Extrarenal Effects of Aldosterone on Potassium Homeostasis
Open accessAbstract
The role of aldosterone in regulating K + excretion in the distal nephron is well established in kidney physiology. In addition to effects on the kidney, aldosterone modulates K + and Na + transport in salivary fluid, sweat, airway epithelia, and colonic fluid. More controversial and less well defined is the role of aldosterone in determining the internal distribution of K + across cell membranes in nontransporting epithelia. In vivo studies have been limited by the difficulty in accurately measuring overall K + balance and factoring in both variability and secondary changes in acid-base balance, systemic hemodynamics, and other K + -regulatory factors such as hormones and adrenergic activity. Despite these limitations, the aggregate data support a contributory role of aldosterone along with insulin and catecholamines in the normal physiologic regulation of internal K + distribution. The authors speculate differences in tissue sensitivity to aldosterone may also contribute to differential tissue response of cardiac and skeletal muscle to conditions of total body K + depletion.
Integrity signals
Registry
Cites
Statistics
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?
Aldosterone increases K+ secretion into distal segments of nephrons and increases cellular K+ uptake via Na+-K+-ATPase pump stimulation.
“ALD impacts K+ regulation by increasing K+ secretion into the distal segments of the nephrons, as well as increasing cellular K+ uptake via Na+-K+-ATPase pump stimulation [1, 13].”
From A mathematical model of potassium homeostasis: Effect of feedforward and feedback controls (2022) · cites this paper as [13]
Cellular uptake of K+ can be enhanced by activation of Na+-K+-ATPase pumps by insulin and aldosterone.
“Cellular uptake of K+ can be enhanced by the activation of Na+-K+-ATPase pumps by insulin and ALD [13, 14].”
From A mathematical model of potassium homeostasis: Effect of feedforward and feedback controls (2022) · cites this paper as [13]
Cites
Mechanisms of sodium pump regulation
Therien, A. G., & Blostein, R. (2000) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.2000.279.3.c541 · Cited by 765 · see citing works
Regulation of Potassium Homeostasis
Palmer, B. F. (2015) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.08580813 · Cited by 535 · see citing works
Self-citationEwart, H. S., & Klip, A. (1995) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.1995.269.2.c295 · Cited by 460 · see citing works
Hyperkalemia and hyporeninemic hypoaldosteronism
DeFronzo, R. A. (1980) · Kidney International · doi:10.1038/ki.1980.14 · Cited by 323 · see citing works
Physiology and pathophysiology of potassium homeostasis
Palmer, B. F., & Clegg, D. J. (2016) · AJP Advances in Physiology Education · doi:10.1152/advan.00121.2016 · Cited by 286 · see citing works
Self-citationMuscle K+, Na+, and Cl− disturbances and Na+-K+ pump inactivation: implications for fatigue
McKenna, M. J., Bangsbo, J., & Renaud, J. (2007) · Journal of Applied Physiology · doi:10.1152/japplphysiol.01037.2007 · Cited by 272 · see citing works
Bauersachs, J. K., Jaisser, F., & Toto, R. D. (2014) · Hypertension · doi:10.1161/hypertensionaha.114.04488 · Cited by 259 · see citing works
Electrolyte and Acid–Base Disturbances in Patients with Diabetes Mellitus
Palmer, B. F., & Clegg, D. J. (2015) · New England Journal of Medicine · doi:10.1056/nejmra1503102 · Cited by 258 · see citing works
Self-citationExtrarenal potassium homeostasis
Bia, M. J., & DeFronzo, R. A. (1981) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1981.240.4.f257 · Cited by 249 · cited 1× · see citing works
“cell such as acid base disorder and changes in tonicity have been reviewed elsewhere and therefore will not be addressed (2,3).”
BackgroundPhysiology and Pathophysiology of Potassium Homeostasis: Core Curriculum 2019
Palmer, B. F., & Clegg, D. J. (2019) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2019.03.427 · Cited by 215 · cited 1× · see citing works
“Aldosterone Aldosterone is the major mineralocorticoid in humans and plays an important role in regulating kidney K + secretion in the distal nephron (17-19).”
BackgroundSelf-citationCatecholamine Modulation of Rapid Potassium Shifts during Exercise
Williams, M. E., Gervino, E. V., Rosa, R. M., Landsberg, L., Young, J. B., Silva, P., & Epstein, F. H. (1985) · New England Journal of Medicine · doi:10.1056/nejm198503283121304 · Cited by 191 · see citing works
Influence of Basal Insulin and Glucagon Secretion on Potassium and Sodium Metabolism
DeFronzo, R. A., Sherwin, R. S., Dillingham, M. A., Hendler, R., Tamborlane, W. V., & Felig, P. (1978) · Journal of Clinical Investigation · doi:10.1172/jci108958 · Cited by 174 · see citing works
Loeb, R. F., Atchley, D. W., Benedict, E. M., et al. (1933) · The Journal of Experimental Medicine · doi:10.1084/jem.57.5.775 · Cited by 166 · see citing works
An extrarenal mechanism of potassium adaptation
ALEXANDER, E. A., & Levinsky, N. G. (1968) · Journal of Clinical Investigation · doi:10.1172/jci105769 · Cited by 143 · see citing works
Takahashi, H., Yoshika, M., Komiyama, Y., & Nishimura, M. (2011) · Hypertension Research · doi:10.1038/hr.2011.105 · Cited by 137 · see citing works
Xue, B., Johnson, A. K., & Hay, M. (2013) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00222.2013 · Cited by 129 · see citing works
Ikeda, U., Hyman, R., Smith, T. W., et al. (1991) · Journal of Biological Chemistry · doi:10.1016/s0021-9258(18)99065-4 · Cited by 125 · see citing works
Distal Colonic K+ Secretion Occurs via BK Channels
Sausbier, M., Matos, J., Sausbier, U., Beranek, G., Arntz, C., Neuhuber, W., Ruth, P., & Leipziger, J. (2006) · Journal of the American Society of Nephrology · doi:10.1681/asn.2005101111 · Cited by 122 · see citing works
Palmer, B. F. (2019) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2019.05.019 · Cited by 113 · see citing works
Self-citationThe Ubiquitous Mineralocorticoid Receptor: Clinical Implications
Hawkins, U. A., Gómez-Sánchez, E. P., Gomez-Sanchez, C. M., & Gómez-Sánchez, C. E. (2012) · Current Hypertension Reports · doi:10.1007/s11906-012-0297-0 · Cited by 110 · see citing works
Advances in the diagnosis and treatment of adrenal insufficiency
Thorn, G. W., Forsham, P. H., Frawley, T. F., et al. (1951) · The American Journal of Medicine · doi:10.1016/0002-9343(51)90330-0 · Cited by 110 · see citing works
Skeletal muscle vasodilatation at the onset of exercise
Clifford, P. S. (2007) · The Journal of Physiology · doi:10.1113/jphysiol.2007.135673 · Cited by 107 · see citing works
Knöchel, J. P., Dotin, L. N., & Hamburger, R. J. (1972) · Journal of Clinical Investigation · doi:10.1172/jci106809 · Cited by 103 · see citing works
Xue, B., Beltz, T. G., Yu, Y., et al. (2010) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00847.2010 · Cited by 103 · see citing works
Extrarenal potassium homeostasis
Brown, R. S. (1986) · Kidney International · doi:10.1038/ki.1986.160 · Cited by 87 · see citing works
Quantitative analysis of aldosterone's role in potassium regulation
Young, D. B. (1988) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1988.255.5.f811 · Cited by 83 · see citing works
Na+influx and Na+-K+pump activation during short-term exposure of cardiac myocytes to aldosterone
Mihailidou, A. S., Buhagiar, K. A., & Rasmussen, H. (1998) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.1998.274.1.c175 · Cited by 82 · see citing works
Comparison of Insulin Action on Glucose versus Potassium Uptake in Humans
Nguyen, T. Q., Maalouf, N. M., Sakhaee, K., & Moe, O. W. (2011) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.00750111 · Cited by 69 · see citing works
11β-hydroxysteroid dehydrogenases: A growing multi-tasking family
Gómez-Sánchez, E. P., & Gómez-Sánchez, C. E. (2021) · Molecular and Cellular Endocrinology · doi:10.1016/j.mce.2021.111210 · Cited by 69 · see citing works
Evidence for a role of endogenous insulin and glucagon in the regulation of potassium homeostasis.
Santeusanio, F., Faloona, G. R., Knöchel, J. P., et al. (1973) · PubMed · Cited by 67 · see citing works
Chadwick, J. A., Hauck, J. S., Lowe, J., Shaw, J. J., D, D. C. G., Gómez-Sánchez, C. E., Gómez-Sánchez, E. P., & Rafael‐Fortney, J. A. (2015) · The FASEB Journal · doi:10.1096/fj.15-276782 · Cited by 56 · see citing works
The role of aldosterone in potassium tolerance: Studies in anephric humans
Sugarman, A., & Brown, R. S. (1988) · Kidney International · doi:10.1038/ki.1988.194 · Cited by 52 · see citing works
Potassium, Na+,K+‐pumps and fatigue in rat muscle
Clausen, T., & Nielsen, O. B. (2007) · The Journal of Physiology · doi:10.1113/jphysiol.2007.136044 · Cited by 52 · see citing works
Potassium Homeostasis in Chronic Diabetes Mellitus
Pérez, G. O. (1977) · Archives of Internal Medicine · doi:10.1001/archinte.1977.03630200026010 · Cited by 50 · see citing works
An extrarenal action of aldosterone on mammalian skeletal muscle
Adler, S. (1970) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1970.218.3.616 · Cited by 50 · see citing works
The effect of adrenal steroids on stool composition, as revealed by in vivo dialysis of faeces.
Rc, C., Leme, C. E., Dr, W., et al. (1969) · PubMed · Cited by 49 · see citing works
Salivary Sodium-Potassium Ratio and Plasma Renin Activity in Hypertension
Adlin, E. V., Channick, B. J., & Marks, A. D. (1969) · Circulation · doi:10.1161/01.cir.39.5.685 · Cited by 48 · see citing works
Effects of aldosterone on potassium distribution
Young, D. B., & Jackson, T. E. (1982) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.1982.243.5.r526 · Cited by 47 · see citing works
Dynamic Aspects of Sodium Metabolism in Experimental Adrenal Insufficiency Using Radioactive Sodium
Stern, T. N., Cole, V. V., Bass, A. C., et al. (1951) · American Journal of Physiology-Legacy Content · doi:10.1152/ajplegacy.1951.164.2.437 · Cited by 46 · see citing works
Necessity for insulin in transfer of excess infused K to intracellular fluid
Hiatt, N., Yamakawa, T., & Davidson, M. B. (1974) · Metabolism · doi:10.1016/0026-0495(74)90102-4 · Cited by 44 · see citing works
Regulation of extrarenal potassium homeostasis by adrenal hormones in rats
BIA, M. J., Tyler, K. A., & DeFronzo, R. A. (1982) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.1982.242.6.f641 · Cited by 43 · see citing works
Effect of insulinopenia and adrenal hormone deficiency on acute potassium tolerance
DeFronzo, R. A., Lee, R. E., Jones, A., et al. (1980) · Kidney International · doi:10.1038/ki.1980.69 · Cited by 42 · see citing works
CLINICAL INVESTIGATION OF THE EFFECTS OF ADRENAL CORTICOSTEROID EXCESS ON THE COLON
Richards, P. (1969) · The Lancet · doi:10.1016/s0140-6736(69)91480-9 · Cited by 34 · see citing works
Perry, M. C., & Hales, C. N. (1969) · Biochemical Journal · doi:10.1042/bj1150865 · Cited by 33 · see citing works
Role of Muscle in Regulating Extracellular [K+]
McDonough, A. A., & Youn, J. H. (2005) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2005.03.009 · Cited by 33 · see citing works
Ho, K. (2011) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.04540511 · Cited by 32 · see citing works
Aldosterone Regulates Na,K-ATPase and Increases Lung Edema Clearance in Rats
OLIVERA, W. G., CICCOLELLA, D. E., Barquín, N., et al. (2000) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.161.2.9808050 · Cited by 32 · see citing works
Adrenergic modulation of extrarenal potassium disposal in men with end-stage renal disease
Allon, M., & Shanklin, N. (1991) · Kidney International · doi:10.1038/ki.1991.321 · Cited by 31 · see citing works
Colonic Potassium Absorption and Secretion in Health and Disease
Rajendran, V. M., & Sandle, G. I. (2018) · Comprehensive physiology · doi:10.1002/cphy.c170030 · Cited by 31 · see citing works
Novel mouse strain with Cre recombinase in 11β-hydroxysteroid dehydrogenase-2-expressing cells
Náray‐Fejes‐Tóth, A., & Fejes‐Tóth, G. (2006) · American Journal of Physiology-Renal Physiology · doi:10.1152/ajprenal.00188.2006 · Cited by 29 · see citing works
Bundgaard, H., & Kjeldsen, K. P. (2002) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00588.2001 · Cited by 24 · see citing works
Potassium-Lowering Effect of Mineralocorticoid Therapy in Patients Undergoing Hemodialysis
Furuya, R., Kumagai, H., Sakao, T., et al. (2002) · The Nephron journals/Nephron journals · doi:10.1159/000064116 · Cited by 23 · see citing works
Jk, D., & Ej, R. (1967) · PubMed · Cited by 22 · see citing works
THOMPSON, B. D., & Edmonds, C. J. (1971) · Journal of Endocrinology · doi:10.1677/joe.0.0500163 · Cited by 21 · see citing works
THE EFFECT OF ALDOSTERONE ON THE ELECTRICAL ACTIVITY OF RAT COLON
Edmonds, C. J., & MARRIOTT, J. C. (1969) · Journal of Endocrinology · doi:10.1677/joe.0.0440363 · Cited by 19 · see citing works
Phakdeekitcharoen, B., Kittikanokrat, W., Kijkunasathian, C., & Chatsudthipong, V. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2010.03912.x · Cited by 17 · see citing works
The effect of aldosterone on water and electrolyte composition of incubated rat diaphragms.
Vs, L., & Webster, G. D. (1967) · PubMed · Cited by 14 · see citing works
Potassium depletion improves myocardial potassium uptake in vivo
Bundgaard, H. (2004) · American Journal of Physiology-Cell Physiology · doi:10.1152/ajpcell.00580.2003 · Cited by 13 · see citing works
Dawborn, J. K., & Watson, L. (1968) · The Medical Journal of Australia · doi:10.5694/j.1326-5377.1968.tb82781.x · Cited by 12 · see citing works
Emrich, H. M., Stoll, E., & Rossi, E. (1970) · Journal of Molecular Medicine · doi:10.1007/bf01484399 · Cited by 10 · see citing works
Paradoxical potassium depletion: A renal mechanism for extrarenal potassium adaptation
Spital, A., & Sterns, R. H. (1986) · Kidney International · doi:10.1038/ki.1986.218 · Cited by 10 · see citing works
Salivary sodium and potassium concentrations in adrenalectomized rats
Catalanotto, F. A., & Sweeney, E. A. (1978) · Behavioral Biology · doi:10.1016/s0091-6773(78)90803-9 · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A mathematical model of potassium homeostasis: Effect of feedforward and feedback controls
Stadt, M. M., Leete, J., Devinyak, S., & Layton, A. T. (2022) · PLOS Computational Biology · doi:10.1371/journal.pcbi.1010607 · Cited by 19 · see citing works
“As mentioned previously, ALD impacts K regulation by 100 increasing K secretion into the distal segments of the nephrons, as well as increasing 101 cellular K uptake via Na-K-ATPase pump stimulation [1, 13].”
BackgroundA Mathematical Model of Whole-Body Potassium Regulation: Global Parameter Sensitivity Analysis
Stadt, M. M., & Layton, A. T. (2024) · SIAM Journal on Applied Dynamical Systems · doi:10.1137/23m161519x · Cited by 3 · see citing works
- Authors
- Palmer, B. F., & Clegg, D. J.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Texas Tech University (US)
- Corresponding author
- Palmer, Biff F.
- Venue
- Kidney360
- Published
- 2022-03-31
- Volume
- 3
- Issue
- 3
- Pages
- 561-568
- ISSN
- 2641-7650 (ISSN-L)
- PMC
- PMC9034816
- OpenAlex
- W4205679320
- Cited by
- 40
- References
- 62
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 16 · 2023: 4 · 2022: 4
- FWCI
- 1.47
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Locations
- Kidney360 (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Potassium and Related Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
- Keywords
- aldosterone, potassium homeostasis, potassium distribution, salivary potassium, sweat potassium, airway epithelium, insulin, catecholamines, potassium depletion
- MeSH terms
- Acid-Base Equilibrium, Aldosterone, Homeostasis, Kidney, Potassium
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
