Circadian rhythm of urinary potassium excretion during treatment with an angiotensin receptor blocker

Ogiyama, Yoshiaki; Miura, Toshiyuki; Watanabe, Shuichi; Fuwa, Daisuke; Tomonari, Tatsuya; Ota, Kohei; Kato, Yoko; Ichikawa, Tadashi; Shirasawa, Yuichi; Ito, Akinori; Yoshida, Atsuhiro; Fukuda, Michio; Kimura, Genjiro

doi:10.1177/1470320313475909

Cited by 6 publications

(9 citation statements)

References 27 publications

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“…Na,K-ATPase is located in the basolateral side of DCTc, CNTc, and CDc, whereas H,K-ATPase is located in the apical or luminal side of Ic. The CNTc contains Na,K-ATPase and ROMK and is a key regulator of potassium by the kidney and the site of origin of kallikrein also influences urinary K + secretion [112]. Because hypertension is a very common illness induced by an unhealthy diet, altogether with aging are risk factors for Alzheimer's disease, another disease that might be influenced by a Na + /K + -ATPase defficient activity (Fig.…”

Section: Discussionmentioning

confidence: 99%

P2C-Type ATPases and Their Regulation

2015

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P2C-type ATPases are a subfamily of P-type ATPases comprising Na(+)/K(+)-ATPase and H(+)/K(+)-ATPase. Na(+)/K(+)-ATPase is ubiquitously expressed and has been implicated in several neurological diseases, whereas H(+)/K(+)-ATPase is found principally in the colon, stomach, and kidney. Both ATPases have two subunits, α and β, but Na(+)/K(+)-ATPase also has a regulatory subunit called FXYD, which has an important role in cancer. The most important functions of these ATPases are homeostasis, potassium regulation, and maintaining a gradient in different cell types, like epithelial cells. Na(+)/K(+)-ATPase has become a center of attention ever since it was proposed that it might play a crucial role in neurological disorders such as bipolar disorder, mania, depression, familial hemiplegic migraine, rapid-onset dystonia parkinsonism, chronic stress, epileptogenesis, and Alzheimer's disease. On the other hand, it has been reported that lithium could have a neuroprotective effect against ouabain, which is the best known Na(+)/K(+)-ATPase inhibitor, but and high concentrations of lithium could affect negatively H(+)/K(+)-ATPase activity, that has a key role in regulating acidosis and potassium deficiencies. Finally, potassium homeostasis regulation is composed of two main mechanisms, extrarenal and renal. Extrarenal mechanism controls plasma levels, shifting potassium from the extracellular to the intracellular, whereas renal mechanism concerns with body balance and is influenced by potassium intake and its urinary excretion. In this article, we discuss the functions, isoforms, and localization of P2C-type ATPases, describe some of their modulators, and discuss their implications in some diseases.

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Section: Discussionmentioning

confidence: 99%

P2C-Type ATPases and Their Regulation

2015

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“…) of ENaC, independent of circulating aldosterone, and can decrease the U K V/U Na V ratio, indicating suppression of ENaC function (Ogiyama et al. ). In this way, ARBs can enhance daytime U Na V, similar to that achieved with diuretics (Fukuda et al.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with CKD, ARBs decrease the urinary potassium (K) excretion rate (U K V) to U Na V ratio, indicating suppression of function of the epithelial sodium channel (ENaC) (Ogiyama et al. ). Previously, we reported that an increase in daytime U Na V in CKD patients can precede restoration of nondipper circadian BP rhythm within 2 days after the start of ARB treatment (acute phase) (Miura et al.…”

Section: Introductionmentioning

confidence: 99%

Sodium balance, circadian BP rhythm, heart rate variability, and intrarenal renin-angiotensin-aldosterone and dopaminergic systems in acute phase of ARB therapy

et al. 2017

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We have revealed that even in humans, activated intrarenal renin–angiotensin–aldosterone system (RAAS) enhances tubular sodium reabsorption to facilitate salt sensitivity and nondipper rhythm of blood pressure (BP), and that angiotensin receptor blocker (ARB) could increase daytime urinary sodium excretion rate (UN aV) to produce lower sodium balance and restore nondipper rhythm. However, the sympathetic nervous system and intrarenal dopaminergic system can also contribute to renal sodium handling. A total of 20 patients with chronic kidney disease (61 ± 15 years) underwent 24‐h ambulatory BP monitoring before and during two‐day treatment with ARB, azilsartan. Urinary angiotensinogen excretion rate (UAGTV, μg/gCre) was measured as intrarenal RAAS; urinary dopamine excretion rate (UDAV, pg/gCre) as intrarenal dopaminergic system; heart rate variabilities (HRV, calculated from 24‐h Holter‐ECG) of non‐Gaussianity index λ 25s as sympathetic nerve activity; and power of high‐frequency (HF) component or deceleration capacity (DC) as parasympathetic nerve activity. At baseline, glomerular filtration rate correlated inversely with UAGTV (r = −0.47, P = 0.04) and positively with UDAV (r = 0.58, P = 0.009). HF was a determinant of night/day BP ratio (β = −0.50, F = 5.8), rather than DC or λ 25s. During the acute phase of ARB treatment, a lower steady sodium balance was not achieved. Increase in daytime UN aV preceded restoration of BP rhythm, accompanied by decreased UAGTV (r = −0.88, P = 0.05) and increased UDAV (r = 0.87, P = 0.05), but with no changes in HRVs. Diminished sodium excretion can cause nondipper BP rhythm. This was attributable to intrarenal RAAS and dopaminergic system and impaired parasympathetic nerve activity. During the acute phase of ARB treatment, cooperative effects of ARB and intrarenal dopaminergic system exert natriuresis to restore circadian BP rhythm.

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“…Attenuation of the TTKG by ARB treatment indicates decreased ENaC action in patients with chronic kidney disease (CKD). 4 …”

Section: To the Editormentioning

confidence: 99%

The natriuretic effect of angiotensin receptor blockers is not attributable to blood pressure reduction during the previous night, but to inhibition of tubular sodium reabsorption

Miura

Watanabe

Urushihara

et al. 2014

J Renin Angiotensin Aldosterone Syst

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Circadian rhythm of urinary potassium excretion during treatment with an angiotensin receptor blocker

Cited by 6 publications

References 27 publications

P2C-Type ATPases and Their Regulation

P2C-Type ATPases and Their Regulation

Sodium balance, circadian BP rhythm, heart rate variability, and intrarenal renin-angiotensin-aldosterone and dopaminergic systems in acute phase of ARB therapy

The natriuretic effect of angiotensin receptor blockers is not attributable to blood pressure reduction during the previous night, but to inhibition of tubular sodium reabsorption

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