Maintaining K+balance on the low-Na+, high-K+diet

Cornelius, Ryan J.; Wang, Bangchen; Wang-France, Jun; Sansom, Steven C.

doi:10.1152/ajprenal.00330.2015

Cited by 10 publications

(15 citation statements)

References 185 publications

(240 reference statements)

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“…Studies showed that a low Na diet increased NKCC2 phosphorylation and caused a shift from the low-affinity NKCC2A to the high-affinity NKCC2B isoform, partly mediated by the actions of Ang II on AT1 receptors 18,41 . Ang II level is greatly increased in mice on LNaHK, but not on HK 7,8,42 . These findings suggest that elevated Ang II may be responsible for the upregulated NKCC2 activity in mice on LNaHK.…”

Section: Discussionmentioning

confidence: 87%

“…This study suggests that the ROMK2 isoform in the TAL is regulated by different signaling pathways than the ROMK1 in the ASDN. Mice on LNaHK have highly elevated aldosterone and Ang II compared to CTRL 7,8,42 . Since TAL is absent of 11-β-hydroxysteroid dehydrogenase 2 (HSD11B2) 48 , aldosterone is unlikely to regulate ROMK in TAL.…”

Section: Discussionmentioning

confidence: 96%

“…Our understanding of such diets have, in large part, derived from studies of the South American Yanomami, an isolated culture known for consuming a high K alkaline diet with nearly zero Na 6 . Our lab has developed and studied the renal K handling of mice on a low Na high K, alkaline diet (LNaHK) as an exaggeration of the ancient diet consumed by the Yanomami 7–9 . Our understanding of the mechanism for handling LNaHK is crucial to choosing effective diuretics and preventing the drastic consequences of hypokalemia or hyperkalemia for patients on such diets 10 .…”

Section: Introductionmentioning

confidence: 99%

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Net K + secretion in the thick ascending limb of mice on a low-Na, high-K diet

Wang

Wen

et al. 2017

Kidney International

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Because of its cardio-protective effects, a low Na, high K diet (LNaHK) is often warranted in conjunction with diuretics to treat hypertensive patients. However, it is necessary to understand the renal handling of such diets in order to choose the best diuretic. Wild type (WT) or Renal Outer Medullary K channel (ROMK) knockout mice (KO) were given a regular (CTRL), LNaHK, or high K diet (HK) for 4–7 days. On LNaHK, mice treated with either IP furosemide for 12 hrs, or given furosemide in drinking water for 7 days, exhibited decreased K clearance. We used free-flow micropuncture to measure the [K+] in the early distal tubule (EDT [K+]) before and after furosemide treatment. Furosemide increased the EDT [K+] in WT on CTRL but decreased that in WT on LNaHK. Furosemide did not affect the EDT [K+] of KO on LNaHK or WT on HK. Furosemide-sensitive Na+ excretion was significantly greater in mice on LNaHK than those on CTRL or HK. Patch clamp analysis of split-open TALs revealed that 70-pS ROMK exhibited a higher open probability (Po) but similar density in mice on LNaHK, compared with CTRL. No difference was found in the density or Po of the 30 pS K channels between two groups. These results indicate mice on LNaHK exhibited furosemide-sensitive net K+ secretion in the TAL that is dependent on increased NKCC2 activity and mediated by ROMK. We conclude that furosemide is a K-sparing diuretic by decreasing the TAL net K+ secretion in subjects on LNaHK.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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Net K + secretion in the thick ascending limb of mice on a low-Na, high-K diet

Wang

Wen

et al. 2017

Kidney International

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“…The diets of early humans and ancestral hominids and primates were plentiful in plant matter rich in potassium (K) and poor in sodium (Na). 1,2 As a result, humans, as did most mammals, evolved to be good at retaining sodium and excreting potassium.…”

mentioning

confidence: 99%

“…This modern diet has been linked to increased incidences of hypertension. 1,3,4 Current thinking is that a diet rich in sodium and poor in potassium contributes to elevated blood pressure because a kidney adapted to retaining sodium and excreting potassium is poorly prepared to excrete sodium when challenged with the high Na + load of a modern diet.…”

mentioning

confidence: 99%

Loop diuretics are K + -sparing in the presence of a low-Na + , high-K + diet

Boiko

Berman

Mironova

et al. 2017

Kidney International

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Under most conditions, loop diuretics are K-wasting, requiring potassium supplementation. In this issue, Wang and colleagues demonstrate that in mice fed a low-Na, high-K diet, loop diuretics, in contrast, are K-sparing. This observation suggests that possible elevations in plasma K should be monitored when using a loop diuretic with a low-Na, high-K diet, particularly when in combination with a potassium supplement.

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Physiologic Influences of Transepithelial K+ Secretion

Halm¹

2020

Physiology in Health and Disease

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Maintaining K⁺balance on the low-Na⁺, high-K⁺diet

Cited by 10 publications

References 185 publications

Net K + secretion in the thick ascending limb of mice on a low-Na, high-K diet

Net K + secretion in the thick ascending limb of mice on a low-Na, high-K diet

Loop diuretics are K + -sparing in the presence of a low-Na + , high-K + diet

Physiologic Influences of Transepithelial K+ Secretion

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