4.7 Review

Recent advances in understanding ion transport mechanisms in polycystic kidney disease

Journal

CLINICAL SCIENCE
Volume 135, Issue 21, Pages 2521-2540

Publisher

PORTLAND PRESS LTD
DOI: 10.1042/CS20210370

Keywords

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Funding

  1. APS Lazaro J. Mandel Young Investigator Award
  2. NIH [NIDDK R00 DK105160, NHLBI R01HL148114]
  3. PKD Foundation Award [221G18a]

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This review provides insights into the recent advancements in understanding electrolyte transport mechanisms in severe inherited renal disorders, particularly focusing on calcium and sodium transport in cystic cells and their implications in polycystic kidney disease.
This review focuses on the most recent advances in the understanding of the electrolyte transport-related mechanisms important for the development of severe inherited renal disorders, autosomal dominant (AD) and recessive (AR) forms of polycystic kidney disease (PKD). We provide here a basic overview of the origins and clinical aspects of ARPKD and ADPKD and discuss the implications of electrolyte transport in cystogenesis. Special attention is devoted to intracellular calcium handling by the cystic cells, with a focus on polycystins and fibrocystin, as well as other calcium level regulators, such as transient receptor potential vanilloid type 4 (TRPV4) channels, ciliary machinery, and purinergic receptor remodeling. Sodium transport is reviewed with a focus on the epithelial sodium channel (ENaC), and the role of chloride-dependent fluid secretion in cystic fluid accumulation is discussed. In addition, we highlight the emerging promising concepts in the field, such as potassium transport, and suggest some new avenues for research related to electrolyte handling.

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