Modulation of the secretion of potassium by accompanying anions in humans

Euan J F Carlisle; Sandra M. Donnelly; Jean H. Ethier; Susan E. Quaggin; Ursula B. Kaiser; Somkiat Vasuvattakul; Kamel S. Kamel; Mitchell L. Halperin

doi:10.1038/ki.1991.152

Modulation of the secretion of potassium by accompanying anions in humans

Euan J F Carlisle, Sandra M. Donnelly, Jean H. Ethier, Susan E. Quaggin, Ursula B. Kaiser, Somkiat Vasuvattakul, Kamel S. Kamel, Mitchell L. Halperin^*

^*Corresponding author for this work

Medicine, Nephrology Division

Research output: Contribution to journal › Article › peer-review

79 Scopus citations

Abstract

In animals, secretion of potassium (K) in the cortical collecting duct (CCD) is modulated by the properties of the accompanying anion. In humans, results are inconclusive as previous studies have not differentiated between a kaliuresis due to a rise in the concentration of K from one due to an increase in the volume of urine. Our purpose was to study the effects of chloride (Cl) and bicarbonate on the secretion of K in the CCD in humans using the transtubular K concentration gradient (TTKG), a semi-quantitative index of secretion of K in the terminal CCD. After control blood and urine samples were obtained, all subjects ingested 0.2 mg fludrocortisone to ensure that mineralocorticoids were not limiting the secretion of K. The anionic composition of the urine was varied using three protocols: Normal subjects (N = 11) ingested cystine and methionine to induce sulfaturia; nine subjects with a contracted ECF volume (to lower the concentration of Cl in the urine) were also studied during sulfaturia following the ingestion of cystine and methionine; 13 normovolemic subjects were studied during bicarbonaturia following the ingestion of acetazolamide. When the concentration of Cl in the urine was >15 mmol/liter, sulfate had no effect on the TTKG. With lower concentrations of Cl in the urine, the TTKG rose 1.5-fold. The TTKG rose 1.8-fold in the presence of bicarbonaturia despite concentrations of Cl in the urine that were >15 mmol/liter, suggesting that bicarbonate has additional effects on this K secretory process. At comparable concentrations of sulfate and bicarbonate in the urine, the TTKG was increased only with bicarbonaturia. We conclude that it is important to control for the effects of the accompanying anions when evaluating the role of the kidney in disorders of K homeostasis.

Original language	English (US)
Pages (from-to)	1206-1212
Number of pages	7
Journal	Kidney international
Volume	39
Issue number	6
DOIs	https://doi.org/10.1038/ki.1991.152
State	Published - Jun 1991

Funding

of Canada Fellowship, Dr. Ethier by a Fonds de Ia Recherche en Sante du Quebec postdoctoral fellowship, and Dr. Vasuvattakul by an edu- cational grant from Merck Frosst Canada. We thank Dr. William Singer for performing the aldosterone assays. The technical assistance of Jolly Mangat, Margaret Savoy, Sonia Perrin and the Department of Clinical Biochemistry is greatly appreciated. Acknowledgments Drs. Carlisle and Donnelly were supported by a Kidney Foundation

ASJC Scopus subject areas

Nephrology

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10.1038/ki.1991.152

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@article{745b032643b249d1b1aa412cc4410a00,

title = "Modulation of the secretion of potassium by accompanying anions in humans",

abstract = "In animals, secretion of potassium (K) in the cortical collecting duct (CCD) is modulated by the properties of the accompanying anion. In humans, results are inconclusive as previous studies have not differentiated between a kaliuresis due to a rise in the concentration of K from one due to an increase in the volume of urine. Our purpose was to study the effects of chloride (Cl) and bicarbonate on the secretion of K in the CCD in humans using the transtubular K concentration gradient (TTKG), a semi-quantitative index of secretion of K in the terminal CCD. After control blood and urine samples were obtained, all subjects ingested 0.2 mg fludrocortisone to ensure that mineralocorticoids were not limiting the secretion of K. The anionic composition of the urine was varied using three protocols: Normal subjects (N = 11) ingested cystine and methionine to induce sulfaturia; nine subjects with a contracted ECF volume (to lower the concentration of Cl in the urine) were also studied during sulfaturia following the ingestion of cystine and methionine; 13 normovolemic subjects were studied during bicarbonaturia following the ingestion of acetazolamide. When the concentration of Cl in the urine was >15 mmol/liter, sulfate had no effect on the TTKG. With lower concentrations of Cl in the urine, the TTKG rose 1.5-fold. The TTKG rose 1.8-fold in the presence of bicarbonaturia despite concentrations of Cl in the urine that were >15 mmol/liter, suggesting that bicarbonate has additional effects on this K secretory process. At comparable concentrations of sulfate and bicarbonate in the urine, the TTKG was increased only with bicarbonaturia. We conclude that it is important to control for the effects of the accompanying anions when evaluating the role of the kidney in disorders of K homeostasis.",

author = "Carlisle, {Euan J F} and Donnelly, {Sandra M.} and Ethier, {Jean H.} and Quaggin, {Susan E.} and Kaiser, {Ursula B.} and Somkiat Vasuvattakul and Kamel, {Kamel S.} and Halperin, {Mitchell L.}",

note = "Funding Information: of Canada Fellowship, Dr. Ethier by a Fonds de Ia Recherche en Sante du Quebec postdoctoral fellowship, and Dr. Vasuvattakul by an edu- cational grant from Merck Frosst Canada. We thank Dr. William Singer for performing the aldosterone assays. The technical assistance of Jolly Mangat, Margaret Savoy, Sonia Perrin and the Department of Clinical Biochemistry is greatly appreciated. Funding Information: Acknowledgments Drs. Carlisle and Donnelly were supported by a Kidney Foundation",

year = "1991",

month = jun,

doi = "10.1038/ki.1991.152",

language = "English (US)",

volume = "39",

pages = "1206--1212",

journal = "Kidney international",

issn = "0085-2538",

publisher = "Elsevier B.V.",

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T1 - Modulation of the secretion of potassium by accompanying anions in humans

AU - Carlisle, Euan J F

AU - Donnelly, Sandra M.

AU - Ethier, Jean H.

AU - Quaggin, Susan E.

AU - Kaiser, Ursula B.

AU - Vasuvattakul, Somkiat

AU - Kamel, Kamel S.

AU - Halperin, Mitchell L.

N1 - Funding Information: of Canada Fellowship, Dr. Ethier by a Fonds de Ia Recherche en Sante du Quebec postdoctoral fellowship, and Dr. Vasuvattakul by an edu- cational grant from Merck Frosst Canada. We thank Dr. William Singer for performing the aldosterone assays. The technical assistance of Jolly Mangat, Margaret Savoy, Sonia Perrin and the Department of Clinical Biochemistry is greatly appreciated. Funding Information: Acknowledgments Drs. Carlisle and Donnelly were supported by a Kidney Foundation

PY - 1991/6

Y1 - 1991/6

N2 - In animals, secretion of potassium (K) in the cortical collecting duct (CCD) is modulated by the properties of the accompanying anion. In humans, results are inconclusive as previous studies have not differentiated between a kaliuresis due to a rise in the concentration of K from one due to an increase in the volume of urine. Our purpose was to study the effects of chloride (Cl) and bicarbonate on the secretion of K in the CCD in humans using the transtubular K concentration gradient (TTKG), a semi-quantitative index of secretion of K in the terminal CCD. After control blood and urine samples were obtained, all subjects ingested 0.2 mg fludrocortisone to ensure that mineralocorticoids were not limiting the secretion of K. The anionic composition of the urine was varied using three protocols: Normal subjects (N = 11) ingested cystine and methionine to induce sulfaturia; nine subjects with a contracted ECF volume (to lower the concentration of Cl in the urine) were also studied during sulfaturia following the ingestion of cystine and methionine; 13 normovolemic subjects were studied during bicarbonaturia following the ingestion of acetazolamide. When the concentration of Cl in the urine was >15 mmol/liter, sulfate had no effect on the TTKG. With lower concentrations of Cl in the urine, the TTKG rose 1.5-fold. The TTKG rose 1.8-fold in the presence of bicarbonaturia despite concentrations of Cl in the urine that were >15 mmol/liter, suggesting that bicarbonate has additional effects on this K secretory process. At comparable concentrations of sulfate and bicarbonate in the urine, the TTKG was increased only with bicarbonaturia. We conclude that it is important to control for the effects of the accompanying anions when evaluating the role of the kidney in disorders of K homeostasis.

AB - In animals, secretion of potassium (K) in the cortical collecting duct (CCD) is modulated by the properties of the accompanying anion. In humans, results are inconclusive as previous studies have not differentiated between a kaliuresis due to a rise in the concentration of K from one due to an increase in the volume of urine. Our purpose was to study the effects of chloride (Cl) and bicarbonate on the secretion of K in the CCD in humans using the transtubular K concentration gradient (TTKG), a semi-quantitative index of secretion of K in the terminal CCD. After control blood and urine samples were obtained, all subjects ingested 0.2 mg fludrocortisone to ensure that mineralocorticoids were not limiting the secretion of K. The anionic composition of the urine was varied using three protocols: Normal subjects (N = 11) ingested cystine and methionine to induce sulfaturia; nine subjects with a contracted ECF volume (to lower the concentration of Cl in the urine) were also studied during sulfaturia following the ingestion of cystine and methionine; 13 normovolemic subjects were studied during bicarbonaturia following the ingestion of acetazolamide. When the concentration of Cl in the urine was >15 mmol/liter, sulfate had no effect on the TTKG. With lower concentrations of Cl in the urine, the TTKG rose 1.5-fold. The TTKG rose 1.8-fold in the presence of bicarbonaturia despite concentrations of Cl in the urine that were >15 mmol/liter, suggesting that bicarbonate has additional effects on this K secretory process. At comparable concentrations of sulfate and bicarbonate in the urine, the TTKG was increased only with bicarbonaturia. We conclude that it is important to control for the effects of the accompanying anions when evaluating the role of the kidney in disorders of K homeostasis.

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Modulation of the secretion of potassium by accompanying anions in humans

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