Institute of Anatomy, University of Zurich, Zurich, Switzerland.
Kidney Int. 2013 May;83(5):811-24. doi: 10.1038/ki.2013.14. Epub 2013 Feb 27.
A dietary potassium load induces a rapid kaliuresis and natriuresis, which may occur even before plasma potassium and aldosterone (aldo) levels increase. Here we sought to gain insight into underlying molecular mechanisms contributing to this response. After gastric gavage of 2% potassium, the plasma potassium concentrations rose rapidly (0.25 h), followed by a significant rise of plasma aldo (0.5 h) in mice. Enhanced urinary potassium and sodium excretion was detectable as early as spot urines could be collected (about 0.5 h). The functional changes were accompanied by a rapid and sustained (0.25-6 h) dephosphorylation of the NaCl cotransporter (NCC) and a late (6 h) upregulation of proteolytically activated epithelial sodium channels. The rapid effects on NCC were independent from the coadministered anion. NCC dephosphorylation was also aldo-independent, as indicated by experiments in aldo-deficient mice. The observed urinary sodium loss relates to NCC, as it was markedly diminished in NCC-deficient mice. Thus, downregulation of NCC likely explains the natriuretic effect of an acute oral potassium load in mice. This may improve renal potassium excretion by increasing the amount of intraluminal sodium that can be exchanged against potassium in the aldo-sensitive distal nephron.
饮食钾负荷会引起快速的尿钾和尿钠排泄,甚至可能在血浆钾和醛固酮(aldo)水平升高之前就已经发生。在这里,我们试图深入了解导致这种反应的潜在分子机制。在给小鼠胃管内灌注 2%的钾后,血浆钾浓度迅速升高(0.25 小时),随后血浆aldo 显著升高(0.5 小时)。在能够收集到点尿时(约 0.5 小时),即可检测到增强的尿钾和尿钠排泄。功能变化伴随着 NaCl 共转运蛋白(NCC)的快速和持续去磷酸化(0.25-6 小时)以及晚期(6 小时)的蛋白水解激活的上皮钠通道的上调。NCC 的快速作用与共同给予的阴离子无关。如aldo 缺乏型小鼠的实验所示,NCC 的去磷酸化也与aldo 无关。观察到的尿钠丢失与 NCC 有关,因为在 NCC 缺乏型小鼠中,其明显减少。因此,NCC 的下调可能解释了急性口服钾负荷对小鼠的利钠作用。这可能通过增加在aldo 敏感的远端肾单位中可以与钾交换的腔内钠量来改善肾脏钾排泄。