| Entry |
|
| Name |
Proximal tubule bicarbonate reclamation
|
| Description |
One of the major tasks of the renal proximal tubule (PT) is to secrete acid into the tubule lumen, thereby reabsorbing approximately 80% of the filtered bicarbonate (HCO3(-)), as well as generating "new HCO3(-)" for regulating blood pH. In the tubular lumen, filtered HCO3(-) combines with H(+) in a reaction catalyzed by CA IV. The CO2 thus produced rapidly diffuses into the tubular cells and is combined with water to produce intracellular H(+) and HCO3(-), catalyzed by soluble cytoplasmic CA II. HCO3(-) is then cotransported with Na(+) into blood via the NBC-1. The intracellular H(+) produced by CA II is secreted into the tubular lumen predominantly via the NHE-3. The PT creates the "new HCO3(-)" by taking glutamine and metabolizing it to two molecules each of NH4(+) and HCO3(-). The NH4(+) is excreted into the tubular lumen, and the HCO3(-) , which is "new HCO3(-) ," is returned to the blood, where it replaces the HCO3(-) lost earlier in the titration of nonvolatile acids.
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| Class |
Organismal Systems; Excretory system
 |
| Pathway map |
| Proximal tubule bicarbonate reclamation |

  |
| Disease |
| Combined proximal and distal renal tubular acidosis (RTA type 3) | | Proximal renal tubular acidosis (RTA type 2) | | Alternating hemiplegia of childhood |
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| Orthology |
| solute carrier family 9 (sodium/hydrogen exchanger), member 3 | | aquaporin-1 | | solute carrier family 4 (sodium bicarbonate cotransporter), member 4 | | sodium/potassium-transporting ATPase subunit alpha [EC: 3.6.3.9] | | sodium/potassium-transporting ATPase subunit beta | | sodium/potassium-transporting ATPase subunit gamma (FXYD domain-containing ion transport regulator 2) | | solute carrier family 38 (sodium-coupled neutral amino acid transporter), member 3 | | | | glutamate dehydrogenase (NAD(P)+) [EC: 1.4.1.3] | | solute carrier family 25 (mitochondrial dicarboxylate transporter), member 10 | | | | phosphoenolpyruvate carboxykinase (GTP) [EC: 4.1.1.32] |
|
| Compound |
| H2O | | CO2 | | NH3 | | L-Glutamate | | 2-Oxoglutarate | | Oxaloacetate | | L-Glutamine | | Phosphoenolpyruvate | | H+ | | (S)-Malate | | Potassium cation | | alpha-D-Glucose | | HCO3- | | Cl- | | Sodium cation | | Carbonic acid | | NH4OH |
|
| Reference |
|
| Authors |
Koeppen BM |
| Title |
The kidney and acid-base regulation. |
| Journal |
Adv Physiol Educ 33:275-81 (2009) |
| Reference |
|
| Authors |
Boron WF |
| Title |
Acid-base transport by the renal proximal tubule. |
| Journal |
J Am Soc Nephrol 17:2368-82 (2006) |
| Reference |
|
| Authors |
Hayashi M |
| Title |
Physiology and pathophysiology of acid-base homeostasis in the kidney. |
| Journal |
Intern Med 37:221-5 (1998) |
| Reference |
|
| Authors |
Wagner CA, Kovacikova J, Stehberger PA, Winter C, Benabbas C, Mohebbi N |
| Title |
Renal acid-base transport: old and new players. |
| Journal |
Nephron Physiol 103:p1-6 (2006) |
| Reference |
|
| Authors |
Fry AC, Karet FE |
| Title |
Inherited renal acidoses. |
| Journal |
Physiology (Bethesda) 22:202-11 (2007) |
| Reference |
|
| Authors |
Pereira PC, Miranda DM, Oliveira EA, Silva AC |
| Title |
Molecular pathophysiology of renal tubular acidosis. |
| Journal |
Curr Genomics 10:51-9 (2009) |
| Reference |
|
| Authors |
Igarashi T, Sekine T, Inatomi J, Seki G |
| Title |
Unraveling the molecular pathogenesis of isolated proximal renal tubular acidosis. |
| Journal |
J Am Soc Nephrol 13:2171-7 (2002) |
| Reference |
|
| Authors |
Alper SL |
| Title |
Genetic diseases of acid-base transporters. |
| Journal |
Annu Rev Physiol 64:899-923 (2002) |
| Reference |
|
| Authors |
Unwin RJ, Capasso G |
| Title |
The renal tubular acidoses. |
| Journal |
J R Soc Med 94:221-5 (2001) |
| Reference |
|
| Authors |
Rodriguez-Soriano J |
| Title |
New insights into the pathogenesis of renal tubular acidosis--from functional to molecular studies. |
| Journal |
Pediatr Nephrol 14:1121-36 (2000) |
| Reference |
|
| Authors |
Nowik M, Lecca MR, Velic A, Rehrauer H, Brandli AW, Wagner CA |
| Title |
Genome-wide gene expression profiling reveals renal genes regulated during metabolic acidosis. |
| Journal |
Physiol Genomics 32:322-34 (2008) |
| Reference |
|
| Authors |
Curthoys NP |
| Title |
Role of mitochondrial glutaminase in rat renal glutamine metabolism. |
| Journal |
J Nutr 131:2491S-5S; discussion 2496S-7S (2001) |