Abstract
The kidneys play a vital role in mineral homeostasis. In this review, the handling of calcium and the methods currently applied to measuring its intracellular concentration are discussed. The bulk of calcium absorption proceeds in proximal tubules, with smaller fractions recovered by thick ascending limbs, distal convoluted tubules, and connecting tubules. Hormonally regulated transcellular calcium absorption is essentially limited to distal convoluted and connecting tubules. At physiological concentrations, parathyroid hormone, calcitonin, and vitamin D increase net calcium absorption. Calcium absorption by polarized epithelial cells is a two-step process wherein calcium enters the cell across apical plasma membranes and exits across basolateral membranes. Recent electrophysiological and pharmacological experiments demonstrate that apical entry is mediated by calcium channels, which are modestly calcium selective, sensitive to dihydropyridine-type calcium channel blockers, and exhibit a wide range of single-channel conductances. Cellular calcium efflux is mediated by Ca(2+)-ATPase and by Na+/Ca2+ exchange. Ca(2+)-ATPase activity is highest in segments that exhibit significant rates of active calcium absorption. Multiple plasma membrane Ca(2+)-ATPase isoforms have been found in the kidney. Several renal Na+/Ca2+ exchange isoforms have been identified, and their role in effecting calcium efflux is under investigation.
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