Final answer:
The medullary osmotic gradient, crucial for urine concentration, is primarily established by the loop of Henle's ability to absorb water and transport solutes, functioning as a countercurrent multiplier.
Step-by-step explanation:
The mechanisms that establish the medullary osmotic gradient depend mostly on the properties of the loop of Henle. In the loop of Henle, the permeability of the membrane changes.
The descending limb is permeable to water, allowing it to absorb water from the filtrate due to the high osmotic pressure in the medulla. Conversely, the ascending limb is impermeable to water but allows for the active and passive movement of solutes like Na* and Cl- out of the filtrate, which contributes to the osmotic gradient.
This system, acting as a countercurrent multiplier, is crucial in concentrating urine and maintaining the body's water balance.