Lack of Renal NHE1 Exacerbates Lithium-Induced Nephrogenic Diabetes Insipidus

Abstract

The sodium-hydrogen exchanger isoform 1 (NHE1) is a transporter with roles in transepithelial Na+/H+ transport, intracellular pH (pHi), and cell volume regulation. Within the kidney, we localized NHE1 to the basolateral membrane of the distal parts of the nephron and collecting duct (co-labelling with AQP2 for principal cells and H+-ATPase B1 subunit for all 3 types of intercalated cells: type A, B, and non-A-non-B). We have previously shown that lack of NHE3 does not affect Li+ clearance, and other studies have shown that NHE1 transports Li+ preferably compared to NHE3. Therefore we hypothesized that NHE1 plays a critical role in Li+-induced nephrogenic diabetes insipidus. To address this question, we used newly generated mice which lack NHE1 protein in the tubule/collecting duct system (NHE1KS-KO) of the kidney. After baseline measurements, control (n=12) and NHE1KS-KO (n=9) mice were switched to a Li+-containing diet (0.2% LiCl [40 mmol/kg], Harlan Teklad, TD09326) for 4 weeks. Urine osmolality was not different between groups under baseline conditions (control: 2641±178, NHE1KS-KO: 2716±244 mmol/kg). In response to Li+, urine osmolality reached a minimum after 7 days that was sustained until the end of the experimental period. Of note, urine osmolality was ~500 mmol/kg lower in NHE1KS-KO versus control mice (1125±170 versus 475±94 mmol/kg, P<0.05) despite genotypes having comparable plasma Li+ concentrations (0.48±0.1 versus 0.45±0.1 mmol/L). Plasma Na+ concentrations were not significantly different under baseline conditions (149±0.5 versus 148±0.4 mmol/L) but increased to a significantly greater extent in NHE1KS-KO versus control mice (156±1.9 versus 152±0.5 mmol/L, P<0.05). Along those lines, plasma Cl− was significantly greater in NHE1KS-KO versus control mice at the end of the experimental period (117±1.9 versus 111±0.4 mmol/L, P<0.05). Taken together, our data indicate that NHE1 in principal cells plays an important role in the development of nephrogenic diabetes insipidus as well as the development of hypernatremia and hyperchloremia. This work was supported by a VA Merit Review Award IBX004968A (to Dr. Rieg) and a Pilot Project from the USF Microbiomes Institute (to T.R. and J.D.R). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.