Key result
Renal chloride channels, particularly ClC-K1/Ka and ClC-K2/Kb, play complementary and essential roles in building the cortico-medullary concentration gradient and NaCl absorption in the distal nephron.
Why the study?
Experimental studies over the last 20 years have renewed views on chloride channels and their role in renal NaCl absorption and function, prompting a synthesis of these mechanisms.
This review summarizes the physiological roles of renal chloride channels, particularly ClC-K1/Ka and ClC-K2/Kb, in sodium chloride transport and renal function.
May inform novel diuretic targets in hypertension; leaves open clinical validation in cardiorenal disease.
The many mechanisms governing NaCl absorption in the diverse parts of the renal tubule have been largely elucidated, although some of them, as neutral NaCl absorption across the cortical collecting duct or regulation through with-no-lysine (WNK) kinases have emerged only recently. Chloride channels, which are important players in these processes, at least in the distal nephron, are the focus of this review. Over the last 20-year period, experimental studies using molecular, electrophysiological, and physiological/functional approaches have deepened and renewed our views on chloride channels and their role in renal function. Two chloride channels of the ClC family, named as ClC-Ka and ClC-Kb in humans and ClC-K1 and ClC-K2 in other mammals, are preponderant and play complementary roles: ClC-K1/Ka is mainly involved in the building of the interstitial cortico-medullary concentration gradient, while ClC-K2/Kb participates in NaCl absorption in the thick ascending limb, distal convoluted tubule and the intercalated cells of the collecting duct. The two ClC-Ks might also be involved indirectly in proton secretion by type A intercalated cells. Other chloride channels in the kidneys include CFTR, TMEM16A, and probably volume-regulated LRRC8 chloride channels, whose function and molecular identity have not as yet been established.
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Teulon et al. (2018) conducted a review in Renal chloride channels and NaCl transport. Renal chloride channels, particularly ClC-K1/Ka and ClC-K2/Kb, play complementary and essential roles in building the cortico-medullary concentration gradient and NaCl absorption in the distal nephron.
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