Dietary anions control potassium excretion: it is more than a poorly absorbable anion effect

Abstract

Dietary anions profoundly impact K + homeostasis. Here, we found that a K + -rich diet, containing [Formula: see text] as the counteranion, enhances the electrogenic K + excretory machinery, epithelial Na + channels, and renal outer medullary K + channels, much more than a high-KCl diet. It also uniquely induces KCC3a and pendrin, in B-intercalated cells, providing an electroneutral KHCO 3 secretion pathway. These findings reveal new K + balance mechanisms that drive adaption to alkaline and K + -rich foods, which should guide new treatment strategies for K + disorders.