In
physiology, transport maximum (alternatively Tm or T
max) refers to the point at which increase in concentration of a substance does not result in an increase in movement of a substance across a
cell membrane.
In
renal physiology, the concept of transport maximum is often discussed in the context of
glucose and
PAH.
For both substances (as with all substances), the quantity ''excreted'' can be determined with the following equation:
* ''excretion'' = (''filtration'' + ''secretion'') - ''reabsorption''
The proximal convoluted tubule of the nephron has protein channels that reabsorb glucose, and others that secrete
para-aminohippuric acid
Aminohippuric acid or ''para''-aminohippuric acid (PAH), a derivative of hippuric acid, is a diagnostic agent useful in medical tests involving the kidney used in the measurement of renal plasma flow. It is an amide derivative of the amino acid g ...
(PAH). However, its ability to do so is proportionate to the channel proteins available for the transport.
* Glucose is not secreted, so ''excretion'' = ''filtration'' - ''reabsorption''. Both filtration and reabsorption are directly proportional to the concentration of glucose in the plasma. However, while the average maximum reabsorption is about 375 mg/min in healthy individuals, filtration has effectively no limit (within reasonable physiological ranges.) Therefore, if the concentration rises above 375 mg/min, the body cannot retain all the glucose, leading to
glucosuria.
* PAH is not reabsorbed ''and'' is secreted, so ''excretion'' = ''filtration'' + ''secretion''. As with glucose, the transfer is at the proximal tubule, but in the opposite direction: from the
peritubular capillaries to the
lumen. At low levels, all the PAH is transferred, but at high levels, the transport maximum is reached, and the PAH takes longer to clear.
In practice, the transport maximum is not all-or-nothing. As the concentration approaches the transport maximum, some of the channels are overwhelmed before others are. For example, with glucose, some sugar appears in the urine at levels much lower than 300 mg/dL. The point at which the effects start to appear is called "
threshold
Threshold may refer to:
Architecture
* Threshold (door), the sill of a door
Media
* ''Threshold'' (1981 film)
* ''Threshold'' (TV series), an American science fiction drama series produced during 2005-2006
* "Threshold" (''Stargate SG-1''), ...
", and the difference between threshold and transport maximum is called "
splay
Splay may refer to:
*Splay, a verb meaning slant, slope or spread outwards
*Splay (physiology), the difference between urine threshold and saturation
*Splay (Japanese band), a J-pop band from Osaka
*Splay Networks, a Sweden-headquartered group of ...
".
Tubular Transport
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References
Circulatory system