Within the nephron of the

kidney The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; blood ...

, the ascending limb of the loop of Henle is a segment of the heterogenous loop of Henle downstream of the descending limb, after the sharp bend of the loop. This part of the renal tubule is divided into a thin and thick ascending limb; the thick portion is also known as the distal straight tubule, in contrast with the distal convoluted tubule downstream.

Structure

The ascending limb of the loop of Henle is a direct continuation from the

descending limb of loop of Henle Within the nephron of the kidney, the descending limb of loop of Henle is the portion of the renal tubule constituting the first part of the loop of Henle. Physiology The permeability is as follows: Also, the medullary interstitium is highly ...

, and one of the structures in the nephron of the kidney. The ascending limb has a thin and a thick segment. The ascending limb drains urine into the distal convoluted tubule. The thin ascending limb is found in the medulla of the kidney, and the thick ascending limb can be divided into a part that is in the renal medulla and a part that is in the renal cortex. The ascending limb is much thicker than the descending limb. At the junction of the thick ascending limb and the distal convoluted tubule are a subset of 15-25 cells known as the macula densa that are part of renal autoregulation through the mechanism of tubuloglomerular feedback.

Histology

As in the descending limb, the epithelium is

simple squamous epithelium A simple squamous epithelium, also known as pavement epithelium, and tessellated epithelium is a single layer of flattened, polygonal cells in contact with the basal lamina (one of the two layers of the basement membrane) of the epithelium. This ...

Function

Thin ascending limb

The thin ascending limb is impermeable to water; but is permeable to ions allowing for some sodium reabsorption. Na/K-ATPase is expressed at very low levels in this segment and thus this reabsorption is likely through passive diffusion. Salt moves out of the tubule and into the interstitium due to osmotic pressure created by the countercurrent system.

Thick ascending limb

Functionally, the parts of the ascending limb in the medulla and cortex are very similar. The medullary ascending limb is largely impermeable to water.

Sodium Sodium is a chemical element with the symbol Na (from Latin ''natrium'') and atomic number 11. It is a soft, silvery-white, highly reactive metal. Sodium is an alkali metal, being in group 1 of the periodic table. Its only stable iso ...

(Na⁺),

potassium Potassium is the chemical element with the symbol K (from Neo-Latin ''kalium'') and atomic number19. Potassium is a silvery-white metal that is soft enough to be cut with a knife with little force. Potassium metal reacts rapidly with atmosphe ...

(K⁺) and

chloride The chloride ion is the anion (negatively charged ion) Cl−. It is formed when the element chlorine (a halogen) gains an electron or when a compound such as hydrogen chloride is dissolved in water or other polar solvents. Chloride salts ...

(Cl⁻) ions are reabsorbed by active transport. The predominant mechanism of active transport in this segment is through the Na⁺/K⁺/Cl⁻ co-transporter NKCC2 as well as the sodium/hydrogen exchanger NHE3. In total this segment accounts for approximately 25-30% of total Na⁺ reabsorption along the nephron. This is of clinical importance since commonly used "loop diuretics" act by inhibiting the NKCC2. This active transport enables the kidney to establish an osmotic gradient that is essential to the kidneys ability to concentrate the urine past isotonicity. K⁺ is passively transported along its concentration gradient through a K⁺ leak channel in the apical aspect of the cells, back into the lumen of the ascending limb. This K⁺ "leak" generates a positive electrochemical potential difference in the lumen. This drives more paracellular reabsorption of Na⁺, as well as other

cation An ion () is an atom or molecule with a net electrical charge. The charge of an electron is considered to be negative by convention and this charge is equal and opposite to the charge of a proton, which is considered to be positive by convent ...

s such as

magnesium Magnesium is a chemical element with the symbol Mg and atomic number 12. It is a shiny gray metal having a low density, low melting point and high chemical reactivity. Like the other alkaline earth metals (group 2 of the periodic ta ...

(Mg²⁺) and importantly

calcium Calcium is a chemical element with the symbol Ca and atomic number 20. As an alkaline earth metal, calcium is a reactive metal that forms a dark oxide-nitride layer when exposed to air. Its physical and chemical properties are most similar to ...

Ca²⁺ due to charge repulsion. This is also the part of the tubule that generates

Tamm-Horsfall protein Uromodulin (UMOD), also known as Tamm–Horsfall protein (THP), is a Zona pellucida-like domain-containing glycoprotein that in humans is encoded by the ''UMOD'' gene. Uromodulin is the most abundant protein excreted in ordinary urine. Gene T ...

. The function of this protein is not well understood, but is responsible for creating

urinary casts Urinary casts are microscopic cylindrical structures produced by the kidney and present in the urine in certain disease states. They form in the distal convoluted tubule and collecting ducts of nephrons, then dislodge and pass into the urine, wher ...

Clinical significance

The thick ascending limb symporter:

Na-K-Cl cotransporter The Na-K-Cl cotransporter (NKCC) is a protein that aids in the secondary active transport of sodium, potassium, and chloride into cells. In humans there are two isoforms of this membrane transport protein, NKCC1 and NKCC2, encoded by two differ ...

References

External links

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Overview at vet.cornell.edu
{{Portal bar, Anatomy Kidney anatomy