Potassium Supplementation Prevents Sodium Chloride Cotransporter Stimulation During Angiotensin II Hypertension

Hypertension. 2016 Oct;68(4):904-12. doi: 10.1161/HYPERTENSIONAHA.116.07389. Epub 2016 Sep 6.

Abstract

Angiotensin II (AngII) hypertension increases distal tubule Na-Cl cotransporter (NCC) abundance and phosphorylation (NCCp), as well as epithelial Na(+) channel abundance and activating cleavage. Acutely raising plasma [K(+)] by infusion or ingestion provokes a rapid decrease in NCCp that drives a compensatory kaliuresis. The first aim tested whether acutely raising plasma [K(+)] with a single 3-hour 2% potassium meal would lower NCCp in Sprague-Dawley rats after 14 days of AngII (400 ng/kg per minute). The potassium-rich meal neither decreased NCCp nor increased K(+) excretion. AngII-infused rats exhibited lower plasma [K(+)] versus controls (3.6±0.2 versus 4.5±0.1 mmol/L; P<0.05), suggesting that AngII-mediated epithelial Na(+) channel activation provokes K(+) depletion. The second aim tested whether doubling dietary potassium intake from 1% (A1K) to 2% (A2K) would prevent K(+) depletion during AngII infusion and, thus, prevent NCC accumulation. A2K-fed rats exhibited normal plasma [K(+)] and 2-fold higher K(+) excretion and plasma [aldosterone] versus A1K. In A1K rats, NCC, NCCpS71, and NCCpT53 abundance increased 1.5- to 3-fold versus controls (P<0.05). The rise in NCC and NCCp abundance was prevented in the A2K rats, yet blood pressure did not significantly decrease. Epithelial Na(+) channel subunit abundance and cleavage increased 1.5- to 3-fold in both A1K and A2K; ROMK (renal outer medulla K(+) channel abundance) abundance was unaffected by AngII or dietary K(+) In summary, the accumulation and phosphorylation of NCC seen during chronic AngII infusion hypertension is likely secondary to potassium deficiency driven by epithelial Na(+) channel stimulation.

Keywords: aldosterone-sensitive distal nephron; angiotensin II hypertension; dietary potassium; hypokalemia; kaliuresis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin II / pharmacology
  • Animals
  • Disease Models, Animal
  • Epithelial Sodium Channels / metabolism*
  • Hypertension / chemically induced
  • Hypertension / physiopathology*
  • Infusions, Intravenous
  • Kidney Function Tests
  • Male
  • Multivariate Analysis
  • Phosphorylation
  • Potassium Deficiency / prevention & control
  • Potassium, Dietary / metabolism
  • Potassium, Dietary / pharmacology*
  • Random Allocation
  • Rats
  • Rats, Sprague-Dawley
  • Sodium Chloride Symporters / drug effects
  • Sodium Chloride Symporters / metabolism*
  • Sodium-Hydrogen Exchangers / metabolism
  • Water-Electrolyte Balance / physiology*

Substances

  • Epithelial Sodium Channels
  • Potassium, Dietary
  • Sodium Chloride Symporters
  • Sodium-Hydrogen Exchangers
  • Angiotensin II