Regulation of the Renal NaCl Cotransporter and Its Role in Potassium Homeostasis.

Regulation of the Renal NaCl Cotransporter and Its Role in Potassium Homeostasis. Physiol Rev. 2020 Jan 01;100(1):321-356 Authors: Hoorn EJ, Gritter M, Cuevas CA, Fenton RA Abstract Daily dietary potassium (K+) intake may be as large as the extracellular K+ pool. To avoid acute hyperkalemia, rapid removal of K+ from the extracellular space is essential. This is achieved by translocating K+ into cells and increasing urinary K+ excretion. Emerging data now indicate that the renal thiazide-sensitive NaCl cotransporter (NCC) is critically involved in this homeostatic kaliuretic response. This suggests that the early distal convoluted tubule (DCT) is a K+ sensor that can modify sodium (Na+) delivery to downstream segments to promote or limit K+ secretion. K+ sensing is mediated by the basolateral K+ channels Kir4.1/5.1, a capacity that the DCT likely shares with other nephron segments. Thus, next to K+-induced aldosterone secretion, K+ sensing by renal epithelial cells represents a second feedback mechanism to control K+ balance. NCC's role in K+ homeostasis has both physiological and pathophysiological implications. During hypovolemia, NCC activation by the renin-angiotensin system stimulates Na+ reabsorption while preventing K+ secretion. Conversely, NCC inactivation by high dietary K+ intake maximizes kaliuresis and limits Na+ retention, despite high aldosterone levels. NCC activation by a low-K+ diet contributes to salt-sensitive hypertension. K+-induced ...
Source: Physiological Reviews - Category: Physiology Authors: Tags: Physiol Rev Source Type: research

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Source: AllAfrica News: Health and Medicine - Category: African Health Source Type: news
(World Scientific) A search using medical data bases reveals that hundreds of meta-analysis papers conducted with tens of millions of people worldwide have confirmed clinically the efficacies of 30 antioxidant-rich foods to prevent or treat chronic diseases, including hypertension, diabetes, cardiovascular disease, cognitive impairment, chronic kidney disease, cancer, and more. Professor Monte Lai, former professor of biophysics at the Medical College of Wisconsin talks about this and more in his new book 'The Food Cure.'
Source: EurekAlert! - Biology - Category: Biology Source Type: news
Publication date: Available online 16 January 2020Source: American Journal of Kidney DiseasesAuthor(s): Jelmer K. Humalda, Gerald Klaassen, Hanne de Vries, Yvette Meuleman, Lara C. Verschuur, Elisabeth J.M. Straathof, Gozewijn D. Laverman, Willem Jan W. Bos, Paul J.M. van der Boog, Karin M. Vermeulen, Olivier A. Blanson Henkemans, Wilma Otten, Martin H. de Borst, Sandra van Dijk, Gerjan J. Navis, P.J.M. van der Boog, S. van Dijk, G.J. Navis, J.K. Humalda (project coordination), G. KlaassenRationale &ObjectivePatients with chronic kidney disease (CKD) are particularly sensitive to dietary sodium. We evaluated a self-man...
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
AbstractCardiovascular diseases, including hypertension, congestive heart failure, myocardial infarction, stroke and atherosclerosis, are common in patients with chronic kidney disease. Aside from the standard biomarkers, measured to determine cardiovascular risk, new ones have emerged: markers of oxidative stress, apoptosis, inflammation, vascular endothelium dysfunction, atherosclerosis, organ calcification and fibrosis. Unfortunately, their utility for routine clinical application remains to be elucidated. A causal relationship between new markers and cardiovascular diseases in patients with chronic kidney disease remai...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Conclusion There is a long way ahead regarding the role of gut microbiota in the pathogenesis and as an adjunctive treatment of hypertension. Treatment of dysbiosis could be a useful therapeutic approach to add to traditional antihypertensive therapy. Manipulating gut microbiota using prebiotics and probiotics might prove a valuable tool to traditional antihypertensives.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Review Source Type: research
The objective of the current review is therefore twofold. First, we aim to demonstrate the emerging role of gastrointestinal microbiome dysbiosis in the pathogenesis and progression of chronic kidney disease. Second, we highlight specific mechanisms as to how microbiome dysbiosis is provoked in chronic kidney disease.Recent FindingsCurrent work has shown that microbiome dysbiosis can directly and indirectly influence renal physiology and contribute to the onset and development of chronic kidney disease, such as by stimulating hypertension. It is also becoming evident that the composition and function of both the intestinal...
Source: Current Oral Health Reports - Category: Dentistry Source Type: research
SUMMARY Type 2 diabetes mellitus is an important public health problem, with a significant impact on cardiovascular morbidity and mortality and an important risk factor for chronic kidney disease. Various hypoglycemic therapies have proved to be beneficial to clinical outcomes, while others have failed to provide an improvement in cardiovascular and renal failure, only reducing blood glucose levels. Recently, sodium-glucose cotransporter-2 (SGLT2) inhibitors, represented by the empagliflozin, dapagliflozin, and canagliflozin, have been showing satisfactory and strong results in several clinical trials, especially regarding...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
Abstract Epidemiological studies show that hyperuricemia independently predicts the development of chronic kidney disease (CKD) in individuals with normal kidney function both in the general population and in subjects with diabetes. As a matter of fact, an unfavorable role of uric acid may somewhat be harder to identify in the context of multiple risk factors and pathogenetic mechanisms typical of overt CKD such as proteinuria and high blood pressure. Although the discrepancy in clinical results could mean that urate lowering treatment does not provide a constant benefit in all patients with hyperuricemia and CKD,...
Source: Journal of Nephrology - Category: Urology & Nephrology Authors: Tags: J Nephrol Source Type: research
Abstract BACKGROUND: Hypertensive urgencies (HypUrg) are define as severe elevation in blood pressure (BP) without acute target organ damage (TOD). In the office setting, treated asymptomatic patients, with severe BP elevation meeting criteria for urgency are often seen. We evaluate incident CV events (fatal and non-fatal stroke or acute myocardial infarction, TIA, coronary or carotid revascularization, atrial fibrillation (n=311)) during follow-up (FU) in patients with HypUrg at first outpatient visit. METHODS: From the Campania Salute Network (CSN) Registry. HypUrg was define by systolic BP ≥180mmHg and/...
Source: American Journal of Hypertension - Category: Cardiology Authors: Tags: Am J Hypertens Source Type: research
This study estimates the prevalence of CKD in the Narsinghpur block of Cuttack district, Odisha. A cross-sectional study was conducted among population members aged 20–60 years. Using a multi-stage cluster sampling. 24 villages were randomly selected for mass screening for CKD. Blood samples were collected and glomerulus filtration rates were calculated. It was found that among the 2978 people screened, 14.3% were diagnosed with CKD and 10.8% were diagnosed with CKD without either diabetes or hypertension. In one-third of the sampled villages, about 20% population was diagnosed with CKD. The prevalence was higher...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Article Source Type: research
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