Question
Asked Nov 19, 2019
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How do Na-H exchangers on the luminal surface of tubular cells promote bicarbonate reabsorption in the renal tubules?

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Expert Answer

Step 1

The Na+/H+ exchange aids NaCl reabsorption and luminal surface of the tubular cells. The NHE3 (in adults) and NHE8 (in neonates) are two Na+/Hexchanger found on the luminal membrane of proximal tubule cells.

The Na+/H+   helps reabsorption of two third quantity of NaCl from the filtrate in the proximal tubule. It also mediates the reabsorption of bicarbonates, amino acids, oligopeptides, citrate and water. Secretion of ammonium is also mediated by Na+/H+ exchange.

Step 2

Mechanism of Na+/H+ exchange

Apical NHE3 which is an exchanger provides the H+. This H+ is coupled with amino acids and oligopeptides and they are cotransporter. Apical NHE3 also interacts with megalin, which is responsible for receptor-mediated endocytosis of some proteins in the proximal tubule. Na+/H+ exchange with Cl−/base exchange and results in acid recycling.  Triple coupling of Na+-sulfate cotransport, sulfate–anion exchange, and Cl−/anion exchange. Along with this transepithelial NaCl reabsorption i...

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