Reclamation of filtered bicarbonate.

DuBose, T D · Kidney Int · 1990

review · Level V

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Abstract

Approximately 85% of the filtered bicarbonate load is reabsorbed in the proximal convoluted tubule. Transport in this segment displays saturation kinetics, and exhibits a higher capacity for reabsorption in the earliest portion. Reclamation of bicarbonate is highly regulated in the proximal tubule: an increase in luminal [HCO3-], flow rate and arterial PCO2 increase, while alkalinization of the peritubular surface inhibits bicarbonate absorption. Angiotensin II also appears to regulate bicarbonate transport, especially in the S1 segment. The majority of the filtered bicarbonate load which escapes reabsorption in the proximal tubule is reabsorbed in the thick ascending limb of Henle's loop. Bicarbonate reclamation in this segment is enhanced by luminal [HCO3-] and furosemide, and by chronic metabolic acidosis and increased dietary sodium intake. Amiloride, AVP and glucagon inhibit absorption in the thick ascending limb.

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