生理情况下肾脏对钾的潴留:聚焦于远端肾单位的适应性及与钠转运系统的相互作用
Renal K retention in physiological circumstances: focus on adaptation of the distal nephron and cross-talk with Na transport systems.
作者信息
Lasaad Samia, Crambert Gilles
机构信息
Centre de Recherche des Cordeliers, Institut National de la Santé et de la Recherche Médicale, Sorbonne Université, Université Paris Cité, Laboratoire de Physiologie Rénale et Tubulopathies, Paris, France.
CNRS EMR 8228-Unité Métabolisme et Physiologie Rénale, Paris, France.
出版信息
Front Physiol. 2023 Aug 31;14:1264296. doi: 10.3389/fphys.2023.1264296. eCollection 2023.
Consumption of salt (NaCl) and potassium (K) has been completely modified, switching from a rich-K/low-NaCl diet in the hunter-gatherer population to the opposite in the modern, westernized population. The ability to conserve K is crucial to maintain the plasma K concentration in a physiological range when dietary K intake is decreased. Moreover, a chronic reduction in the K intake is correlated with an increased blood pressure, an effect worsened by a high-Na diet. The renal adaptation to a low-K diet in order to maintain the plasma K level in the normal range is complex and interconnected with the mechanisms of the Na balance. In this short review, we will recapitulate the general mechanisms allowing the plasma K value to remain in the normal range, when there is a necessity to retain K (response to low-K diet and adaptation to gestation), by focusing on the processes occurring in the most distal part of the nephron. We will particularly outline the mechanisms of K reabsorption and discuss the consequences of its absence on the Na transport systems and the regulation of the extracellular compartment volume and blood pressure.
盐(氯化钠)和钾的摄入量已发生了彻底改变,从狩猎采集人群中富含钾/低氯化钠的饮食模式转变为现代西方化人群中相反的模式。当饮食中钾摄入量减少时,保留钾的能力对于将血浆钾浓度维持在生理范围内至关重要。此外,钾摄入量的长期减少与血压升高相关,高钠饮食会使这种影响加剧。肾脏为维持血浆钾水平在正常范围内而对低钾饮食的适应是复杂的,并且与钠平衡机制相互关联。在这篇简短的综述中,我们将通过关注肾单位最远端发生的过程,概括当有必要保留钾时(对低钾饮食的反应和对妊娠的适应)使血浆钾值保持在正常范围内的一般机制。我们将特别概述钾重吸收的机制,并讨论其缺失对钠转运系统以及细胞外液容量调节和血压的影响。