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2015 ; 24
(5
): 444-9
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Chloride secretion by renal collecting ducts
#MMPMID26125646
Rajagopal M
; Wallace DP
Curr Opin Nephrol Hypertens
2015[Sep]; 24
(5
): 444-9
PMID26125646
show ga
PURPOSE OF REVIEW: Renal collecting ducts maintain NaCl homeostasis by
fine-tuning urinary excretion to balance dietary salt intake. This review focuses
on recent studies on transcellular Cl secretion by collecting ducts, its
regulation and its role in cyst growth in autosomal dominant polycystic kidney
disease (ADPKD). RECENT FINDINGS: Lumens of nonperfused rat medullary collecting
ducts collapse in control media but expand with fluid following treatment with
cAMP, demonstrating the capacity for both salt absorption and secretion.
Recently, inhibition of apical epithelial Na channels (ENaC) unmasked Cl
secretion in perfused mouse cortical collecting ducts (CCDs), involving Cl uptake
by basolateral NKCC1 and efflux through apical Cl channels. AVP, the key hormone
for osmoregulation, promotes cystic fibrosis transmembrane conductance regulator
(CFTR)-mediated Cl secretion. In addition, prostaglandin E2 stimulates Cl
secretion through both CFTR and Ca-activated Cl channels. SUMMARY: Renal Cl
secretion has been commonly overlooked because of the overwhelming capacity for
the nephron to reabsorb NaCl from the glomerular filtrate. In ADPKD, Cl secretion
plays a central role in the accumulation of cyst fluid and the remarkable size of
the cystic kidneys. Investigation of renal Cl secretion may provide a better
understanding of NaCl homeostasis and identify new approaches to reduce cyst
growth in PKD.
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