TY - JOUR
T1 - A New Understanding of Potassium's Influence Upon Human Health and Renal Physiology
AU - McCormick, James A.
AU - Topf, Joel
AU - Tomacruz, Isabelle Dominique
AU - Grimm, P. Richard
N1 - Publisher Copyright:
© 2023 National Kidney Foundation, Inc.
PY - 2023/3
Y1 - 2023/3
N2 - Potassium channels are expressed in virtually all cell types, and their activity is the dominant determinant of cellular membrane potential. As such, potassium flux is a key regulator of many cellular processes including the regulation of action potentials in excitable cells. Subtle changes in extracellular potassium can initiate signaling processes vital for survival (insulin signaling) while more extreme and chronic changes may lead to pathological states (acid-base disturbances and cardiac arrhythmia). While many factors acutely influence extracellular potassium levels, it is principally the role of the kidneys to maintain potassium balance by matching urinary excretion with dietary intake. When this balance is disrupted, human health is negatively impacted. In this review, we discuss evolving views of dietary potassium intake as means of preventing and mitigating diseases. We also provide an update on a molecular pathway called the potassium switch, a mechanism by which extracellular potassium regulates distal nephron sodium reabsorption. Finally, we review recent literature describing how several popular therapeutics influence potassium homeostasis.
AB - Potassium channels are expressed in virtually all cell types, and their activity is the dominant determinant of cellular membrane potential. As such, potassium flux is a key regulator of many cellular processes including the regulation of action potentials in excitable cells. Subtle changes in extracellular potassium can initiate signaling processes vital for survival (insulin signaling) while more extreme and chronic changes may lead to pathological states (acid-base disturbances and cardiac arrhythmia). While many factors acutely influence extracellular potassium levels, it is principally the role of the kidneys to maintain potassium balance by matching urinary excretion with dietary intake. When this balance is disrupted, human health is negatively impacted. In this review, we discuss evolving views of dietary potassium intake as means of preventing and mitigating diseases. We also provide an update on a molecular pathway called the potassium switch, a mechanism by which extracellular potassium regulates distal nephron sodium reabsorption. Finally, we review recent literature describing how several popular therapeutics influence potassium homeostasis.
KW - Blood pressure regulation
KW - Chronic kidney disease
KW - Hyperkalemia
KW - Potassium switch
KW - SGLT2 inhibitors
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U2 - 10.1053/j.akdh.2023.01.001
DO - 10.1053/j.akdh.2023.01.001
M3 - Review article
AN - SCOPUS:85179365679
SN - 2949-8139
VL - 30
SP - 137
EP - 147
JO - Advances in Kidney Disease and Health
JF - Advances in Kidney Disease and Health
IS - 2
ER -