Proximal tubule

Structure

The most distinctive characteristic of the proximal tubule is its luminal brush border.

Brush border cell

The luminal surface of the epithelial cells of this segment of the nephron is covered with densely packed microvilli forming a border readily visible under the light microscope giving the brush border cell its name. The microvilli greatly increase the luminal surface area of the cells, presumably facilitating their reabsorptive function as well as putative flow sensing within the lumen. The microvilli are composed of actin filament bundles that have been visualized using confocal microscopy.

The cytoplasm of the cells is densely packed with mitochondria, which are largely found in the basal region within the infoldings of the basal plasma membrane. The high quantity of mitochondria gives the cells an acidophilic appearance. The mitochondria are needed in order to supply the energy for the active transport of sodium ions out of the cells to create a concentration gradient which allows more sodium ions to enter the cell from the luminal side. Water passively follows the sodium out of the cell along its concentration gradient.

Cuboidal epithelial cells lining the proximal tubule have extensive lateral interdigitations between neighboring cells, which lend an appearance of having no discrete cell margins when viewed with a light microscope.

Agonal resorption of the proximal tubular contents after interruption of circulation in the capillaries surrounding the tubule often leads to disturbance of the cellular morphology of the proximal tubule cells, including the ejection of cell nuclei into the tubule lumen.

This has led some observers to describe the lumen of proximal tubules as occluded or "dirty-looking", in contrast to the "clean" appearance of distal tubules, which have quite different properties.

Divisions

Based on its appearance at low magnification, the proximal tubule can be divided into two sections: the proximal convoluted tubule (PCT), and the proximal straight tubule (PST). Differences in cell outlines exist between these segments, and therefore presumably in function too.

Based on ultrastructure, it can be divided into three segments, S1, S2, and S3.

Proximal convoluted tubule (pars convoluta)

The pars convoluta (Latin "convoluted part") is the initial convoluted portion.

In relation to the morphology of the kidney as a whole, the convoluted segments of the proximal tubules are confined entirely to the renal cortex.

Some investigators on the basis of particular functional differences have divided the convoluted part into two segments designated S1 and S2.

Proximal straight tubule (pars recta)

The pars recta (Latin "straight part") is the following straight (descending) portion.

Straight segments descend into the outer medulla. They terminate at a remarkably uniform level and it is their line of termination that establishes the boundary between the inner and outer stripes of the outer zone of the renal medulla.

As a logical extension of the nomenclature described above, this segment is sometimes designated as S3.