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Osmolarity is greatest in the innermost portion of the medulla near the renal pelvis due to the osmotic gradient. As one goes deeper into the renal medulla, the osmotic gradient increase. The osmolarity varies from 300 mOsm at the edge of the medulla to the innermost at approximately 1200-1400 mOsm. Think of the movie, Silence of the Lamb, when Anthony Hopkins eats that kidney, as he eat closer and closer to the kidney, it get salter.

The medullary osmotic gradient is used for water reabsorption in the collecting duct, when ADH is present, thus increasing blood volume and result in increasing blood pressure.

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