Distal convoluted tubule
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| Distal convoluted tubule | |
|---|---|
 | |
| Kidney nephron (labeled as "2nd convoluted tubule", near top) | |
 | |
| Section of cortex of human kidney. | |
| Latin | tubulus contortus distalis |
| Gray's | subject #253 1223 |
| Precursor | Metanephric blastema |
| MeSH | Distal+Kidney+Tubule |
| Dorlands/Elsevier | t_22/12830066 |
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Overview
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 regulates pH by absorbing bicarbonate and secreting protons (H+) into the filtrate.
- Sodium and potassium levels are controlled by secreting K+ and absorbing Na+. Sodium absorption by the distal tubule is mediated by the hormone aldosterone. Aldosterone increases sodium reabsorption. Sodium and chlorine (salt) reabsorption is also mediated by a group of kinases called WNK kinases. There are 4 different WNK kinases, WNK1, WNK2, WNK3, and WNK4.
- It also participates in calcium regulation by absorbing Ca2+ in response to parathyroid hormone.[1]
- Arginine vasopressin receptor 2 is also expressed in the DCT.
Clinical significance
Thiazide diuretics inhibit Na+/Cl- reabsorption from the DCT by blocking the thiazide-sensitive Na-Cl cotransporter.
Histology
The distal convoluted tubule (DCT)is the final segment of the nephron. It is lined with simple cuboidal cells that are shorter then those of the PCT. The lumen appears larger in DCT than the proximal convoluted tubule (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 afferent arteriole of renal corpuscle 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 have | do not have |
| eosinophilicity? | more | less |
| cytoplasm? | more | less |
| have visible nuclei? | less likely | more likely |
Additional images
 1 Glomerulus, 2 proximal tubule, 3 distal tubule |
 Transverse section of pyramidal substance of kidney of pig, the bloodvessels of which are injected. |
References
External links
- Organology at UC Davis Urinary/mammal/cortex1/cortex7 - "Mammal, kidney cortex (LM, Medium)"
- Histology at OU 35_19
- Physiology at MCG 7/7ch03/7ch03p18
- Physiology at MCG 7/7ch07/7ch07p14
- Histology at BU 16004loa
- Histology at BU 16007loa
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
