2014
DOI: 10.2215/cjn.08860813
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Homeostasis, the Milieu Intérieur, and the Wisdom of the Nephron

Abstract: The concept of homeostasis has been inextricably linked to the function of the kidneys for more than a century when it was recognized that the kidneys had the ability to maintain the "internal milieu" and allow organisms the "physiologic freedom" to move into varying environments and take in varying diets and fluids. Early ingenious, albeit rudimentary, experiments unlocked a wealth of secrets on the mechanisms involved in the formation of urine and renal handling of the gamut of electrolytes, as well as that … Show more

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Cited by 89 publications
(43 citation statements)
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“…The reabsorption of the solutes and ions is dependent on the function of a wide variety of channels and transporters localized on the luminal membrane of the epithelial cells that form the nephron tubules . The coordinated action of the channels and transport systems in the nephron results in the fine‐tuning of the plasma composition that is essential for the normal functioning of the body . The expression and function of these systems are regulated by a complex array of hormones, including the renin–angiotensin–aldosterone system and vasopressin .…”
Section: Introductionmentioning
confidence: 99%
“…The reabsorption of the solutes and ions is dependent on the function of a wide variety of channels and transporters localized on the luminal membrane of the epithelial cells that form the nephron tubules . The coordinated action of the channels and transport systems in the nephron results in the fine‐tuning of the plasma composition that is essential for the normal functioning of the body . The expression and function of these systems are regulated by a complex array of hormones, including the renin–angiotensin–aldosterone system and vasopressin .…”
Section: Introductionmentioning
confidence: 99%
“…It is concerned with many homeostatic mechanisms. It maintains the overall chemical composition of the intracellular environment by regulating the quantity of water, sodium chloride, potassium, phosphate and numerous other substances in the body [3] [4]. It is a common target for toxic xenobiotics due to its capacity to extract and concentrate toxic substances by highly specialized cells and also, due to its large blood flow [5].…”
Section: Introductionmentioning
confidence: 99%
“…This is important for many lower organisms that have developed elaborate mechanisms for cell volume regulation, and usually involves not only water transport but also ion fluxes (mostly Na + , K + , and Cl -) across membranes to recover from excessive swelling or shrinkage when they are exposed to external fluids of different osmolality (e.g., from salty seawater to dilute rainwater) [1] . While these ion transport mechanisms also exist in mammals, much of the regulatory "homeostatic" function in higher organisms is achieved by maintaining a constant internal environment in which our cells reside -the famous "milieu intérieur" or "the sea inside" defined by Claude Bernard [2] . This is achieved in large part by the action of the kidneys, in coordination with brain sensing of plasma volume and concentration (osmolality), and then reacting by increasing or reducing the amount of water that they release into the urine.…”
Section: Why Do We Need Water Channels?mentioning
confidence: 99%