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Kurtz I. NBCe1 as a model carrier for understanding the structure-function properties of Na⁺ -coupled SLC4 transporters in health and disease. Pflugers Arch 2014; 466:1501-16. [PMID: 24515290 DOI: 10.1007/s00424-014-1448-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Revised: 01/07/2014] [Accepted: 01/08/2014] [Indexed: 01/17/2023]
Abstract
SLC4 transporters are membrane proteins that in general mediate the coupled transport of bicarbonate (carbonate) and share amino acid sequence homology. These proteins differ as to whether they also transport Na(+) and/or Cl(-), in addition to their charge transport stoichiometry, membrane targeting, substrate affinities, developmental expression, regulatory motifs, and protein-protein interactions. These differences account in part for the fact that functionally, SLC4 transporters have various physiological roles in mammals including transepithelial bicarbonate transport, intracellular pH regulation, transport of Na(+) and/or Cl(-), and possibly water. Bicarbonate transport is not unique to the SLC4 family since the structurally unrelated SLC26 family has at least three proteins that mediate anion exchange. The present review focuses on the first of the sodium-dependent SLC4 transporters that was identified whose structure has been most extensively studied: the electrogenic Na(+)-base cotransporter NBCe1. Mutations in NBCe1 cause proximal renal tubular acidosis (pRTA) with neurologic and ophthalmologic extrarenal manifestations. Recent studies have characterized the important structure-function properties of the transporter and how they are perturbed as a result of mutations that cause pRTA. It has become increasingly apparent that the structure of NBCe1 differs in several key features from the SLC4 Cl(-)-HCO3 (-) exchanger AE1 whose structural properties have been well-studied. In this review, the structure-function properties and regulation of NBCe1 will be highlighted, and its role in health and disease will be reviewed in detail.
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Affiliation(s)
- Ira Kurtz
- Division of Nephrology, David Geffen School of Medicine, and Brain Research Institute, UCLA, Los Angeles, CA, USA,
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REFSUM HE. Hypokalemic Alkalosis During Recovery from Compensated Respiratory Acidosis. Scandinavian Journal of Clinical and Laboratory Investigation 2009; 14:545-53. [PMID: 13973621 DOI: 10.3109/00365516209051277] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Affiliation(s)
- Jorge E Albina
- Department of Surgical Research, Rhode Island Hospital, 593 Eddy Street, NAB-217, Providence, RI 02903, USA.
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TOUSSAINT C, TELERMAN M, VEREERSTRAETEN P. Effect of potassium salts administration on the renal excretion of bicarbonate during acute respiratory acidosis and hypochloremic alkalosis in the dog. ACTA ACUST UNITED AC 2000; 15:232-4. [PMID: 13672188 DOI: 10.1007/bf02158124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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TOUSSAINT C, TELERMAN M, VEREERSTRAETEN P. Effects of acute hypochloremia on glomerular filtration rate and electrolyte excretion in the dog. ACTA ACUST UNITED AC 2000; 14:417-9. [PMID: 13609615 DOI: 10.1007/bf02160440] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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HUTH EJ, SQUIRES RD, ELKINTON JR. Experimental potassium depletion in normal human subjects. II. Renal and hormonal factors in the development of extracellular alkalosis during depletion. J Clin Invest 2000; 38:1149-65. [PMID: 13664790 PMCID: PMC293262 DOI: 10.1172/jci103891] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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RECTOR FC, BUTTRAM H, SELDIN DW. An analysis of the mechanism of the inhibitory influence of potassium ion on renal hydrogen ion secretion. J Clin Invest 1998; 41:611-7. [PMID: 14490898 PMCID: PMC290956 DOI: 10.1172/jci104516] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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TOUSSAINT C, TELERMAN M, VEREERSTRAETEN P. Bicarbonate excretion after prolonged exposure to carbon dioxide in the normal dog. ACTA ACUST UNITED AC 1998; 15:434-6. [PMID: 13839063 DOI: 10.1007/bf02157700] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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RECTOR FC, BLOOMER HA, SELDIN DW. EFFECT OF POTASSIUM DEFICIENCY ON THE REABSORPTION OF BICARBONATE IN THE PROXIMAL TUBULE OF THE RAT KIDNEY. J Clin Invest 1996; 43:1976-82. [PMID: 14236221 PMCID: PMC289642 DOI: 10.1172/jci105071] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Chapter 10 Potassium and Acid-Base Balance. ACTA ACUST UNITED AC 1987. [DOI: 10.1016/s0070-2161(08)60414-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
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Berger BE, Cogan MG, Sebastian A. Reduced glomerular filtration and enhanced bicarbonate reabsorption maintain metabolic alkalosis in humans. Kidney Int 1984; 26:205-8. [PMID: 6503138 DOI: 10.1038/ki.1984.157] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The mechanism that sustains chloride-depletion metabolic alkalosis is presumed to be a stimulation of renal acidification, so that the elevated filtered bicarbonate load that attends hyperbicarbonatemia is completely reabsorbed. However, such enhancement of renal bicarbonate reabsorption is not necessary to maintain hyperbicarbonatemia if the filtered bicarbonate load is not increased owing to a concomitant reduction in glomerular filtration rate (GFR). To assess the relative contributions of enhanced renal bicarbonate reabsorption and reduced GFR in the maintenance of chloride-depletion alkalosis in humans, selective hydrochloric acid depletion was induced in five normal subjects. Plasma bicarbonate concentration increased by 27% (25.3 +/- 0.1 to 32.1 +/- 0.3 mEq/liter, P less than 0.005), whereas the rate of renal bicarbonate reabsorption increased by only 17% (2.7 +/- 0.1 to 3.2 +/- 0.2 mEq/min, P less than 0.05) owing to a 10% reduction in GFR (93.2 +/- 4.4 to 84.3 +/- 4.1 ml/min, P less than 0.01). Thus, in chloride-depletion metabolic alkalosis in humans, the increase in plasma bicarbonate concentration is not attended by a commensurate increase in filtered bicarbonate and rate of renal bicarbonate reabsorption. Both a reduction in GFR and an enhancement of renal bicarbonate reabsorption contribute to maintenance of the alkalotic state.
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Cogan MG, Liu FY. Metabolic alkalosis in the rat. Evidence that reduced glomerular filtration rather than enhanced tubular bicarbonate reabsorption is responsible for maintaining the alkalotic state. J Clin Invest 1983; 71:1141-60. [PMID: 6853706 PMCID: PMC436975 DOI: 10.1172/jci110864] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Maintenance of chronic metabolic alkalosis might occur by a reduction in glomerular filtration rate (GFR) without increased bicarbonate reabsorption or, alternatively, by augmentation of bicarbonate reabsorption with a normal GFR. To differentiate these possibilities, free-flow micropuncture was performed in alkalotic Munich-Wistar rats with a glomerular ultrafiltrate total CO2 concentration of 46.5 +/- 0.9 mM (vs. 27.7 +/- 0.9 mM in controls). Alkalotic animals had a markedly reduced single nephron GFR compared with controls (27.4 +/- 1.5 vs. 51.6 +/- 1.6 nl/min) and consequently unchanged filtered load of bicarbonate. Absolute proximal bicarbonate reabsorption in alkalotic animals was similar to controls (981 +/- 49 vs. 1,081 +/- 57 pmol/min), despite a higher luminal bicarbonate concentration, contracted extracellular volume, and potassium depletion. When single nephron GFR during alkalosis was increased toward normal by isohydric volume expansion or in another group by isotonic bicarbonate loading, absolute proximal bicarbonate reabsorption was not substantially augmented and bicarbonaturia developed. To confirm that a fall in GFR occurs during metabolic alkalosis, additional clearance studies were performed. Awake rats were studied before and after induction of metabolic alkalosis associated with varying amounts of potassium and chloride depletion. In all cases, the rise in blood bicarbonate concentration was inversely proportional to a reduction in GFR; filtered bicarbonate load remained normal. In conclusion, a reduction in GFR is proposed as being critical for maintaining chronic metabolic alkalosis in the rat. Constancy of the filtered bicarbonate load allows normal rates of renal bicarbonate reabsorption to maintain the alkalotic state.
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Abstract
In management of fluid and electrolyte problems in the emergency department several important principles are: (1) never completely trust the laboratory, (2) abnormalities should be treated at approximately the rate at which they developed, (3) correct only half the calculated deficit at a time and reevaluate the patient, (4) the highest priority in treatment is maintenance of intravascular volume and tissue perfusion. The osmolarity of fluid compartments as related to the fluid and electrolyte responses to stress and resultant fluid requirements for basic needs, current losses and deficits of fluid and electrolytes are discussed in depth. The characteristics of volume, sodium, potassium, chloride, bicarbonate, calcium and magnesium deficits and how to correct them are outlined.
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Herms W. [The effects of disorders of electrolyte balance on the structure and function of the kidneys]. KLINISCHE WOCHENSCHRIFT 1967; 45:1169-80. [PMID: 4876332 DOI: 10.1007/bf01727630] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Kinney VR. Disorders of renal function associated with intestinal diseases. Med Clin North Am 1966; 50:997-1006. [PMID: 5295983 DOI: 10.1016/s0025-7125(16)33146-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Isaacs M, Vanamee P. The importance of the etiology of hypokalemic alkalosis in determining replacement therapy. Metabolism 1965; 14:1169-88. [PMID: 5848852 DOI: 10.1016/0026-0495(65)90089-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Pharmakologie. Naunyn Schmiedebergs Arch Pharmacol 1961. [DOI: 10.1007/bf02433510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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McCrory WW. I. Growth disorders associated with renal acidosis. The journal The Journal of Pediatrics 1960. [DOI: 10.1016/s0022-3476(60)80205-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nierenfunktion bei unterschiedlicher Hydratation unter Ber�cksichtigung volumenregulatorischer Gesichtspunkte. ACTA ACUST UNITED AC 1960. [DOI: 10.1007/bf01483934] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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KRUCK F. Titrierbare Urinacidit�t und Ammonium-Ausscheidung bei St�rungen der Hydrogenbilanz. ACTA ACUST UNITED AC 1958; 36:946-51. [PMID: 13612079 DOI: 10.1007/bf01486699] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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BARKER ES, SINGER RB, ELKINTON JR, CLARK JK. The renal response in man to acute experimental respiratory alkalosis and acidosis. J Clin Invest 1957; 36:515-29. [PMID: 13416380 PMCID: PMC1072673 DOI: 10.1172/jci103449] [Citation(s) in RCA: 67] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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HILTON JG, CAPECI NE, KISS GT, KRUESI OR, GLAVIANO VV, WEGRIA R. The effect of acute elevation of the plasma chloride concentration on the renal excretion of bicarbonate during acute respiratory acidosis. J Clin Invest 1956; 35:481-7. [PMID: 13319482 PMCID: PMC438835 DOI: 10.1172/jci103300] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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ROBERTS KE, VANAMEE P, POPPELL JW, RUBIN A, BRAVEMAN W, RANDALL HT. Electrolyte alterations in liver disease and hepatic coma. Med Clin North Am 1956; 40:901-14. [PMID: 13308495 DOI: 10.1016/s0025-7125(16)34573-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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MUDGE GH, HARDIN B. Response to mercurial diuretics during alkalosis: a comparison of acute metabolic and chronic hypokalemic alkalosis in the dog. J Clin Invest 1956; 35:155-63. [PMID: 13286334 PMCID: PMC438792 DOI: 10.1172/jci103260] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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ROBERTS KE, VANAMEE P, RANDALL HT, WALKER JM. Common electrolyte abnormalities encountered in bowel surgery; mechanism of hypochloremic alkalosis, hypokalemic alkalosis and hyperchloremic acidosis. Surg Clin North Am 1955:1189-200. [PMID: 13267696 DOI: 10.1016/s0039-6109(16)34680-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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