MetaTOC stay on top of your field, easily

Increasing Plasma [K+] by Intravenous Potassium Infusion Reduces NCC Phosphorylation and Drives Kaliuresis and Natriuresis

, , , , ,

Renal Physiology

Published online on

Abstract

Dietary potassium loading results in rapid kaliuresis, natriuresis and diuresis associated with reduced phosphorylation (-p) of the distal tubule Na+-Cl- cotransporter (NCC). Decreased NCC-p inhibits NCC mediated Na+ reabsorption and shifts Na+ downstream for reabsorption by epithelial Na+ channels (ENaC) which can drive K+ secretion. Whether the signal is initiated by ingesting potassium or a rise in plasma [K+] is not understood. We tested the hypothesis, in male rats, that an increase in plasma [K+] is sufficient to reduce NCC-p and drive kaliuresis. After an overnight fast, a single 3 hr 2% potassium (2%K) containing meal increased plasma [K+] from 4.0±0.1 to 5.2±0.2 mM, increased urinary K+, Na+, and volume excretion, decreased NCC-p by 60%, and marginally reduced cortical Na+-K+-2Cl- cotransporter (NKCC) phosphorylation 25% (P=0.055). When plasma [K+] was increased by tail vein infusion of KCl to 5.5±0.1 mM over 3 hr, significant kaliuresis and natriuresis ensued, NCC-p decreased by 60% and STE20/SPS1-related proline alanine-rich kinase (SPAK) phosphorylation was marginally reduced 35% (P=0.052). The following were unchanged at 3 hr by either the potassium-rich meal or KCl infusion: Na+/H+ exchanger 3 (NHE3), NHE3-p, NKCC, ENaC subunits, renal outer medullary K+ channel. In summary, raising plasma [K+] by intravenous infusion to a level equivalent to that observed after a single potassium-rich meal triggers renal kaliuretic and natriuretic responses, independent of K+ ingestion, likely driven by decreased NCC-p and activity sufficient to shift sodium reabsorption downstream to where Na+ reabsorption and flow drive K+ secretion.