Role of the Paracellular Pathway in Isotonic Fluid Movement Across the Renal Tubule

Evidence for a highly permeable paracellular shunt in the proximal tubule is reviewed. The paracellular pathway is described as a crucial site for the regulation of net absorption and for solute-solvent interaction. Available models for the coupling of salt and water transport are assessed with respect to the problem of isotonic water movement. Two new models are proposed taking into account that the tight junctions are permeable to salt and water and that active transport sites for sodium are distributed uniformly along the lateral cell membrane. The first model (continuous model) is a modification of Diamond and Bossert's proposal using different assumptions and boundary conditions. No appreciable standing gradients are predicted by this model. The second model (compartmental model) is an expansion of Curran's double membrane model by including additional compartments and driving forces. Both models predict a reabsorbate which is not isosmotic. For the particular case of the proximal tubule it is shown that in the presence of a leaky epithelium these deviations from isotonicity might have escaped experimental observation.