Sodium-calcium exchanger 1 is the key molecule for urinary potassium excretion against acute hyperkalemia

PLoS One. 2020 Jun 30;15(6):e0235360. doi: 10.1371/journal.pone.0235360. eCollection 2020.

Abstract

The sodium (Na+)-chloride cotransporter (NCC) expressed in the distal convoluted tubule (DCT) is a key molecule regulating urinary Na+ and potassium (K+) excretion. We previously reported that high-K+ load rapidly dephosphorylated NCC and promoted urinary K+ excretion in mouse kidneys. This effect was inhibited by calcineurin (CaN) and calmodulin inhibitors. However, the detailed mechanism through which high-K+ signal results in CaN activation remains unknown. We used Flp-In NCC HEK293 cells and mice to evaluate NCC phosphorylation. We analyzed intracellular Ca2+ concentration ([Ca2+]in) using live cell Ca2+ imaging in HEK293 cells. We confirmed that high-K+-induced NCC dephosphorylation was not observed without CaN using Flp-In NCC HEK29 cells. Extracellular Ca2+ reduction with a Ca2+ chelator inhibited high-K+-induced increase in [Ca2+]in and NCC dephosphorylation. We focused on Na+/Ca2+ exchanger (NCX) 1, a bidirectional regulator of cytosolic Ca2+ expressed in DCT. We identified that NCX1 suppression with a specific inhibitor (SEA0400) or siRNA knockdown inhibited K+-induced increase in [Ca2+]in and NCC dephosphorylation. In a mouse study, SEA0400 treatment inhibited K+-induced NCC dephosphorylation. SEA0400 reduced urinary K+ excretion and induced hyperkalemia. Here, we identified NCX1 as a key molecule in urinary K+ excretion promoted by CaN activation and NCC dephosphorylation in response to K+ load.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aniline Compounds / pharmacology
  • Animals
  • HEK293 Cells
  • Humans
  • Hyperkalemia / metabolism*
  • Kidney Tubules, Distal / metabolism
  • Mice
  • Phenyl Ethers / pharmacology
  • Phosphorylation / drug effects
  • Potassium* / metabolism
  • Potassium* / urine
  • Sodium / metabolism
  • Sodium-Calcium Exchanger* / antagonists & inhibitors
  • Sodium-Calcium Exchanger* / metabolism

Substances

  • Aniline Compounds
  • Phenyl Ethers
  • SEA 0400
  • Sodium-Calcium Exchanger
  • sodium-calcium exchanger 1
  • Sodium
  • Potassium