Some reflections on the mechanism of renal tubular potassium transport.

Analysis of the driving forces acting on the movement of potassium across individual membranes of tubule cells shows that both active and passive components play an important role in the regulation of potassium transport. Distal and cortical collecting tubule and papillary collecting duct elements are the key nephron sites participating in a complex fashion to translate a wide variety of metabolic challenges into the appropriate excretory response. The latter involves both secretory and reabsorptive activity. The analysis of the factors modulating tubular potassium transfer has shown that the potassium concentration in the cells of the distal nephron is a dey factactors involved in setting the cellular potassium concentration are active potassium uptake at the peritubular and luminal membrane of the cells as well as electrogenic solium extrusion across the peritubular boundary of the cells. Additional factors regulating potassium transport involve the electrical potential difference, sensitive to changes in the sodium concentration in the lumen, the flow rate past the late distal tubular site of potassium secretion, and the activity of a reabsorptive potassium pump in the luminal membranes of the cells. In the cortical collecting tubule, active potassium secretion is also present at the luminal membrane of the cell, but the role of such an additional secretory mechanism in the late distal tubule is presently unknown. Most of these individual transport mechanisms exist along the whole distal nephron, but their relative prominence varies among the late distal tubule, the cortical collecting tubule, and the papilary collecting duct.