Contemporary Nephrology: Volume 4

766 Pages·1987·27.948 MB·English

by  Luis Reuss, Calvin U. Cotton (auth.), Saulo Klahr M.D., Shaul G. Massry M.D. (eds.)

Contemporary
Nephrology
Volume 4
Cootemporary Nephrology
Editors-in-Chief: SAULO KLAHR. St. Louis, Missouri
SHAUL G. MASSRY • Los Angeles, California
Editorial Board
WILLIAM M. BENNETI' • Portland, Oregon
VITO M. CAMPESE • Los Angeles, California
WILLIAM G. COUSER. Seattle, Washington
MICHAEL J. DUNN. Cleveland, Ohio
GARABED EKNOYAN • Houston, Texas
LEE W. HENDERSON. San Diego, California
H. DAVID HUMES. Ann Arbor, Michigan
FRANKLYN G. KNOX. Rochester, Minnesota
NEIL A. KURTZMAN. Lubbock, Texas
MANUEL MARTfNEZ-MALDONADO. Sanjuan, Puerto Rico
WILLIAM E. MITCH. Atlanta, Georgia
LUIS REUSS. Galveston, Texas
ANTON C. SCHOOLWERTH. Hershey, Pennsylvania
TERRY B. STROM. Boston, Massachusetts
WADI N. SUKI. Houston, Texas
ROGER A. L. SUTI'ON. Vancouver, Canada
A Continuation Order Plan is available for this series. A continuation order will bring delivery of
each new volume immediately upon publication. Volumes are billed only upon actual shipment.
For further information please contact the publisher.
Contemporary
Nephrology
Volume 4
Edited by
Saulo Klahr, M. D.
Washington University Sclwol of Medicine
St. Louis, Missouri
and
Shaul G. Massry, M. D.
University of StJuthem California Sclwol of Medicine
Los Angeles, California
PLENUM MEDICAL BOOK COMPANY
NEW YORK AND LONDON
ISBN-13: 978-1-4612-9037-7 e-ISBN-13: 978-1-4613-1859-0
DOl: 10.1007/978-1-4613-1859-0
© 1987 Plenum Publishing Corporation
Softcover reprint of the hardcover lst edition 1987
233 Spring Street, New York, N.Y. 10013
Plenum Medical Book Company is an imprint of Plenum Publishing Corporation
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
Contributors
Luis Baez-Draz, M.D. • Hematology Section, Veterans Administration
Center, and Department of Medicine, University of Puerto Rico School
of Medicine, San Juan, Puerto Rico 00936
Julio E. Benabe, M.D. • Renal Section, Veterans Administration Cen
ter, and Department of Medicine, University of Puerto Rico School of
Medicine, San Juan, Puerto Rico 00936
William M. Bennett, M.D. • Department of Medicine and Pharmacol
ogy, Oregon Health Sciences University, Portland, Oregon 97201
E.C. Cameron, M.D., F.R.C.P.(C) • Division of Nephrology, Depart
ment of Medicine, The University of British Columbia, Vancouver, Brit
ish Columbia, Canada V5Z IM9
Vito M. Campese, M.D .• Divisions of Nephrology and Endocrinology,
Department of Medicine, University of Southern California School of
Medicine, Los Angeles, California 90033
calvin U. Cotton, M.D. • Department of Physiology and Biophysics,
University of Texas Medical Branch, Galveston, Texas 77550
William G. Couser, M.D .• Division of Nephrology, Department of
Medicine, University of Washington School of Medicine, Seattle, Wash
ington 98195
Wilfred Druml, M.D. • Renal Division, Emory University School of
Medicine, Atlanta, Georgia 30322
Michael J. Dunn, M.D. • Case Western Reserve University School of
Medicine, and Division of Nephrology, University Hospitals of Cleve
land, Cleveland, Ohio 44106
v
vi CONTRIBUTORS
Garabed Eknoyan, M.D. • Renal Section and Department of Medicine,
Baylor College of Medicine, Houston, Texas 77030
Joey P. Granger, M.D .• Departments of Physiology and Biophysics
and Medicine, Mayo Medical School, Mayo Foundation, Rochester, Min
nesota 55905
Lee W. Henderson, M.D. • Veterans Administration Medical Center,
and University of California, San Diego, California 92161
Willa Hsueh, M.D .• Divisions of Nephrology and Endocrinology, De
partment of Medicine, University of Southern California School of Med
icine, Los Angeles, California 90033
H. David Humes, M.D. • Department of Internal Medicine, Veterans
Administration Medical Center, and University of Michigan Medical
School, Ann Arbor, Michigan 48105
Ali A. Khraibi, M.D. • Departments of Physiology and Biophysics and
Medicine, Mayo Medical School, Mayo Foundation, Rochester, Minne
sota 55905
Franklyn G. Knox, M.D. • Departments of Physiology and Biophysics
and Medicine, Mayo Medical School, Mayo Foundation, Rochester, Min
nesota 55905
Nell A. Kurtzman, M.D. • Department of Internal Medicine, Texas Tech
University Health Sciences Center, Lubbock, Texas 79430
Melvin E. laski, M.D .• Division of Nephrology, Department of Inter
nal Medicine, Texas Tech University Health Sciences Center, Lubbock,
Texas 79430
Manuel Martrnez-Maldonado, M.D .• Medical Service, Veterans
Administration Center, and Departments of Medicine and Physiology,
University of Puerto Rico School of Medicine, San Juan, Puerto Rico
00936
William E. Mitch, M.D. • Renal Division, Emory University School of
Medicine, Atlanta, Georgia 30322
Vo D. Nguyen, M.D. • Department of Internal Medicine, Veterans
Administration Medical Center, and University of Michigan Medical
School, Ann Arbor, Michigan 48105
Luis Reuss, M.D. • Department of Physiology and Biophysics, Uni
versity of Texas Medical Branch, Galveston, Texas 77550
Russell C. Scaduto, Jr., Ph.D. • Departments of Surgery and Physi
ology, The Milton S. Hershey Medical Center, Pennsylvania State Uni
versity, Hershey, Pennsylvania 17033
Anton C. Schoolwerth, M.D. • Division of Nephrology, Department of
Internal Medicine, Medical College of Virginia, Virginia Commonwealth
University, Richmond, Virginia 23298
Terry B. Strom, M.D. • Department of Medicine, Beth Israel Hospital,
CONTRIBUTORS vII
and Harvard Medical School, Boston, Massachusetts 02215
Wadi N. Sukl, M.D. • Department of Medicine and Department. of
Physiology and Biophysics, and Renal Section, Baylor College of Med
icine and The Methodist Hospital, Houston, Texas 77030
Roger A. L. Sutton, M.D., F.R.C.P., F.R.C.P.(C) • Division of Nephrol
ogy, Department of Medicine, The University of British Columbia, Van
couver, British Columbia, Canada V5Z IM9
Charles O. Watlington, M.D., Ph.D. • Division of Endocrinology, De
partment of Internal Medicine, Medical College of Virginia, Virginia
Commonwealth University, Richmond, Virginia 23298
Preface
Volume 4 of Contemporary Nephrology summarizes major advances in 16
different areas of nephrology during the years 1985 and 1986. Major
changes in the composition of the Editorial Board and authorship of
the different chapters have occurred in this volume. Six distinguished
contributors have retired from the Editorial Board. They include Dr.
Zalman A. Agus, Philadelphia; Dr. Robert Anderson, Denver; Dr. Eli
Friedman, Brooklyn; Dr. Richard Glassock, Torrance, California; Dr.
James Schafer, Birmingham, Alabama; and Dr. Gordon Williams, Bos
ton. We are grateful to them for their outstanding contributions to the
first three volumes of this series and for their advice and suggestions as
members of the Editorial Board. They certainly deserve substantial credit
for the success of this series.
Seven outstanding academicians have joined the Board. They in
clude Dr. Vito M. Campese, Professor of Medicine at the University of
Southern California, who contributed the chapter on "Recent Advances
in the Role of the Renal Nervous System and Renin in Hypertension";
Dr. William G. Couser, Professor of Medicine and Head of the Division
of Nephrology at the University of Washington in Seattle ("Immunologic
Aspects of Renal Disease"); Dr. Garabed Eknoyan, Professor of Medicine
and Vice Chairman of the Department of Medicine at Baylor College
of Medicine ("The Uremic Syndrome"); Dr. H. David Humes, Associate
Professor of Medicine and Chief of the Nephrology Section at the Uni
versity of Michigan Medical School, Veterans Administration Medical
Center ("Acute Renal Failure and Toxic Nephropathy"); Dr. Luis Reuss,
Ix
x PREFACE
Professor and Chairman of the Department of Physiology and Biophysics
at the University of Texas Galveston Branch ("Isosmotic Fluid Transport
across Epithelia"); Dr. Wadi N. Suki, Professor of Medicine and Physi
ology at Baylor College of Medicine ("The Kidney in Systemic Disease");
and Dr. Roger A. L. Sutton, Professor of Medicine and Head of the
Division of Nephrology at the University of British Columbia ("Mineral
Metabolism"). We would like to welcome these distinguished clini
cian-investigators as members of the Editorial Board and look forward
to working with them in the next three volumes of this series.
A new chapter on "Congenital Renal Disorders and Kidney Tumors"
is included in this volume. Dr. Manuel Martinez-Maldonado, who was
previously responsible for the chapter on "The Kidney in Systemic Dis
ease," contributed this new chapter. In addition, the volume includes
contributions by previous members of the Editorial Board: Dr. William
J.
M. Bennett ("Drugs and the Kidney"); Dr. Michael Dunn ("Renal
Prostaglandins"); Dr. Lee W. Henderson ("Dialysis"); Dr. Franklyn G.
Knox ("Renal Hemodynamics and Sodium Chloride Excretion"); Dr.
Neil A. Kurtzman ("Acid-Base Physiology and Pathophysiology"); Dr.
William E. Mitch ("Nutrition in Renal Disease"); Dr. Anton C. School
werth ("Renal Metabolism"); and Dr. Terry B. Strom ("Renal Trans
plantation").
It is our belief that this series continues to serve well the original
design of the editors, to provide the reader with an update of important
developments in the major areas that comprise modern nephrology. It
has become evident in recent years that the explosion of knowledge in
different areas of nephrology has accelerated, and it is becoming more
and more difficult to keep abreast of developments in the different areas
of the subspecialty. This volume provides a summary, written by rec
ognized experts, of major advances that have occurred in their particular
areas of interest in the last 2 years. The editors would again like to
express their deep appreciation to the members of the Editorial Board,
those who have participated since the beginning of the series and those
who have just joined, for their contributions to the success of this series.
At the same time, we would like to thank the different authors for their
contributions, which made this volume possible. We again expect our
readers to provide us with comments and criticisms so that we may better
serve their needs in future volumes of this series.
Saulo Klahr, M.D.
Shaul G. Massry, M.D.
St. Louis and Los Angeles
Contents
Chapter 1
Isosmotic Fluid Transport across Epithelia
Luis Reuss and Calvin U. Cotton
1. Introduction ........................................... 1
2. Basic Principles ............................. . . . . . . . . . . . 1
2.1. Osmotic Equilibrium ............................... 2
2.2. Osmotic Water Flow ............................... 3
2.3. Diffusion .......................................... 7
2.4. Unstirred Layers ................................... 9
2.5. Solute Reflection Coefficient ........................ 11
2.6. Two Solutes with Different Reflection Coefficients .... 14
2.7. Solvent Drag ...................................... 15
3. Isosmotic Water Transport in Epithelia ................... 15
3.1. Theories of Water Transport ....................... 15
3.2. Transepithelial and Cell Membrane Osmotic
Water Permeabilities ............................... 19
3.3. Water Transport Pathway .......................... 28
3.4. Driving Forces for Isosmotic Water Transport ........ 32
References ................................. . . . . . . . . . . . . . . 33
xl