The Na+/K+/2Cl- cotransporter (NKCC2) on the loop of Henle is the site of action of furosemide. Since outer medullary potassium channel (ROMK) inhibitors prevent reabsorption by NKCC2, we tested the hypothesis that ROMK inhibition with a novel, selective ROMK inhibitor (Compound C) blocks tubuloglomerular feedback (TGF) and reduces vascular resistance. Loop perfusion of either ROMK inhibitor or furosemide caused dose-dependent blunting of TGF, but the response to furosemide was 10-fold more sensitive (IC50= 10-6M for furosemide and IC50=10-5M for Compound C). During systemic infusion, both diuretics inhibited TGF but ROMK inhibitor was 10-fold more sensitive (Compound C: 63% inhibition; furosemide: 32% inhibition). Despite blockade of TGF, one hour of constant systemic infusion of both diuretics reduced the glomerular filtration rate (GFR) and renal blood flow (RBF) by 40-60% and increased renal vascular resistance (RVR) by 100-200%. Neither diuretic altered blood pressure or hematocrit. Proximal tubule hydrostatic pressures (PPT) increased transiently with both diuretics (Compound C: 56% increase; furosemide: 70% increase) but returned to baseline. ROMK inhibitor caused more natriuresis (3400% increase vs 1600% increase) and calciuresis (1200% increase vs 800% increase) but less kaliuresis (33% increase vs 167% increase) than furosemide. In conclusion, blockade of ROMK or Na+/K+/2Cl- transport inhibits TGF yet increases renal vascular resistance. The renal vasoconstriction was independent of volume depletion, blood pressure, TGF or PPT.
- Copyright © 2016, American Journal of Physiology-Renal Physiology