Zhang, Wensheng, and Aurélie Edwards. A model of glucose transport and conversion to lactate in the renal medullary microcirculation. Am J Physiol Renal Physiol 290: F87-F102, 2006. First published August 23, 2005 doi:10.1152/ajprenal.00168.2005In this study, we modeled mathematically the transport of glucose across renal medullary vasa recta and its conversion to lactate by anaerobic glycolysis. Uncertain parameter values were determined by seeking good agreement between predictions and experimental measurements of lactate generation rates, as well as glucose and lactate concentration ratios between the papilla and the corticomedullary junction; plausible kinetic rate constant and permeability values are summarized in tabular form. Our simulations indicate that countercurrent exchange of glucose from descending (DVR) to ascending vasa recta (AVR) in the outer medulla (OM) and upper inner medulla (IM) severely limits delivery to the deep inner medulla, thereby limiting medullary lactate generation. If the permeability to glucose of OMDVR and IMDVR is taken to be the same and equal to 4 ϫ 10 Ϫ4 cm/s, the fraction of glucose that bypasses the IM is calculated as 54%; it is predicted as 37% if the presence of pericytes in OMDVR reduces the glucose permeability of these vessels by a factor of 2 relative to that of IMDVR. Our results also suggest that red blood cells (RBCs) act as a reservoir that reduces the bypass of glucose from DVR to AVR. The rate of lactate generation by anaerobic glycolysis of glucose supplied by blood from glomerular efferent arterioles is predicted to range from 2 to 8 nmol/s, in good agreement with lower estimates obtained from the literature (Bernanke D and Epstein FH. Am J Physiol 208: 541-545, 1965; Bartlett S, Espinal J, Janssens P, and Ross BD. Biochem J 219: [73][74][75][76][77][78] 1984). kidney; glycolysis; mathematical model THE URINARY CONCENTRATING mechanism is made possible by the steep corticomedullary osmolality concentration gradient, which is created and maintained by countercurrent exchange between the descending and ascending limbs of the loops of Henle, the collecting ducts, and the descending (DVR) and ascending vasa recta (AVR). However, the manner in which the hyperosmolality in the inner medullary interstitium is built up and preserved remains unclear. A hypothesis involving an external osmolyte proposed by Niesel and Roeskenbleck (30) and summarized by Kriz and Lever (23) has recently been examined by Jen and Stephenson (20) and Thomas and Wexler (43). These investigators showed that an unspecified solute, external to the tubular fluid, that can provide an added 20 -100 mosmol/l to the interstitial osmolality throughout the inner medulla (IM), may very significantly increase water reabsorption.Because of hypoxia in the IM, anaerobic glycolysis appears to be the dominant energy supply for IM metabolism (37).Lactate is produced by anaerobic glycolysis, and it may later be used for gluconeogenesis in the outer medulla (OM) and cortex (37). Because anaerobic glycol...