salt concentra-
tion there. It also increases the blood volume and blood
How Kidneys Help manage Fluid Balance
and Blood pressure
Figure 12.8 aDH and aldosterone act in
different parts of kidney nephrons.
ADH targets
aldosterone
KIDNEY target
CORTEX
KIDNEY
MEDULLA
Figure 12.7 Water and salt are reabsorbed in the
loop of Henle.
H 2 O
Na+
Cl–
kidney loop of
medulla Henle
saltiest
near turn
cortex
medulla
n The kidneys concentrate urine before it flows to the
bladder. These concentration mechanisms help regulate
blood volume and blood pressure.
n Links to Chemical bonds 2.3, Liver functions 11.5
Overall, the total volume of your body fluids, including
blood plasma, doesn’t vary much. This is because during
reabsorption, the kidneys adjust how much water and salt
(sodium 1 chloride ions) the body conserves or excretes
in urine. As you know, blood and tissue fluid are mostly
water. In general, when the volume of blood increases or
decreases, so does blood pressure. The kidneys help ensure
that the volume of extracellular fluid, and blood in particu-
lar, stays within a normal range.
Water follows salt as urine forms
Although about two-thirds of filtered salt and water is
reabsorbed in the proximal tubule, the filtrate usually still
contains more of both than the body can afford to lose in
urine. This situation is addressed as the filtrate enters the
loop of Henle, which descends into
the kidney medulla (Figure 12.7).
There the loop is surrounded by
extremely salty tissue fluid. Water
can pass through the thin wall of
the loop’s descending limb, so more
water moves out by osmosis and
is reabsorbed. As the water leaves,
the salt concentration in the fluid
still inside the descending limb
increases until it matches that in the
fluid outside.
Now the filtrate “rounds the turn” of the loop and enters
the ascending limb. The wall of this part of the nephron
tubule doesn’t allow water to pass through. This is an
important variation in the tubule’s structure, because here
12.4
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