Diseases of renal adenosine triphosphatase.
Most renal transport is a primary or secondary result of the action of one of three membrane bound ion translocating ATPase pumps. The proximal tubule mechanisms for the reabsorption of salt, volume, organic compounds, phosphate, and most bicarbonate reabsorption depend upon the generation and maintenance of a low intracellular sodium concentration by the basolateral membrane Na-K-ATPase pump. The reabsorption of fluid and salt in the loop of Henle is similarly dependent on the energy provided by Na-K-ATPase activity. Some proximal tubule bicarbonate reabsorption and all distal nephron proton excretion is a product of one of two proton translocating ATPase pumps, either an electrogenic H-ATPase or an electroneutral H-K-ATPase. In this article, the authors review the biochemistry and physiology of pump activity and consider the pathophysiology of proximal and distal renal tubular acidosis, the Fanconi syndrome, and Bartter's syndrome as disorders of ATPase pump function.
Eiam-Ong
S
S
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock 79430.
Laski
M E
ME
Kurtzman
N A
NA
D000141:Acidosis, Renal Tubular / Q000201:enzymology*; D000315:Adrenalectomy; D001477:Bartter Syndrome / Q000201:enzymology*; D005198:Fanconi Syndrome / Q000201:enzymology*; D017506:H(+)-K(+)-Exchanging ATPase / Q000032:analysis*; D006801:Humans; D017136:Ion Transport; D007684:Kidney Tubules / Q000201:enzymology / Q000503:physiopathology; D006180:Proton-Translocating ATPases / Q000032:analysis*; D000254:Sodium-Potassium-Exchanging ATPase / Q000032:analysis*
D017506:H(+)-K(+)-Exchanging ATPase; D006180:Proton-Translocating ATPases; D000254:Sodium-Potassium-Exchanging ATPase