Renal Filtration and Electrolyte Balance · USMLE Step 1

Which nephron segment is impermeable to water but actively reabsorbs ions, contributing to the counter-current multiplier system and concentrating the medullary interstitium?

  1. Proximal tubule
  2. Thin descending limb of loop of Henle
  3. Thick ascending limb of loop of Henle
  4. Collecting duct
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Correct answer: Thick ascending limb of loop of Henle

The thick ascending limb is impermeable to water but reabsorbs Na⁺, K⁺, and Cl⁻ via NKCC2; by doing so, it dilutes tubular fluid and contributes to the hyperosmolar medullary gradient essential for urine concentration.

Difficulty: Medium Question 15 of 20

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