Amlal H, Wang Z, Soleimani M
Department of Medicine, University of Cincinnati School of Medicine, Cincinnati, Ohio 45267-0585, USA.
J Clin Invest. 1998 Mar 1;101(5):1045-54. doi: 10.1172/JCI686.
Potassium depletion (KD) causes renal chloride wasting, suggesting defect(s) in Cl- reabsorption in renal tubules. To determine whether alterations in expression of the major Cl- transporter genes might contribute to the chloride wasting, we analyzed their expression in renal cortex and medulla of animals placed on KD diet. Feeding KD diet to rats resulted in significant hypokalemia at 14 d but not at 6 d. Northern hybridization revealed that mRNA levels for the apical Na-K-2Cl cotransporter in the medulla decreased by 56 and 51% at 6 and 14 d of KD diet, respectively. Functional studies in tubular suspensions from medullary thick ascending limb demonstrated that the Na-K-2Cl cotransporter activity decreased by approximately 45 and approximately 37% at 6 and 14 d of KD diet, respectively. mRNA levels for the thiazide-sensitive Na-Cl cotransporter decreased by 57 and 64% at 6 and 14 d of KD diet. Decreased expression of the apical Na-Cl and the Na-K-2Cl cotransporters became evident at 48 and 72 h of KD, respectively. Urinary chloride excretion increased at 48 h and further increased at 72 h of KD, correlating with suppression of the Na-Cl and the Na-K-2Cl transporters. Our results indicate that increased urinary chloride loss in KD results from suppression of the chloride-absorbing transporters. Downregulation of chloride transporters in KD is an early event and can lead to hypochloremia and subsequently hypovolemia and decreased glomerular filtration rate.
钾缺乏(KD)会导致肾脏氯化物流失,提示肾小管中氯离子重吸收存在缺陷。为了确定主要氯离子转运蛋白基因表达的改变是否可能导致氯化物流失,我们分析了置于低钾饮食的动物肾皮质和髓质中这些基因的表达情况。给大鼠喂食低钾饮食在第14天导致显著低钾血症,但在第6天未出现。Northern杂交显示,低钾饮食第6天和第14天,髓质顶端钠钾2氯协同转运蛋白的mRNA水平分别下降了56%和51%。对髓质厚升支肾小管悬浮液的功能研究表明,低钾饮食第6天和第14天,钠钾2氯协同转运蛋白活性分别下降了约45%和约37%。低钾饮食第6天和第14天,噻嗪类敏感钠氯协同转运蛋白的mRNA水平分别下降了57%和64%。顶端钠氯和钠钾2氯协同转运蛋白表达的降低分别在低钾饮食48小时和72小时变得明显。低钾饮食48小时时尿氯化物排泄增加,72小时时进一步增加,这与钠氯和钠钾2氯转运蛋白的抑制相关。我们的结果表明,低钾饮食中尿氯化物流失增加是由于氯化物吸收转运蛋白的抑制所致。低钾饮食中氯离子转运蛋白的下调是一个早期事件,可导致低氯血症,随后导致血容量减少和肾小球滤过率降低。