Department of Physiology, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.
Nat Rev Nephrol. 2020 Jun;16(6):337-351. doi: 10.1038/s41581-020-0259-8. Epub 2020 Mar 3.
The kidney is a remarkable organ that accomplishes the challenge of removing waste from the body and simultaneously regulating electrolyte and water balance. Pro-urine flows through the nephron in a highly dynamic manner and adjustment of the reabsorption rates of water and ions to the variable tubular flow is required for electrolyte homeostasis. Renal epithelial cells sense the tubular flow by mechanosensation. Interest in this phenomenon has increased in the past decade since the acknowledgement of primary cilia as antennae that sense renal tubular flow. However, the significance of tubular flow sensing for electrolyte handling is largely unknown. Signal transduction pathways regulating flow-sensitive physiological responses involve calcium, purinergic and nitric oxide signalling, and are considered to have an important role in renal electrolyte handling. Given that mechanosensation of tubular flow is an integral role of the nephron, defective tubular flow sensing is probably involved in renal disease. Studies investigating tubular flow and electrolyte transport differ in their methodology, subsequently hampering translational validity. This Review provides the basis for understanding electrolyte disorders originating from altered tubular flow sensing as a result of pathological conditions.
肾脏是一个非凡的器官，它完成了从体内清除废物的挑战，同时调节电解质和水的平衡。原尿以高度动态的方式流经肾单位，需要调整水和离子的重吸收率以适应可变的管状流，从而实现电解质的体内平衡。肾上皮细胞通过机械感觉来感知管状流。由于认识到初级纤毛是感应肾管状流的天线，过去十年中人们对这一现象的兴趣有所增加。然而，管状流感应对电解质处理的意义在很大程度上尚不清楚。调节对流量敏感的生理反应的信号转导途径涉及钙、嘌呤能和一氧化氮信号，被认为在肾脏电解质处理中起重要作用。鉴于管状流的机械感觉是肾单位的一个基本功能，因此，管状流感应缺陷可能与肾脏疾病有关。研究管状流和电解质转运的方法不同，因此妨碍了转化的有效性。本综述为理解源自病理条件下改变的管状流感应的电解质紊乱提供了基础。
