8 - Counter-Current - 2021-FINAL

Counter current mechanism
Dr Afroza Khanam Sumy

Associate Professor, EMC
 Countercurrent system
Countercurrent system is a system in which the

inflow runs parallel to, counter to, and in close
proximity to the outflow for some distance.

 Hypothesis of CCM
A small difference in osmotic concentration in

any level between the fluid in counter direction
in the parallel tubes connected in hairpin
manner can be multiplied many times along
the length of the tubes.

Components of Countercurrent mechanism:
 Loop of Henle – countercurrent multiplier
 Vasa recta – countercurrent exchanger

 Counter current multiplier
Loop of Henle gives the nephron a peculiar shape–
this anatomical peculiarity has great physiological
significance:
 Two tubes lie close to each other
 Fluid flowing through them in opposite

direction –act as “counter current multiplier”

 Countercurrent multiplier effect:
 The horizontal osmotic gradient from the

ascending limb to peritubular fluid to the
descending limb, at any level is small.
 But because of the countercurrent flow, a high

vertical osmotic gradient is built up– this
phenomenon is called countercurrent multiplier
effect.
 Benefits of countercurrent multiplication
 It stablishes a vertical osmotic gradient in the
medullary interstitial fluid. This gradient, in turn, is
used by the CD to concentrate the tubular fluid so
that a urine more concentrated than normal body
fluids can be excreted.
 The fluid is hypotonic as it enters the distal parts of

the tubule enables the kidneys to excrete a urine
more dilute than normal body fluids.
 Requirements for forming a concentrated urine:
 A high level of ADH
 A high osmolarity of the renal medullary

interstitial fluid.
 Due to increased concentration of NaCl and urea
 Occurs by countercurrent multiplier mechanism

 Major factors that contribute to build up solute
conc. into renal medulla
/ Genesis of medullary osmotic pressure:
 Active transport (co-transport) of Na+, K+ and Cl-

out of the thick portion of the ascending limb of
the loop of Henle into the medullary interstitium.
 Active transport of ions from the CD into the

medullary interstitium
 Genesis of medullary osmotic pressure……cont
 Facilitated diffusion of large amounts of urea

from the inner medullary CD into the
medullary interstitium.
 Diffusion of only small amounts of water from

the medullary tubules into the medullary
interstitium.

Role of urea
 Urea contributes ….
 to the establishment of the osmotic gradient

in the medullary interstitium and
 to the ability to form a concentrated urine in

the CD.
 Urea transport…..
 mediated by urea transporters, by FD
 in the collecting duct is regulated by ADH.

Recirculation of urea
40 to 50%
Maintanance of medullary hyperosmolarity/
medullary Osmotic Pressure Gradient
 Medullary blood flow is low, minimize

<5 % of the total RBF washout of
solutes from
 U shaped vasa recta serve as the
medullary
countercurrent exchangers interstitium

Maintanance of medullary hyperosmolarity ….cont
Maintanance of medullary hyperosmolarity ….cont
 In the descending limb of

vasa recta
 Loses water by osmosis
 Gains solutes by diffusion

from the renal interstitial fluid
 In the ascending limb of

vasa recta
 Gains of water by osmosis
 Solutes goes out by diffusion
back into the interstitial fluid
 Thus vasa recta prevents any significant
washout of solutes from the medullary interstitium.
 Advantage of medullary osmotic pressure gradient
 Proximal tubule delivers to the descending limb of loop of

Henle a fluid of similar osmolarity as plasma i,e. 300
mOsm/L.
 But, osmolarity of final urine 50 to 1200 mOsm/L

depending on the fluid and electrolyte status of the body.
 This remarkable ability of the kidney to dilute or

concentrate the urine is due to the medullary osmotic
gradient.
 When the body is in ideal fluid balance, 1 ml/min
of isotonic urine is formed.
 The kidneys can excrete urine of varying

concentrations depending on the body’s state of
hydration.

Filtrate has concentration of Reabsorption of
100 mOsm as it enters DCT water occurs in
presence of
ADH from late
DCT, CT and
CD
Formation of
Cortex
concentrated urine
when ADH levels
are high
Reabsorbed
water picked
up by vasa
recta and
conserved
Small volume of concentrated urine excreted

 Formation of dilute urine
 Kidneys excrete excess water by forming
dilute urine. This is achieved by---
 Continual reabsorption of solute in
excess of water in distal parts of nephron,

including the late DCT and CD.

Filtrate has concentration of
100 mOsm as it enters DCT
Formation of
dilute urine
when ADH levels
are very low
Large volume of dilute urine excreted

 Obligatory Urine Volume
The minimal volume of urine that must be

excreted each day to excrete the waste
products of metabolism and ions that are
ingested, called the obligatory urine volume.

 Obligatory Urine Volume
A normal 70 kg human must excrete about

600 mOsml of solute (urea, sulfate,
phosphate, other waste products, and ions)
each day.

Obligatory Urine Volume………………..cont
If maximal urine concentrating ability is

1200 mOsm/L, the obligatory urine volume,
can be calculated as…..
600 mOsm day

= 0.5 L day
1200 mOsm L


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Counter current mechanism

Dr Afroza Khanam Sumy

Countercurrent system is a system in which the

Dr Afroza Khanam Sumy

A small difference in osmotic concentration in

Dr Afroza Khanam Sumy

 Loop of Henle – countercurrent multiplier

 Vasa recta – countercurrent exchanger

Dr Afroza Khanam Sumy

 Two tubes lie close to each other

 Fluid flowing through them in opposite

Dr Afroza Khanam Sumy

 The horizontal osmotic gradient from the

 But because of the countercurrent flow, a high

 The fluid is hypotonic as it enters the distal parts of

 A high level of ADH

 A high osmolarity of the renal medullary

 Occurs by countercurrent multiplier mechanism

Dr Afroza Khanam Sumy

 Active transport (co-transport) of Na+, K+ and Cl-

 Active transport of ions from the CD into the

 Facilitated diffusion of large amounts of urea

 Diffusion of only small amounts of water from

Dr Afroza Khanam Sumy

 to the establishment of the osmotic gradient

 to the ability to form a concentrated urine in

 mediated by urea transporters, by FD

 in the collecting duct is regulated by ADH.

 Medullary blood flow is low, minimize

Dr Afroza Khanam Sumy

 In the descending limb of

 Gains solutes by diffusion

 In the ascending limb of

 Proximal tubule delivers to the descending limb of loop of

 But, osmolarity of final urine 50 to 1200 mOsm/L

 This remarkable ability of the kidney to dilute or

 The kidneys can excrete urine of varying

Dr Afroza Khanam Sumy

Small volume of concentrated urine excreted

 Continual reabsorption of solute in

excess of water in distal parts of nephron,

Dr Afroza Khanam Sumy

Large volume of dilute urine excreted

The minimal volume of urine that must be

Dr Afroza Khanam Sumy

A normal 70 kg human must excrete about

Dr Afroza Khanam Sumy

If maximal urine concentrating ability is

600 mOsm day

Dr Afroza Khanam Sumy

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