Regulated acid–base transport in the collecting duct

• Published in: Pflügers Archiv Vol. 458; no. 1; pp. 137 - 156
• Main Authors: Wagner, Carsten A., Devuyst, Olivier, Bourgeois, Soline, Mohebbi, Nilufar
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01-05-2009; Springer Nature B.V
• Subjects: Acid-Base Equilibrium - physiology; Acidosis, Renal Tubular - physiopathology; Acids; Animals; Anion Exchange Protein 1, Erythrocyte - genetics; Anion Exchange Protein 1, Erythrocyte - metabolism; Bicarbonates - metabolism; Biomedical and Life Sciences; Biomedicine; Cation Transport Proteins - metabolism; Cell Biology; Epithelial Sodium Channels; Human Physiology; Humans; Ion Channels; Kidney Tubules, Collecting - physiology; Kidney Tubules, Collecting - physiopathology; Kidneys; Membrane Glycoproteins - metabolism; Membrane Transport Proteins - metabolism; Metabolism, Inborn Errors - physiopathology; Molecular Medicine; Neurosciences; Proton-Translocating ATPases - metabolism; Receptors; Receptors and Transporters; Symporters - metabolism; Vacuolar Proton-Translocating ATPases - metabolism; pH; Bicarbonate transport; Ammonium; Acid–base balance; Acidosis
• ISSN: 0031-6768; 1432-2013
• DOI: 10.1007/s00424-009-0657-z

The renal collecting system serves the fine-tuning of renal acid–base secretion. Acid-secretory type-A intercalated cells secrete protons via a luminally expressed V-type H
+
-ATPase and generate new bicarbonate released by basolateral chloride/bicarbonate exchangers including the AE1 anion exchanger. Efficient proton secretion depends both on the presence of titratable acids (mainly phosphate) and the concomitant secretion of ammonia being titrated to ammonium. Collecting duct ammonium excretion requires the Rhesus protein RhCG as indicated by recent KO studies. Urinary acid secretion by type-A intercalated cells is strongly regulated by various factors among them acid–base status, angiotensin II and aldosterone, and the Calcium-sensing receptor. Moreover, urinary acidification by H
+
-ATPases is modulated indirectly by the activity of the epithelial sodium channel ENaC. Bicarbonate secretion is achieved by non-type-A intercalated cells characterized by the luminal expression of the chloride/bicarbonate exchanger pendrin. Pendrin activity is driven by H
+
-ATPases and may serve both bicarbonate excretion and chloride reabsorption. The activity and expression of pendrin is regulated by different factors including acid–base status, chloride delivery, and angiotensin II and may play a role in NaCl retention and blood pressure regulation. Finally, the relative abundance of type-A and non-type-A intercalated cells may be tightly regulated. Dysregulation of intercalated cell function or abundance causes various syndromes of distal renal tubular acidosis underlining the importance of these processes for acid–base homeostasis.