The DOI matches its Crossref record; 262 of the 262 references it cites were found in a registry or an index.
Regulation of muscle potassium: exercise performance, fatigue and health implications
Abstract
This review integrates from the single muscle fibre to exercising human the current understanding of the role of skeletal muscle for whole-body potassium (K+) regulation, and specifically the regulation of skeletal muscle [K+]. We describe the K+ transport proteins in skeletal muscle and how they contribute to, or modulate, K+ disturbances during exercise. Muscle and plasma K+ balance are markedly altered during and after high-intensity dynamic exercise (including sports), static contractions and ischaemia, which have implications for skeletal and cardiac muscle contractile performance. Moderate elevations of plasma and interstitial [K+] during exercise have beneficial effects on multiple physiological systems. Severe reductions of the trans-sarcolemmal K+ gradient likely contributes to muscle and whole-body fatigue, i.e. impaired exercise performance. Chronic or acute changes of arterial plasma [K+] (hyperkalaemia or hypokalaemia) have dangerous health implications for cardiac function. The current mechanisms to explain how raised extracellular [K+] impairs cardiac and skeletal muscle function are discussed, along with the latest cell physiology research explaining how calcium, β-adrenergic agonists, insulin or glucose act as clinical treatments for hyperkalaemia to protect the heart and skeletal muscle in vivo. Finally, whether these agents can also modulate K+-induced muscle fatigue are evaluated.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Additionally, extracellular potassium levels, which rise during intense exercise, can further disrupt muscle excitation and contraction processes, contributing to muscle fatigue17,39.”
From Evaluating bioenergetic pathway contributions from single to multiple sprints (2024) · cites this paper as [39]
Citations
Cites
Items 201–262 of 262
Changes in interstitial K+ and pH during exercise: implications for blood flow regulation
Juel, C. (2007) · Applied Physiology Nutrition and Metabolism · doi:10.1139/h07-065 · Cited by 22
Wyckelsma, V. L., Perry, B. D., Bangsbo, J., & McKenna, M. J. (2019) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01076.2018 · Cited by 22
Wan, X., Bryant, S. M., & Hart, G. (2000) · Experimental Physiology · doi:10.1111/j.1469-445x.2000.02048.x · Cited by 21
DiFranco, M., Quiñonez, M., & Vergara, J. L. (2012) · The Journal of General Physiology · doi:10.1085/jgp.201210802 · Cited by 21
Clausen, T. (2010) · Experimental Physiology · doi:10.1113/expphysiol.2010.054999 · Cited by 20
The Effect of Calcium on the Skeletal Muscle Membrane after Treatment with Phospholipase C
Albuquerque, E. X., & Thesleff, S. (1968) · Acta Physiologica Scandinavica · doi:10.1111/j.1748-1716.1968.tb03852.x · Cited by 20
Ammar, T. A. R. A., Lin, W., Higgins, A., Hayward, L. J., & Renaud, J. (2015) · The Journal of General Physiology · doi:10.1085/jgp.201511476 · Cited by 20
Lucas, B., Ammar, T. A. R. A., Khogali, S., DeJong, D., Barbalinardo, M., Nishi, C., Hayward, L. J., & Renaud, J. (2014) · Physiological Genomics · doi:10.1152/physiolgenomics.00166.2013 · Cited by 20
Watanabe, D., & Wada, M. (2020) · The Journal of Physiology · doi:10.1113/jp279574 · Cited by 20
Cairns, S. P., Leader, J. P., & Loiselle, D. S. (2011) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-011-0927-4 · Cited by 19
Self-citationPotassium and Breathing in Exercise
Paterson, D. J. (1997) · Sports Medicine · doi:10.2165/00007256-199723030-00002 · Cited by 19
Jennische, E. (1982) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/bf00583697 · Cited by 18
Clausen, T. (2000) · The Journal of Physiology · doi:10.1111/j.1469-7793.2000.00121.x · Cited by 18
Lam, Y., Zeng, W., Sauer, D. B., & Jiang, Y. (2014) · The Journal of General Physiology · doi:10.1085/jgp.201411191 · Cited by 18
Atanasovska, T., Smith, R. L., Graff, C., Tran, C. T., Melgaard, J., Kanters, J. K., Petersen, A. C., Tobin, A. E., Kjeldsen, K. P., & McKenna, M. J. (2018) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00680.2017 · Cited by 18
Anomalous ion diffusion within skeletal muscle transverse tubule networks
Shorten, P. R., & Soboleva, T. K. (2007) · Theoretical Biology and Medical Modelling · doi:10.1186/1742-4682-4-18 · Cited by 17
Effects of catecholamines and potassium on cardiovascular performance in the rabbit
Paterson, D. J., Blake, G., Leitch, S. P., Phillips, S. M., & Brown, H. F. (1992) · Journal of Applied Physiology · doi:10.1152/jappl.1992.73.4.1413 · Cited by 17
Pedersen, K. K., Cheng, A. J., Westerblad, H., Olesen, J. H., & Overgaard, K. (2019) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00104.2019 · Cited by 17
Broch‐Lips, M., de Paoli, F. V., Pedersen, T. H., Overgaard, K., & Nielsen, O. B. (2011) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00687.2010 · Cited by 16
The Pharmacokinetics of Potassium in Humans Is Unusual
Hinderling, P. H. (2016) · The Journal of Clinical Pharmacology · doi:10.1002/jcph.713 · Cited by 16
Ferreira, J. J., Pequera, G., Manno, C. D., Rı́os, E., & Brum, G. (2017) · The Journal of General Physiology · doi:10.1085/jgp.201611725 · Cited by 16
An integrative, in situ approach to examining K+ flux in resting skeletal muscle
Lindinger, M. I., Hawke, T. J., Vickery, L., Bradford, L., & Lipskie, S. L. (2001) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/y01-083 · Cited by 16
Self-citationLeitch, S. P., & Patterson, D. J. (1994) · Journal of Applied Physiology · doi:10.1152/jappl.1994.77.3.1164 · Cited by 15
Cairns, S. P., Leader, J. P., Loiselle, D. S., Higgins, A., Lin, W., & Renaud, J. (2015) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00705.2013 · Cited by 15
Self-citationMatsuoka, T., Yamasaki, M., Abe, M., Matsuda, Y., Morino, H., Kawakami, H., Sakimura, K., Watanabe, M., & Hashimoto, K. (2020) · The Journal of Physiology · doi:10.1113/jp280342 · Cited by 15
Leitch, S. P., & Paterson, D. J. (1994) · Journal of Applied Physiology · doi:10.1152/jappl.1994.77.5.2391 · Cited by 14
K+ as a vasodilator in resting human muscle: implications for exercise hyperaemia
Juel, C., Olsen, S., Rentsch, R. L., González‐Alonso, J., & Rosenmeier, J. B. (2007) · Acta Physiologica · doi:10.1111/j.1748-1716.2007.01678.x · Cited by 14
Lindinger, M. I., & Grudzien, S. P. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2003.052860 · Cited by 14
Self-citationExercise-induced stimulation of K+transport in human erythrocytes
Lindinger, M. I., Horn, P. L., & Grudzien, S. P. (1999) · Journal of Applied Physiology · doi:10.1152/jappl.1999.87.6.2157 · Cited by 14
Self-citationNegative inotropic effect of K+: its modification by Ca++ and acetylstrophanthidin in dogs
Logic, Krotkiewski, A., Koppius, A., & Surawicz, B. (1968) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1968.215.1.14 · Cited by 14
Cairns, S. P., Inman, L. A. G., MacManus, C. P., van de Port, I. G. L., Ruell, P. A., Thom, J. M., & Thompson, M. W. (2017) · European Journal of Applied Physiology · doi:10.1007/s00421-017-3640-y · Cited by 14
Self-citationTerwoord, J. D., Hearon, C. M., Luckasen, G. J., Richards, J. C., Joyner, M. J., & Dinenno, F. A. (2018) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00183.2018 · Cited by 14
Durelli, L., Mutani, R., Fassio, F., & Delsedime, M. (1982) · Journal of the Neurological Sciences · doi:10.1016/0022-510x(82)90123-x · Cited by 13
Karelis, A. D., Péronnet, F., & Gardiner, P. F. (2005) · Canadian Journal of Applied Physiology · doi:10.1139/h05-108 · Cited by 13
Qayyum, M. S., Barlow, C. W., O'Connor, D. F., Paterson, D. J., & Robbins, P. A. (1994) · The Journal of Physiology · doi:10.1113/jphysiol.1994.sp020138 · Cited by 13
Structure-Function Relationships in Excitable Membranes
Landowne, D., Potter, L. T., & Terrar, D. A. (1975) · Annual Review of Physiology · doi:10.1146/annurev.ph.37.030175.002413 · Cited by 13
O'Neill, M. D., Sears, C. E., & Paterson, D. J. (1997) · Journal of Applied Physiology · doi:10.1152/jappl.1997.82.4.1046 · Cited by 13
Rannou, F., Leschiera, R., Giroux-Metges, M. A., & Pennec, J. (2012) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00944.2011 · Cited by 12
Karelis, A. D., Péronnet, F., & Gardiner, P. F. (2003) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00040.2003 · Cited by 12
Altarawneh, M. M., Petersen, A. C., Smith, R. L., Rouffet, D., Billaut, F., Perry, B. D., Wyckelsma, V. L., Tobin, A. E., & McKenna, M. J. (2016) · European Journal of Applied Physiology · doi:10.1007/s00421-016-3481-0 · Cited by 12
Functional protection against cardiac diseases depends on ATP‐sensitive potassium channels
Ye, P., Zhu, Y.-R., Gu, Y., Zhang, D.-M., & Chen, S.-L. (2018) · Journal of Cellular and Molecular Medicine · doi:10.1111/jcmm.13893 · Cited by 12
Hegyi, B., Chen‐Izu, Y., Izu, L. T., & Bányász, T. (2019) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/cjpp-2019-0056 · Cited by 12
Lower Ca2+ enhances the K+-induced force depression in normal and HyperKPP mouse muscles
Uwera, F., Ammar, T. A. R. A., McRae, C., Hayward, L. J., & Renaud, J. (2020) · The Journal of General Physiology · doi:10.1085/jgp.201912511 · Cited by 12
M�lgaard, H., St�rup-Johansen, M., & Flatman, J. A. (1980) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/bf00581880 · Cited by 10
Does metabosensitive afferent fibers activity differ from slow- and fast-twitch muscles?
Caron, G., Decherchi, P., & Marqueste, T. (2015) · Experimental Brain Research · doi:10.1007/s00221-015-4326-5 · Cited by 9
ATP-sensitive potassium channels mediate hyperosmotic stimulation of NKCC in slow-twitch muscle
Gosmanov, A. R., Fan, Z., Mi, X., Schneider, E. G., & Thomason, D. B. (2004) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00247.2003 · Cited by 9
Robertson, M. J., & Lumley, P. (1989) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.1989.tb14624.x · Cited by 9
Andersen, J. B., Gesser, H., & Wang, T. (2004) · Physiological and Biochemical Zoology · doi:10.1086/383501 · Cited by 9
O'Neill, M. D., Dorrington, K. L., & Paterson, D. (1993) · Experimental Physiology · doi:10.1113/expphysiol.1993.sp003707 · Cited by 8
Aging augments interstitial K+concentrations in active muscle of rats
Li, J., Sinoway, L. I., & Ng, Y.-C. (2005) · Journal of Applied Physiology · doi:10.1152/japplphysiol.00639.2005 · Cited by 8
Restoration of cardiac contraction by angiotensin II during raised [K+]o in the rabbit
RYAN, D. M., & Paterson, D. J. (1996) · Acta Physiologica Scandinavica · doi:10.1046/j.1365-201x.1996.453213000.x · Cited by 7
Lindinger, M. I. (2005) · Equine and comparative exercise physiology · doi:10.1079/ecp200566 · Cited by 7
Self-citationHakimjavadi, H., Stiner, C. A., Radzyukevich, T. L., Lingrel, J. B., Norman, N. J., Figueroa, J. A. L., & Heiny, J. A. (2018) · International Journal of Molecular Sciences · doi:10.3390/ijms19092725 · Cited by 7
Choate, J., Nandhabalan, M., & Paterson, D. J. (2001) · Experimental Physiology · doi:10.1113/eph8602062 · Cited by 5
Barthel, J. M. G., & JAENICKE, R. (1982) · Berichte der Bunsengesellschaft für physikalische Chemie · doi:10.1002/bbpc.19820860319 · Cited by 5
Maximum-likelihood q-estimator uncovers the role of potassium at neuromuscular junctions
da Silva, A. J., Trindade, M. A. S., Santos, D. O. C., & Lima, R. F. (2015) · Biological Cybernetics · doi:10.1007/s00422-015-0673-3 · Cited by 5
Goodman, C. A., Bennie, J. A., Leikis, M. J., & McKenna, M. J. (2014) · PLoS ONE · doi:10.1371/journal.pone.0101039 · Cited by 4
Rizvi, M. H., Azeem, M. A., & Savanur, A. (2019) · Journal of Muscle Research and Cell Motility · doi:10.1007/s10974-019-09551-9 · Cited by 4
Phasic Oscillations of Extracellular Potassium (Ko) in Pregnant Rat Myometrium
Young, R. C., & Goloman, G. (2013) · PLoS ONE · doi:10.1371/journal.pone.0065110 · Cited by 3
Watanabe, I., & Gettes, L. S. (2018) · International Heart Journal · doi:10.1536/ihj.17-175 · Cited by 2
Electrolyte homeostasis in trained and untrained healthy subjects during prolonged hypokinesia
Deogenes, K. G., Kakuris, K. K., Deogenov, V. A., & Yerullis, K. B. (2007) · Clinical Biochemistry · doi:10.1016/j.clinbiochem.2007.01.017 · Cited by 1
Inability of healthy subjects to deposit potassium during hypokinesia and potassium supplementation
Zorbas, Y. G., Kakuris, K. K., Federenko, Y. F., & Deogenov, V. A. (2009) · Clinical and investigative medicine · doi:10.25011/cim.v32i1.5085 · Cited by 1
Cited by
Sorted by citations
Grgic, J., Pedisic, Z., Saunders, B., Artioli, G. G., Schoenfeld, B. J., McKenna, M. J., Bishop, D. J., Kreider, R. B., Stout, J. R., Kalman, D. S., et al. (2021) · Journal of the International Society of Sports Nutrition · doi:10.1186/s12970-021-00458-w · Cited by 138
A monolithically integrated in-textile wristband for wireless epidermal biosensing
Ma, X., Wang, P., Huang, L., Ding, R., Zhou, K., Shi, Y., Chen, F., Zhuang, Q., Huang, Q., Lin, Y., et al. (2023) · Science Advances · doi:10.1126/sciadv.adj2763 · Cited by 116
Potassium homeostasis: sensors, mediators, and targets
McDonough, A. A., & Fenton, R. A. (2022) · Pflügers Archiv - European Journal of Physiology · doi:10.1007/s00424-022-02718-3 · Cited by 61
Potassium homeostasis – Physiology and pharmacology in a clinical context
Kettritz, R., & Loffing, J. (2023) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2023.108489 · Cited by 54
McKenna, M. J., Renaud, J., Ørtenblad, N., & Overgaard, K. (2024) · European Journal of Applied Physiology · doi:10.1007/s00421-023-05335-9 · Cited by 41
Metadata
- Authors
- Lindinger, M. I., & Cairns, S. P.
- Affiliations
- Auckland University of Technology (NZ)
- Corresponding author
- Cairns, Simeon P.
- Venue
- European Journal of Applied Physiology
- Published
- 2021-01-04
- Volume
- 121
- Issue
- 3
- Pages
- 721-748
- ISSN
- 0020-9376 (ISSN-L)
- 1439-6319
- 1439-6327
- OpenAlex
- W3119220887
- Cited by
- 78
- References
- 262
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 17 · 2023: 11 · 2022: 15 · 2021: 6
- FWCI
- 1.98
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Journal of Applied Physiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Nephrology › Potassium and Related Disorders
- Health Sciences › Medicine › Physiology (medical) › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Keywords
- physical activity, muscle fatigue, hyperkalemia, hypokalemia, plasma potassium, ischemia, cardiac function, exercise performance, calcium, beta-adrenergic agonists, insulin, glucose
- MeSH terms
- Humans, Potassium, Exercise, Muscle, Skeletal, Muscle Fatigue
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review