Abstract

Growing infants must maintain a state of positive K + balance, a task accomplished, in large part, by the kidney. The distal nephron is uniquely adapted to retain total body K + early in life. The magnitude and direction of net K + transport in the cortical collecting duct (CCD), the segment responsible for the final renal regulation of K + balance in the adult, reflect the balance of opposing fluxes of K + secretion and K + absorption. Evidence now indicates that the low capacity of the neonatal CCD for K + secretion is due, at least in part, to a relative paucity of conducting K + channels in the urinary membrane. A relative excess of K + absorption in this nephron segment may further reduce net urinary K + secretion. Under conditions prevailing in vivo, the balance of fluxes in the CCD likely contributes to the relative K + retention characteristic of the neonatal kidney.

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