<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1870-7203</journal-id>
<journal-title><![CDATA[Acta médica Grupo Ángeles]]></journal-title>
<abbrev-journal-title><![CDATA[Acta méd. Grupo Ángeles]]></abbrev-journal-title>
<issn>1870-7203</issn>
<publisher>
<publisher-name><![CDATA[Grupo Ángeles, Servicios de Salud]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1870-72032021000200304</article-id>
<article-id pub-id-type="doi">10.35366/100465</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La sabiduría del riñón II. La concentración de la orina y el mecanismo multiplicador por contracorriente del asa de Henle]]></article-title>
<article-title xml:lang="en"><![CDATA[The wisdom of the kidney II. Urine concentration and the countercurrent multiplier mechanism of the loop of Henle]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peña Rodríguez]]></surname>
<given-names><![CDATA[José Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Diagnóstico Ángeles  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2021</year>
</pub-date>
<volume>19</volume>
<numero>2</numero>
<fpage>304</fpage>
<lpage>312</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1870-72032021000200304&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1870-72032021000200304&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1870-72032021000200304&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: A mitad del siglo pasado (1950) se suscitó una interesante controversia relacionada con el mecanismo de la concentración urinaria, en la cual participó activamente el Dr. Homer W. Smith, en ese momento el gran líder de la fisiología renal. Hasta esa fecha la nefrona se dibujaba rectilínea y eliminaba al asa de Henle, ya que el Dr. Smith la consideraba como un remanente de la organogénesis sin ninguna función. En 1950, durante el XVIII Congreso Internacional de Fisiología en Copenhague, enfrentó unas observaciones que le mostró uno de sus exalumnos, el Dr. Heinrich Wirz de la Universidad de Basilea, Suiza. Los resultados obtenidos en rebanadas del riñón de la rata mostraban un gradiente de concentración osmolar, donde el fluido de la corteza era isosmótico al plasma y la médula mostraba un incremento constante en la presión osmótica desde la unión corticomedular hasta la papila. En este ambiente el fluido tubular que viajaba a lo largo del nefrón de corteza a papila, particularmente el tubo colector, se concentraba progresivamente. Para explicar estos sorprendentes resultados, Wirz y sus colegas, Bartholomaüs Hargitay y Werner Kuhne de la Universidad de Basilea, invocaron un principio conocido como multiplicador por contracorriente; donde dos flujos opuestos de líquido en la rama descendente y en la rama ascendente del asa de Henle jugaban un papel crítico en este mecanismo. En el curso de esta revisión que analiza y revisa los estudios publicados en los años 50 con los conceptos fisiológicos que se tenían en esa época sobresalen los trabajos de H. Wirz y colaboradores, Carl Gottschalk y Margaret Mylle y el análisis lúcido y puntual que de estos y otros trabajos no menos importantes hace el Dr. Smith, para finalmente aceptar la realidad de la hipótesis del sistema multiplicador por contracorriente y de su papel en el mecanismo de la concentración y dilución urinaria, que tanto trabajo le costó aceptar y que llegó para quedarse hasta nuestros días. Al final de esta revisión se comenta sobre algunos aspectos de la concentración osmolar en deshidratación máxima, en la médula interna y la papila, para los que todavía no existe una explicación.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract: In the middle (1950) of the last century, an interesting controversy on the mechanisms of the urine concentration, evolved. In which, Dr. Homer W. Smith the great leader of Renal Physiology at that time, actively participated. Until that moment, the nephron was drawn in a rectilinear fashion, without the presence of the Henle´s Loop. Dr. Smith considered the loop an incident of organogenesis with no functional significance. In that year during the XVIII International Congress in Copenhagen, he was faced with the data presented to him by his former fellow, M.D. Heinrich Wirz from the University of Basel, Switzerland. The observations of H. Wirz, consisted of measurements of the osmotic pressure at various levels of the rat kidney and showed as that the fluids in the cortex were isosmotic to plasma, the medulla depicted a continuous increase in osmotic pressure from the cortico-medullary junction up to the papilla. In this environment the urine travelling along the nephron from cortex to papilla particularly the collecting that became progressively concentrated. To explain this surprising results, Bartholomaüs Hargitay y Werner Kuhne, of the University of Basel, invoked a principle known as the countercurrent multiplier; wherein the opposing streams in the descending and ascending limbs of the loop of Henle played an important role. In the course of this review is analyzed the results published along that decade with the physiological concepts accepted in that period. Among the papers revised, excel the articles published by H. Wirz an collaborators, Carl Gottschalk and Margaret Mylle, plus the punctual and exhaustive analysis of the most important publications of that period, all included in this review. At the end, Dr. Smith accepted the fundamentals of the concentrating mechanism and the countercurrent hypothesis as concevied by all the authors mentioned. At the end of this review is described the osmolar concentration during severe dehydration, in the inner medulla and the papilla. For this condition, until today, there is not a plausible explanation.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Mecanismo multiplicador de contracorriente]]></kwd>
<kwd lng="es"><![CDATA[asa de Henle]]></kwd>
<kwd lng="es"><![CDATA[rama ascendente del asa de Henle]]></kwd>
<kwd lng="es"><![CDATA[tubo colector]]></kwd>
<kwd lng="es"><![CDATA[concentración]]></kwd>
<kwd lng="es"><![CDATA[dilución]]></kwd>
<kwd lng="en"><![CDATA[Countercurrent multiplier mechanism]]></kwd>
<kwd lng="en"><![CDATA[loop of Henle]]></kwd>
<kwd lng="en"><![CDATA[ascending branch of the loop of Henle]]></kwd>
<kwd lng="en"><![CDATA[collecting tube]]></kwd>
<kwd lng="en"><![CDATA[concentration]]></kwd>
<kwd lng="en"><![CDATA[dilution]]></kwd>
</kwd-group>
</article-meta>
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