The connecting tubule is the main site of the furosemide-induced urinary acidification by the vacuolar H+-ATPase

Kidney Int. 2006 Nov;70(10):1706-16. doi: 10.1038/sj.ki.5001851. Epub 2006 Sep 20.

Abstract

Final urinary acidification is achieved by electrogenic vacuolar H(+)-ATPases expressed in acid-secretory intercalated cells (ICs) in the connecting tubule (CNT) and the cortical (CCD) and initial medullary collecting duct (MCD), respectively. Electrogenic Na(+) reabsorption via epithelial Na(+) channels (ENaCs) in the apical membrane of the segment-specific CNT and collecting duct cells may promote H(+)-ATPases-mediated proton secretion by creating a more lumen-negative voltage. The exact localization where this supposed functional interaction takes place is unknown. We used several mouse models performing renal clearance experiments and assessed the furosemide-induced urinary acidification. Increasing Na(+) delivery to the CNT and CCD by blocking Na(+) reabsorption in the thick ascending limb with furosemide enhanced urinary acidification and net acid excretion. This effect of furosemide was abolished with amiloride or benzamil blocking ENaC action. In mice deficient for the IC-specific B1 subunit of the vacuolar H(+)-ATPase, furosemide led to only a small urinary acidification. In contrast, in mice with a kidney-specific inactivation of the alpha subunit of ENaC in the CCD and MCD, but not in the CNT, furosemide alone and in combination with hydrochlorothiazide induced normal urinary acidification. These results suggest that the B1 vacuolar H(+)-ATPase subunit is necessary for the furosemide-induced acute urinary acidification. Loss of ENaC channels in the CCD and MCD does not affect this acidification. Thus, functional expression of ENaC channels in the CNT is sufficient for furosemide-stimulated urinary acidification and identifies the CNT as a major segment in electrogenic urinary acidification.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acid-Base Equilibrium / drug effects*
  • Acid-Base Equilibrium / physiology
  • Amiloride / pharmacokinetics
  • Amiloride / pharmacology
  • Animals
  • Diuretics / pharmacokinetics
  • Diuretics / pharmacology*
  • Epithelial Sodium Channels / genetics
  • Epithelial Sodium Channels / metabolism
  • Furosemide / pharmacokinetics
  • Furosemide / pharmacology*
  • Gene Expression Regulation / drug effects
  • Gene Expression Regulation / genetics
  • Gene Expression Regulation, Enzymologic / drug effects
  • Gene Expression Regulation, Enzymologic / genetics
  • Hydrochlorothiazide / pharmacokinetics
  • Hydrochlorothiazide / pharmacology
  • Hydrogen-Ion Concentration
  • Kidney Tubules, Collecting / metabolism
  • Kidney Tubules, Distal / drug effects*
  • Kidney Tubules, Distal / metabolism
  • Metabolic Clearance Rate / drug effects
  • Metabolic Clearance Rate / physiology
  • Mice
  • Mice, Knockout
  • Nephrons / drug effects
  • Nephrons / physiology
  • Proton-Translocating ATPases / genetics
  • Proton-Translocating ATPases / metabolism*
  • Water-Electrolyte Balance / physiology

Substances

  • Diuretics
  • Epithelial Sodium Channels
  • Hydrochlorothiazide
  • Amiloride
  • Furosemide
  • Proton-Translocating ATPases