Aldosterone and Renal Potassium Excretion

Rabinowitz, L.

doi:10.1159/000172713

Cited by 9 publications

(9 citation statements)

References 33 publications

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“…Chronic and acute aldosterone replacement, in contrast, had a potent stimulatory effect on sodium reabsorption. These data confirm the potent effect of physiological levels of aldosterone on sodium transport in the kidney (reviewed in [1][2][3].…”

Section: Discussionsupporting

confidence: 84%

“…This dual action of corticosteroids has significant implications. Failure of an acute infusion of aldosterone to stimulate urinary potassium excretion has been observed (2,3,10,16,17). It is most likely that this is related to the attendant fall in urinary flow and sodium excretion, which oppose a direct stimulatory effect of the hormone on distal potassium secretion.…”

Section: Discussionmentioning

confidence: 99%

“…Adrenal corticosteroids play an important role in potassium homeostasis (reviewed in [1][2][3][4]. Chronic adrenal insufficiency is associated with hyperkalemia and with a decreased ability to excrete an acute potassium load (5-1 1).…”

Section: Introductionmentioning

confidence: 99%

“…First, there is considerable controversy concerning the nature of the selective effects of mineralocorticoids vs. glucocorticoids on potassium excretion (reviewed in [1][2][3][4]. Previous investigators often employed supraphysiologic or pharmacologic doses of steroids that were likely to result in nonspecific effects through binding to both glucocorticoid and mineralocorticoid receptors in the kidney (4,(25)(26)(27).…”

Section: Introductionmentioning

confidence: 99%

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Effects of adrenalectomy and chronic adrenal corticosteroid replacement on potassium transport in rat kidney.

Giebisch¹,

Klein-Robbenhaar²,

Wade³

et al. 1985

J. Clin. Invest.

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Clearance experiments were carried out in pair-fed rats to examine the long-term effects of adrenalectomy and selective adrenal corticosteroid replacement in physiological amounts on renal potassium transport. To this end, clearance studies were conducted in rats that were sham operated, or adrenalectomized (ADX). ADX animals were given either vehicle, aldosterone (0.5 Mig/i00 g body wt per day), dexamethasone (1.2 Mg/i00 g body wt per day), or aldosterone and dexamethasone, by osmotic minipump for 7-9 d whereupon clearance experiments were conducted. After chronic hormone treatment, during basal conditions when only Ringers solution was infused, all groups excreted similar amounts of potassium. However, in all ADX animals without mineralocorticoid replacement, the maintenance of urinary potassium excretion at control levels was associated with hyperkalemia, increased urine flow, and natriuresis; all are factors known to stimulate urinary potassium excretion. During acute potassium infusion, the increase in urinary potassium excretion was less in ADX rats than in controls. This functional deficiency in potassium excretion was partially corrected by dexamethasone and was uniformly associated with a significant increase in urine flow. Aldosterone replacement or aldosterone and dexamethasone given together chronically, sharply increased potassium excretion but did not restore excretion to control levels. Only acute aldosterone infusion (0.2 ,ug/100 g body wt bolus plus 0.2 Mg/100 g body wt per hour), superimposed upon chronic aldosterone and dexamethasone treatment, fully restored potassium excretion to control levels. This aldosterone induced enhancement of potassium excretion, both chronic and acute, was not associated with hyperkalemia, and increased urine flow or natriuresis. Thus, physiological levels of both classes of adrenal corticosteroids stimulate renal potassium excretion albeit by different mechanisms. Mineralocorticoids stimulate tubular potassium excretion directly, whereas glucocorticoids augment excretion indirectly by increasing fluid and sodium delivery along the distal nephron.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of adrenalectomy and chronic adrenal corticosteroid replacement on potassium transport in rat kidney.

Giebisch¹,

Klein-Robbenhaar²,

Wade³

et al. 1985

J. Clin. Invest.

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show abstract

“…Although evidence from animal studies (2,3), as well as from clinical experience (4,5), generally supports a role for chronic alterations in plasma aldosterone levels in regulating potassium balance, there is less agreement regarding its acute effect on renal potassium handling. Thus, as pointed out in a recent review (6), relatively few published reports demonstrate a kaliuretic response to acute aldosterone administration, and these results are often obtained only under conditions of sodium loading or potassium depletion, which make the physiological meaning of the findings uncertain.…”

mentioning

confidence: 99%

Differential acute effects of aldosterone, dexamethasone, and hyperkalemia on distal tubular potassium secretion in the rat kidney.

Field¹,

Stanton²,

Giebisch³

1984

J. Clin. Invest.

131

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Abstract. To determine the specific effects on renal potassium transport of acute elevations in plasma aldosterone, dexamethasone, and potassium concentrations, we studied adrenalectomized rats prepared such that each factor could be varied independently. Clearance data alone could not be used to deduce the underlying tubular transport effects, however, since infusion of each of these agents was associated with a marked change in urinary flow rate, which may itself have influenced potassium excretion. We therefore used a technique of continuous microperfusion, in vivo, of single superficial distal tubules to evaluate potassium secretion at constant luminal flow rate during each experimental maneuver. Acute aldosterone infusion was associated with a 90% stimulation of potassium secretion by microperfused tubules. However, total kidney sodium excretion and urinary flow rate were markedly reduced, and these factors opposed the direct tubular action of aldosterone, resulting in no net change in the amount of potassium excreted into the final urine. Conversely, dexamethasone had no direct effect on potassium secretion by single microperfused tubules, but it caused a sharp increase in urinary flow and sodium excretion, and secondarily enhanced urinary potassium excretion by 50%. Hyperkalemia per se stimulated renal potassium excretion both via a direct tubular effect and by increasing urinary Portions of this study have been published previously in abstract form (1984. Kidney Int.

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Chapter 11 Renal Potassium Adaptation: Cellular Mechanisms and Morphology

Stanton

1987

Current Topics in Membranes and Transport

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Aldosterone and Renal Potassium Excretion

Cited by 9 publications

References 33 publications

Effects of adrenalectomy and chronic adrenal corticosteroid replacement on potassium transport in rat kidney.

Effects of adrenalectomy and chronic adrenal corticosteroid replacement on potassium transport in rat kidney.

Differential acute effects of aldosterone, dexamethasone, and hyperkalemia on distal tubular potassium secretion in the rat kidney.

Chapter 11 Renal Potassium Adaptation: Cellular Mechanisms and Morphology

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