Cisplatin Decreases ENaC Activity Contributing to Renal Sodium Wasting

Abstract

Cisplatin (CDDP) is a platinum‐containing compound that has antineoplastic effects due to its ability to bind DNA and inhibit replication. While an important chemotherapy drug, CDDP results in a renal salt and water‐wasting syndrome and is nephrotoxic. The origin of the renal salt and water‐wasting caused by CDDP is obscure; though, some evidence suggests that broad inhibition of the Na+/K+‐ATPase by CDDP results in generalized decreases in tubular reabsorption causing increases in sodium and water excretion. The effects of CDDP on the epithelial Na+ channel (ENaC), which is the final arbiter of renal Na+ excretion, are unknown. We test here if CDDP affects the activity of ENaC to influence renal salt and water excretion. These studies focus on understanding the cellular mechanism by which CDDP may affect ENaC. For these studies, C57Bl/6 male mice were randomly divided into 3 groups, as follow: 1) Saline, 2) CDDP and 3) Benzamil (BZM) treated. For metabolic cages experiments, C57Bl/6 male mice received a Na+ load (100 μL of a 0.9% NaCl solution) and were treated with CDDP (25 mg/kg, i.p.) or BZM (1.4 mg/kg, i.p.). Then, water consumption, Na+ intake, urine volume, urinary Na+ and creatine excretion were evaluated every 2 h over a 10 h period. To directly quantify ENaC activity in these animals, principal cells were patch‐clamped in split‐open tubules using the cell‐attached configuration. After recording baseline ENaC activity for 5 min in these tubules, they were treated with CDDP (0.5 to 1.5 μM) with ENaC activity quantified in the presence of this drug over the next 5 min. Preliminary results show that CDDP increases excretion of a Na+ load, increases fractional excretion of sodium (FeNa) and decreases ENaC activity in isolated tubules. Importantly, our studies show that, unlike ouabain, CDDP does not affect channel conductance in cell‐attached patches. Such observations are most consistent with CDDP not affecting the electrochemical forces driving Na+ transport across principal cells, which would change in response to changes in pump activity, but rather decreasing ENaC activity through direct effects on the channel or a channel regulator. In conclusion, these observations are consistent with CDDP actions on ENaC, independent of effects on the pump, contributing to the renal salt and water wasting caused by this chemotherapy drug.Support or Funding InformationThis research was supported by NIH/NIDDK grants R01DK113816 and R01DK117909.