Distal convoluted tubule

Distal convoluted tubule

Kidney nephron ("1st proximal convoluted tubule", "2nd distal convoluted tubule")

Section of cortex of human kidney.
Details
Precursor Metanephrogenic blastema
Identifiers
Latin tubulus contortus distalis
MeSH Distal+Kidney+Tubule
FMA 17721

Anatomical terminology

The distal convoluted tubule (DCT) is a portion of kidney nephron between the loop of Henle and the collecting duct system.

Physiology

It is partly responsible for the regulation of potassium, sodium, calcium, and pH. It is the primary site for the kidneys' hormone based regulation of calcium (Ca).

On its apical surface (lumen side), cells of the DCT have a thiazide-sensitive Na-Cl cotransporter and are permeable to Ca, via the TRPV5 channel. On the basolateral surface (blood) there is an ATP-dependent Na/K antiporter pump, a secondary active Na/Ca transporter, and an ATP dependent Ca transporter. The basolateral ATP dependent Na/K pump produces the gradient for Na to be absorbed from the apical surface via the Na/Cl symporter, and for Ca to be reclaimed into the blood by the Na/Ca basolateral antiporter.

Clinical significance

Thiazide diuretics inhibit Na+/Cl reabsorption from the DCT by blocking the thiazide-sensitive Na-Cl cotransporter.

By inhibiting the cotransporter, thiazide diuretics increase the gradient potential for Na. This increases the activity of the basolateral Na/Ca antiport and causes the increase in calcium reclamation associated with thiazide diuretics.

Histology

The DCT is lined with simple cuboidal cells that are shorter than those of the proximal convoluted tubule (PCT). The lumen appears larger in DCT than the PCT lumen because the PCT has a brush border (microvilli). DCT can be recognized by its numerous mitochondria, basal infoldings and lateral membrane interdigitations with neighboring cells.

The point where DCT contacts the cortical thick ascending limb of the loop of Henle is called macula densa. It has tightly packed columnar cells which display reversed polarity and may monitor the osmolarity of blood.

Histologically, cells of the DCT can be differentiated from cells of the proximal convoluted tubule:

Characteristic PCT DCT
Apical brush border Usually present Not present
Eosinophilicity More Less
Cytoplasm More Less
Readily discernible nuclei Less likely More likely

Additional images

References

External links

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