Fiziologia aparatului excretor
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?00 FIZIOI.OGIA APARATULUI EXCRETOR
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Fig. $l.Interrelatii intre nivellrl sodiului plasrnatic gi se'
cretia de aldosteron.
rinichiului are acfiune de 100 de ori mai puternie5 dtrcare Ia nivelulc6t DOC.
De remarcataceea de K'* la
ci aldosteronul reduce eliminarea de Na+ $i creqte pe
;i""l"l ti"i.ti.rtri, glandelor sudoripare, glandelor sa
l i vare e tc . .6 - ! : -^ . : . .Aldosteronul eliberat in circula{ie rqi manifestd ac[iunea cu preca
dere la nivelull"b"l;i distal, -sil*"U"a,
3q" cLun :-a. p.recizat in pagi
nile anterioare, .""ur"ruii. tia* din urini'in celura tubulari qi elimr
"l"a f. in llmenul tubului. Se pare. cd aldosteronul nu actioneaz:i
,umai ra ,.,iv"'rur-iuulr"i aistat, -intiucat
s-a observat faciiitarea trans
portului de N;; ii in t"g*.tti,'ti proximal qi chiar in tubul colect.'t
( f ig. 38a).Efectele aldosteronului la nivelul celulei tubulare se realizeazS dtrl 'r
cuplarea prealabili cu receptorii din teritoriul celular - ipoteza ttt
duc[ici.Existi qi alte pdreri q.r privire Ia modalitdtile de realizare a eftr
telof aldosterott"i"i. Unii cercetdtori presupun cd mineralocorticoizii trt'
cletermina creqterea p"r-*iititatii polului apical al- eelulei epitt'li'tlr'
pent^r ionul de sodiu prin cleschideiea unor canale de sodiu 5i':tstfr' l '
ar facilita contactul siu cu pompa - teoria permeazelor'
Alti autori presupun. un efeet de cregtere a activitii[i i pomlx'i tlr'
sorliri -qi,stimui"riu
siniezei saut activ5rii Na+,K+-ATPazei'
$i, in sfargit , o alt [ tenrie stts{ ine ci alclosterontt l 5i ;rr l r t ' t r t i f r" l ' r
; r r l i r rnr . ; r l l r in act ivarea uneia r i : l l l mai mul tor eta l l . metabol i t ' t ' ( ' r l t . ' l
i t t s t i t r r r t l ; t r r ' ; t s i n t cze i de ATP l n : l (Y ' s t n t r l t l ' : t l c l c l s t c t ' < l t r u l n r t l t ' t t ' r l l r l r r I
t , r . r . : r t r . r - r . , r ( . , ) ^ ( . ( . l r t r i l [ i c i t n i t t r . r i r r l r r l r t r c r r c t ' 11 r ' l i t ' l l ( ' ( ' ( ' i ; ; l t ' l r 0 l r t r r t f t l t t t ' ( i t t r "
I r ' , ; l l x l l l l l x ' l
REGI.,AREA TUNCTIEI RENALE 70r
Ftg.btfe
!E5. Mecanisme posi-de_ reglare a secrefiei
de aldosteron.
Dupd unii autori, glanda suprarenald este stimuraH in vederea se-crefiei de mineralocprtiooizi, in afara ionilor de Na+, K+, a sistemuluireninA-angiotensini qi |.CTH $i qe citre un factor eliberat de epifizicienumit adrenoglomerulotropin[ (fig. BBb).
ln. regbrea-activitefli rinale, rln rol' deosebit il au qi peptidele na-trlttreticc. Eviden{iati pentru prima datd in cardiomiocitele atriale, sin-teza factorului natriuretic atrial (ANF) a fost iclentificatd apoi 9i in sis-tcrnul nervos qi chiar in rinidri. Aceste peptide. cu structurd si denumiredlterite tn funcfie de locul de sinteze, ilnLrvin in prineipal in homeostaziahemodinamieii organismului. Intervenfia peptideio. r,ihi,tretice in prG-crrul amintit se realizeazd, Pe de o parte, prin impliearea lor in meea-nlrmele de reglare a metabolismului hidroelectrolitic, iar, pe de altd,Pltte, prin--variatii ale tonusului vaseular-
Departe de a fi elucidate toate implicafiile sistemului de peptide na-lrluretiee ln eco-nomia funcfionali a organismului, se admite pdnb in pre-frnt ed cele mai importante mluri s-ar-rezutna la:
'- lnhibarea secrefiei de vasopresintr de la nivelul neurohipofizei;- relaxarea musculaturii netede;- inhibarea reabsorb$iei Na+ qi apei la nivelul tubului urinifer;'-- inhibarea seere{iei de renind la nivelul aparatului juxtaglomeru-
renal; t- rcAderea slntezei de aldosteron de citre celulele zonei glomeru-
n glandei corticosuprarenale.llrln aeeste efecte, peptidele natriuretice realiz eazl o scddere a vo-
ultt l l i prcsiunii sangrrine ca lrrmare a erogter i i r l i r r rozei . e l iminr l r i lor
III
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