An apical K+-dependent HCO-3 transport pathway opposes transepithelial HCO3- absorption in rat medullary thick ascending limb

Absorption of HCO(3)(-) in the medullary thick ascending limb ( MTAL) is mediated by apical membrane Na(+)/H(+) exchange. The identity and function of other apical acid-base transporters in this segment have not been defined. The present study was designed to examine apical membrane HCO(3)(-)/OH(-)/H(+) transport pathways in the rat MTAL and to determine their role in transepithelial HCO(3)(-) absorption. MTALs were perfused in vitro in Na(+)-and Cl(-)-free solutions containing 25 mM HCO(3)(-), 5% CO(2). Lumen addition of either 120 mM Cl(-) or 50 mM Na(+) (50 muM EIPA present) had no effect on intracellular pH (pH(i)). Lumen Cl(-) addition also had no effect on pHi in the presence of 145 mM Na(+) or in the nominal absence of HCO(3)(-)/CO(2). Thus there was no evidence for apical Cl(-)/HCO(3)(-) (OH(-)) exchange, Na(+)-dependent Cl(-)/HCO(3)(-) exchange, or Na(+)-HCO(3)(-) cotransport. In contrast, in tubules studied in Na(+)-and Cl(-)-free solutions containing 25 mM HCO(3)(-), 5% CO(2) and 120 mM K(+), removal of luminal K(+) induced a rapid and pronounced decrease in pH(i) (Delta pH(i) = 0.56 +/- 0.06 pH U). pH(i) recovered following lumen K(+) readdition. The initial rate of net base efflux induced by lumen K(+) removal was decreased 85% at the same pHi in the nominal absence of HCO(3)(-)/CO(2), indicating a dependence on HCO(3)(-)/CO(2) and arguing against apical K(+)/H(+) exchange. A combination of the apical K(+) channel blockers quinidine (0.1 mM) and glybenclamide (0.25 mM) had no effect on the lumen K(+)-induced pH(i) changes, arguing against electrically coupled K(+) and HCO(3)(-) conductances. The effect of lumen K(+) on pH(i) was inhibited by 1 mM H(2)DIDS. In addition, lumen addition of DIDS increased transepithelial HCO(3)(-) absorption from 10.7 +/- 0.7 to 14.9 +/- 0.7 pmol.min(-1).mm(-1) (P < 0.001) and increased pHi slightly in MTAL studied in physiological solutions (25 mM HCO(3)(-) and 4 mM K(+)). Lumen DIDS stimulated HCO(3)(-) absorption in the absence and presence of furosemide. These results are consistent with an apical membrane K(+)-dependent HCO(3)(-) transport pathway that mediates coupled transfer of K(+) and HCO(3)(-) from cell to lumen in the MTAL. This mechanism, possibly an apical K(+)-HCO(3)(-) cotransporter, functions in parallel with apical Na(+)/H(+) exchange and opposes transepithelial HCO(3)(-) absorption.