Regulation of Blood Volume by Renal Excretion of Water and Sodium

Journal of Blood Research & Hematologic Diseases is an open access journal and celebrating the 5th Anniversary, an esteemed journal which mainly deals with Blood Research & Hematologic Diseases.
This Journal of Blood Research & Hematologic Diseases is a peer reviewing processing journal and publishes the articles on Blood Vessels, Circulatory System, Haematology, Haematopoiesis, Haemoglobin, Haemostasis
Blood is filtered at the glomerulus. This filtrate contains sodium, water and other substances. As the filtrate travels through the proximal tubule, loop of Henle, distal and collecting tubules, the concentration of sodium is altered by transport of sodium across the tubular wall and into the renal interstitium, where it can diffuse into a dense network of intrarenal capillaries. Some of the renal tubules are permeable to water, so water leaves those tubular regions along with the sodium..
The primary mechanism by which the kidneys regulate blood volume is by adjusting the amount of water and sodium lost into the urine. At different sites along the proximal tubules, thick ascending limb of the loop of Henle, distal and collecting tubules, sodium transport is regulated by angiotensin II (Ang II), which increases sodium transport thereby leading to sodium retention. In the collecting tubules, another hormone (aldosterone), stimulates sodium transport from the tubular fluid into the interstitium. Together, Ang II and aldosterone provide a powerful mechanism for increasing sodium retention and consequently fluid volume in the body. A third hormone, antidiuretic hormone (ADH), increases water permeability in the late distal tubules and collecting tubules. This enables water to diffuse from the tubulular fluid into the hypertonic interstitium, thereby reducing urine volume and therefore water loss. Beside these hormone actions on sodium transport and water movement, changes in renal blood flow and glomerular filtration can affect the amount of sodium and water filtered at the glomerulus and entering the renal tubules. For example, increased blood volume increases arterial pressure, renal perfusion, and glomerular filtration rate. This leads to an increase in renal excretion of water and sodium that is termed pressure natriuresis. In certain types of renal disease, the pressure natriuresis relationship is altered so that the kidneys retain more sodium and water at a given pressure, thereby increasing blood volume.
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