Distal Convoluted Tubule

Abstract

The distal convoluted tubule is the nephron segment that lies immediately downstream of the macula densa. Although short in length, the distal convoluted tubule plays a critical role in sodium, potassium, and divalent cation homeostasis. Recent genetic and physiologic studies have greatly expanded our understanding of how the distal convoluted tubule regulates these processes at the molecular level. This article provides an update on the distal convoluted tubule, highlighting concepts and pathophysiology relevant to clinical practice.

Kidney Cadmium Toxicity, Diabetes and High Blood Pressure: The Perfect Storm

“…The distal tubule (DT) could thus be the segment of nephron that is at risk of Cd toxicity because of lower expression of MT than the proximal tubule, in which both MT and HO-1 are expressed. Na/K-ATPase, a primary Cd toxicity target (Thevenod and Friedmann 1999), is expressed in the DT in the highest density, especially in the basolateral membrane (Subramanya and Ellison 2014).…”

Alternatively spliced proline-rich cassettes link WNK1 to aldosterone action

“…1). Mutations in WNK1, WNK4, and the KLHL3/ CUL3 complex, which regulates WNK abundance, are 4 known genes that cause familial hyperkalemic hypertension (FHHt, PHA2, Gordon Syndrome), a Mendelian disorder of thiazide-sensitive hypertension, hyperkalemia, and normal glomerular filtration rate (2). WNK1 and WNK4 are key regulators of renal sodium-coupled cation chloride cotransporters, including the thiazide-sensitive NaCl cotransporter (NCC) of the distal convoluted tubule (DCT) and the Na…”

New insights into sodium transport regulation in the distal nephron: Role of G-protein coupled receptors

“…As opposed to the rodent DCT, the human DCT is uniform; it has the same expression profile as the Morla L et al . Role of GPCRs in the distal nephron murine DCT1 [6] . Sodium reabsorption through NCC is electroneutral and sensitive to thiazide diuretics such as hydrochlorothiazide (HCTZ), whereas sodium reabsorption through ENaC is electrogenic and sensitive to amiloride.…”