Urea transporters in kidney and erythrocytes

Physiological and molecular data demonstrate that urea transport in kidney and erythrocytes is regulated by specific urea transporter proteins. The urea transporter in the terminal inner medullary collecting duct permits very high rates of regulated transepithelial urea transport and results in the delivery of large amounts of urea into the deepest portions of the inner medulla, where it is needed to maintain a high interstitial osmolality for concentrating the urine maximally. The urea transporter in erythrocytes permits these cells to lose urea rapidly as they ascend through the ascending vasa recta, thereby preventing loss of urea from the medulla. Urea lost from the medulla would decrease concentrating ability by decreasing the efficiency of countercurrent exchange, as occurs in individuals who lack the Kidd antigen. The recent cloning of cDNAs for these two urea transporters has begun to yield new insights into the mechanisms underlying acute and long-term regulation of urea transport and should permit exciting new insights in the future. This review focuses on the physiological and biophysical evidence that established the concept of urea transporters, the subsequent cloning of cDNAs for urea transporters, and the recent integrative studies into the regulation of urea transport. We also propose a new systematic nomenclature and a new structural model for urea transporters.