Lee C, Ng H, Lee Y, Lai L, Lien YH. The role of calbindinD28k on renal calcium and magnesium handling during treatment with loop and thiazide diuretics. Am J Physiol Renal Physiol 310: F230 -F236, 2016. First published November 18, 2015 doi:10.1152/ajprenal.00057.2015) is a calcium binding protein located in the distal convoluted tubule (DCT) and plays an important role in active calcium transport in the kidney. Loop and thiazide diuretics affect renal Ca and Mg handling: both cause Mg wasting, but have opposite effects on Ca excretion as loop diuretics increase, but thiazides decrease, Ca excretion. To understand the role of CBD-28k in renal Ca and Mg handling in response to diuretics treatment, we investigated renal Ca and Mg excretion and gene expression of DCT Ca and Mg transport molecules in wild-type (WT) and CBD-28k knockout (KO) mice. Mice were treated with chlorothiazide (CTZ; 50 mg·kg Ϫ1 ·day Ϫ1 ) or furosemide (FSM; 30 mg·kg Ϫ1 ·day Ϫ1 ) for 3 days. To avoid volume depletion, salt was supplemented in the drinking water. Urine Ca excretion was reduced in WT, but not in KO mice, by CTZ. FSM induced similar hypercalciuria in both groups. DCT Ca transport molecules, including transient receptor potential vanilloid 5 (TRPV5), TRPV6, and CBD-9k, were upregulated by CTZ and FSM in WT, but not in KO mice. Urine Mg excretion was increased and transient receptor potential subfamily M, member 6 (TRPM6) was upregulated by both CTZ and FSM in WT and KO mice. In conclusion, CBD-28k plays an important role in gene expression of DCT Ca, but not Mg, transport molecules, which may be related to its being a Ca, but not a Mg, intracellular sensor. The lack of upregulation of DCT Ca transport molecules by thiazides in the KO mice indicates that the DCT Ca transport system is critical for Ca conservation by thiazides.furosemide; thiazides; TRPV5; TRPV6; TRPM6; calbindin-D28k; calbindin-D9k LOOP AND THIAZIDE DIURETICS are commonly used for treating hypertension, congestive heart failure, and other disorders with fluid overload (21). Loop diuretics are inhibitors of the Na-K2Cl cotransporter (NKCC) in the thick ascending limb of the loop of Henle (TALH), while thiazides inhibit the Na-Cl cotransporter (NCC) in the distal convoluted tubule (DCT). Both cause renal loss of Na, K, and Mg, but have different effects on renal Ca handling: loop diuretics cause hypercalciuria, while thiazides cause hypocalciuria (6,19). Those distinct effects on Ca excretion are also observed in patients with mutations in the NKCC (Barter syndrome) and NCC (Gitelman syndrome), respectively (22).In the kidney, Ca is reabsorbed through passive paracellular transport in the proximal tubule (PT) and TALH and active transcellular transport in the DCT (3). The gatekeeper of this active Ca transport mechanism is TRPV5. Ca enters cells across the apical TRPV5, then binds to calbindin-D28k (CBD28k), the major intracellular calcium binding proteins in DCT, and diffuses to the basolateral membrane, where Ca is extruded via the Na/Ca exchanger or Ca pumps (5)....