1. Sodium ions actively removed from the ascending limb using ATP from mitochondria in the cells that line its walls
2. This creates low water potential (high osmolarity) in the region of the medulla between the two limbs. Normally, water would leave the ascending limb by osmosis because of this. However, the thick walls of it prevent this.
3. The walls of the descending limb are very permeable to water, so it passes out of the filtrate by osmosis into the interstitial space then to the blood capillaries and is carried away.
4. The filtrate loses water as it moves down the descending limb lowering its water potential (increasing its osmolarity). It reaches its lowest water potential at the top of the loop.
5. At this point, sodium ions diffuse out of the filtrate as it moves up the ascending limb, and they are also actively pumped out. The filtrate decreases in the number of solutes dissolved per litre (osmolarity) but increases in its water potential the further up the medulla it goes.
6. In the interstitial space between the ascending limb and collecting duct there is a gradient of water potential with the lowest concentration of ions in the cortex. The further into the medulla you go the increasingly higher concentration of ions you’ll find (lower water potential).
7. The collecting duct is permeable to water and so as the filtrate moves down it, water passes out through osmosis. It goes into the blood vessels that surround it and is carried away.
8. As water passes out of the filtrate, the water potential is lowered (osmolarity increases). However, the water potential is also lowered in the interstitial space as it is being removed by the blood vessels. Water therefore continues to be removed for the entire length of the collecting duct. The counter current multiplier ensures there is always a water potential gradient drawing water out of the tubule.