Peter A. Friedman
1998 Annual Review of Physiology  
Calcium and sodium absorption by the kidney normally proceed in parallel. However, a number of physiological, pharmacological, pathological, and genetic conditions dissociate this relation. In each instance, the dissociation can be traced to the distal convoluted tubule, where calcium and sodium transport are inversely related. Based on the identification of the relevant sodium transporters in these cells and on analysis of the mechanism of calcium transport, an explanation for this inverse
more » ... or this inverse relation can be developed. Apical membrane calcium entry is mediated by voltage-sensitive calcium channels that are activated upon membrane hyperpolarization. Basolateral calcium efflux is effected primarily by Na + /Ca 2+ exchange. According to the model, inhibition of sodium entry through either the Na-Cl cotransporter or the Na + channel hyperpolarizes the cell, as does parathyroid hormone, thereby activating the calcium entry channel and increasing the driving force for diffusional entry. Membrane hyperpolarization also increases the driving force of calcium efflux through the Na + /Ca 2+ exchanger. Thus sodiumdependent changes of calcium transport are indirect and occur secondarily through effects on membrane voltage.
doi:10.1146/annurev.physiol.60.1.179 pmid:9558460 fatcat:uby5h26jsnahtiurnkz3axdbny