THE RENAL ADENOSINE TRIPHOSPHATASES - FUNCTIONAL-INTEGRATION AND CLINICAL-SIGNIFICANCE

The ion-transporting ATPases determine the chemical composition of cel ls both directly and through their secondary effects. The Na,K-ATPase generates the transmembrane sodium gradient which provides the primary energy for uptake and extrusion of a wide variety of solutes by renal tubular epithelia. The H-ATPase and the H,K-ATPase acidify the urine, and also generate bicarbonate for excretion by the cortical collectin g duct. Calcium ATPase regulates the intracellular calcium, which in t urn impacts on the myriad of cellular functions for which calcium serv es as an intracellular messenger. If one considers the impact of poten tial pump dysfunction in a purely speculative mode, the list of disord ers which might be potentially ascribed to 'pump disease' would be eno rmous. This article reviews those disorders of renal transport already considered to be 'pump diseases'.