How the kidney regulates magnesium: a modelling study

肾脏如何调节镁:一项建模研究

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Abstract

The kidneys are crucial for maintaining Mg(2+) homeostasis. Along the proximal tubule and thick ascending limb, Mg(2+) is reabsorbed paracellularly, while along the distal convoluted tubule (DCT), Mg(2+) is reabsorbed transcellularly via transient receptor potential melastatin 6 (TRPM6). TRPM6 and other renal transporter expressions are regulated by sex hormones. To investigate renal Mg(2) handling, we have developed sex-specific computational models of electrolyte transport along rat superficial nephron. Model simulations indicated that along the proximal tubule and thick ascending limb, Mg(2+) and Na(+) transport occur parallelly, but they are dissociated along the DCT. In addition, our models predicted higher paracellular Mg(2+) permeability in females to attain similar cortical thick ascending limb fractional Mg(2+) reabsorption in both sexes. Furthermore, DCT fractional Mg(2+) reabsorption is higher in females than in males, allowing females to better fine-tune Mg(2+) excretion. We validated our models by simulating the administration of three classes of diuretics. The model predicted significantly increased, marginally increased and significantly decreased Mg(2+) excretions for loop, thiazide and K-sparing diuretics, respectively, aligning with experimental findings. The models can be used to conduct in silico studies on kidney adaptations to Mg(2+) homeostasis alterations during conditions such as pregnancy, diabetes and chronic kidney disease.

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