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Dietary potassium restriction causes hypercalciuria, hypocalcemia, and bone loss in male mice
Sathish K. Murali, Mariavittoria D’Acierno, Xiang Zheng, Lena K. Rosenbaek, Louise N. Odgaard, P. Richard Grimm, Alice Ramesova, Robert Little, Judith Radloff, Paul A. Welling, Qi Wu, Reinhold G. Erben, Robert A. Fenton
Sathish K. Murali, Mariavittoria D’Acierno, Xiang Zheng, Lena K. Rosenbaek, Louise N. Odgaard, P. Richard Grimm, Alice Ramesova, Robert Little, Judith Radloff, Paul A. Welling, Qi Wu, Reinhold G. Erben, Robert A. Fenton
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Research Article Bone biology Nephrology

Dietary potassium restriction causes hypercalciuria, hypocalcemia, and bone loss in male mice

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Abstract

Loss of bone mass has a devastating effect on quality of life. Higher potassium (K+) intake is positively correlated with bone health. Here, we investigated whether kidney calcium (Ca2+) and phosphate (Pi) handling mechanisms mediate dietary K+ effects. Kidney Ca2+ and Pi handling proteins were altered in abundance in mice fed a 0% K+ diet for 2 weeks. In mice fed a 0.1% K+ diet for 4 or 8 weeks, urinary Ca2+ excretion increased, plasma Ca2+ levels were lower and plasma parathyroid hormone (PTH) levels were higher relative to control 1% K+ fed mice. The 0.1% K+ fed mice had greater excretion of the bone resorption marker deoxypyridinoline, increased osteoclast number, and decreased total femoral bone mineral density. During chronic low K+ intake, major changes in renal Ca2+ and Pi transport pathways were absent, except higher abundances of the sodium-potassium-chloride cotransporter (NKCC2) and the sodium-chloride cotransporter (NCC), in line with their role in kidney Ca2+ handling. Low dietary K+ induced hypocalcemia and changes in PTH were absent in mice with constitutively active NCC, supporting its role in mediating low K+ effects on Ca2+ homeostasis. Our study provides insights into the management of bone disorders in conditions of chronic electrolyte imbalance.

Authors

Sathish K. Murali, Mariavittoria D’Acierno, Xiang Zheng, Lena K. Rosenbaek, Louise N. Odgaard, P. Richard Grimm, Alice Ramesova, Robert Little, Judith Radloff, Paul A. Welling, Qi Wu, Reinhold G. Erben, Robert A. Fenton

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Figure 1

A K+-deficient diet for 2 weeks alters kidney Ca2+ and Pi handling proteins.

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A K+-deficient diet for 2 weeks alters kidney Ca2+ and Pi handling prote...
(A) Study 1. Experimental overview where mice were fed a control diet containing 1% K+ (1K+) or a diet deficient in K+ (0K+) for 2 weeks. Created in BioRender. (B) Plasma concentrations of sodium (Na+), potassium (K+), chloride (Cl–), total calcium (Ca2+), phosphate (Pi), PTH, and VitD [1,25(OH)2D or calcitriol]. (C) Urinary fractional excretion of same ions, creatine clearance, and daily aldosterone excretion. Each data point arises from an individual mouse and the data are shown as mean ± SEM. Statistical analyses were performed using a Student’s unpaired t test and annotations represent the level of significance. (D) Kidney samples were examined using quantitative proteomics. The volcano plot shows the distribution of all quantifiable proteins. The x axis is the log2 ratio between 1K+ and 0K+ diets, while the y axis represents the significance level of the ratio. Significantly changed proteins were defined using a Benjamini-Hochberg FDR of 5%. Proteins (genes names shown) highlighted in blue are examples of proteins involved in Ca2+ handling, proteins in green are involved in Pi handling, and red means involvement in both. (E) Ingenuity pathway analysis on significantly changed proteins. Lower x axis is the ratio of proteins (genes) that are involved in this pathway versus the total input, while upper x axis is the significance level determined by Fisher’s exact test. Color of bars represent either promotion (positive z score) or inhibition (negative z score) of the pathway. Canonical pathways under the category “Intracellular and Second Messenger Signaling” were plotted with a cutoff of 0.5 on both minus log(P value by Fisher’s exact test) and absolute value of z score.

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