This review provides an overview of the molecular mechanisms of K transport in the mammalian connecting tubule (CNT) and cortical collecting duct (CCD), both nephron segments responsible for the regulation of renal K secretion. Aldosterone and dietary K intake are two of the most important factors regulating K secretion in the CNT and CCD. Recently, angiotensin II (AngII) has also been shown to play a role in the regulation of K secretion. In addition, genetic and molecular biological approaches have further identified new mechanisms by which aldosterone and dietary K intake regulate K transport. Thus, the interaction between serum-glucocorticoid-induced kinase 1 (SGK1) and with-no-lysine kinase 4 (WNK4) plays a significant role in mediating the effect of aldosterone on ROMK (Kir1.1), an important apical K channel modulating K secretion. Recent evidence suggests that WNK1, mitogen-activated protein kinases such as P38, ERK, and Src family protein tyrosine kinase are involved in mediating the effect of low K intake on apical K secretory channels.
KeywordsPotassium transport; Potassium channel; Potassium secretion; Angiotensin; Aldosterone; K channel; Kidney
Overview of K transport mechanism in CNT and CCDMaintaining plasma K within a narrow physiological range is essential for the function of neurons, cardiac myocytes, and skeletal muscles. The kidney plays a key role in regulating K excretion by completely filtering K in the glomerulus, reabsorbing K extensively along the proximal tubule and thick ascending limb, secreting K in the connecting tubule (CNT) and cortical collecting duct (CCD), and reabsorbing K in outer medullary collecting duct (OMCD). Two morphological distinct cells, principal cell (PC) and intercalated cell (IC), are present in the CNT and CCD [29,75], and it is generally accepted that PC and IC are responsible for K secretion and for K absorption, respectively [27,30]. Figure 1 is a cell model illustrating the K transport mechanism under control conditions (normal K intake) in both PC and IC in the CCD [29,74,75]. K secretion takes place by a two-step process: K enters the cell via the basolateral Na,K-ATPase and is secreted into the lumen through apical K channels along a favorable electrochemical gradient [76,101]. K absorption is achieved by K entering the cell across the apical membrane through a luminal H,K-ATPase and leaving the cell across the basolateral membrane along a favorable K electrochemical gradient [19,21,33]. Although H,K-ATPase is Luminal Na transport provides normally an important driving force for K secretion [97], but recent evidence has shown that K secretion may continue when luminal Na transport is compromised. As demonstrated in microperfused rabbit CCD, K secretion may continue, albeit at a reduced rate, in the absence of luminal Na [69]. Since inhibition of basolateral Na/H exchanger significantly decreases such K secretion in the absence of luminal Na, it is most likely that Na recycling across the basolateral membrane through Na/H exchange supplies enough ...