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The mechanism of blood pressure regulation by high potassium diet in the kidney

MENG Gui-Lin¹, MENG Xin-Xin¹, GU Rui-Min², WANG Ming-Xiao^1,*

¹Department of Physiology, Zhuhai Campus of Zunyi Medical University, Zhuhai 519040, China；²Department of Pharmacology, Harbin Medical University, Harbin 150081, China

Abstract

Hypertension is one of the strongest risk factors for cardiovascular diseases, cerebral stroke, and kidney failure. Lifestyle and nutrition are important factors that modulate blood pressure. Hypertension can be controlled by increasing physical activity, decreasing alcohol and sodium intake, and stopping tobacco smoking. Chronic kidney disease patients often have increased blood pressure, which indicates that kidney is one of the major organs responsible for blood pressure homeostasis. The decrease of renal sodium reabsorption and increase of diuresis induced by high potassium intake is critical for the blood pressure reduction. The beneficial effect of a high potassium diet on hypertension could be explained by decreased salt reabsorption by sodium-chloride cotransporter (NCC) in the distal convoluted tubule (DCT). In DCT cells, NCC activity is controlled by with-no-lysine kinases (WNKs) and its down-stream target kinases, Ste20-related proline-alanine-rich kinase (SPAK) and oxidative stress-responsive 1 (OSR1). The kinase activity of WNKs is inhibited by intracellular chloride ([Cl−]i) and WNK4 is known to be the major WNK positively regulating NCC. Based on our previous studies, high potassium intake reduces the basolateral potassium conductance, decreases the negativity of DCT basolateral membrane (depolarization), and increases [Cl−]i. High [Cl−]i inhibits WNK4-SPAK/OSR1 pathway, and thereby decreases NCC phosphorylation. In this review, we discuss the role of DCT in the blood pressure regulation by dietary potassium intake, which is the mechanism that has been best dissected so far.

Key words: Hypertension; high potassium diet; distal convoluted tubule; sodium-chloride cotransporter

Received: 　　Accepted:

Corresponding author: 王明晓　　E-mail: wmxzyzh@163.com

DOI: 10.13294/j.aps.2021.0066

Citing This Article：

MENG Gui-Lin, MENG Xin-Xin, GU Rui-Min, WANG Ming-Xiao. The mechanism of blood pressure regulation by high potassium diet in the kidney. Acta Physiol Sin 2022; 74 (1): 110-116 (in Chinese with English abstract).