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(Hypertension. 2004;43:1175.)
© 2004 American Heart Association, Inc.

Rapid Communication

Activating Mutation of the Renal Epithelial Chloride Channel ClC-Kb Predisposing to Hypertension

Nikola Jeck; Siegfried Waldegger; Angelika Lampert; Christoph Boehmer; Petra Waldegger; Philipp A. Lang; Bernd Wissinger; Björn Friedrich; Teut Risler; Robert Moehle; Undine E. Lang; Peter Zill; Brigitta Bondy; Elke Schaeffeler; Stephen Asante-Poku; Hannsjörg Seyberth; Matthias Schwab; Florian Lang

From the Department of Pediatrics (N.J., S.W., P.W., H.S.), University of Marburg, Germany; Departments of Physiology (A.L., C.B., P.A.L., F.L.), Ophthalmology (B.W.), and Internal Medicine (B.F., T.R., R.M.), University of Tübingen, Germany; Department of Psychiatry (U.E.L.), University of Berlin, Germany; Department of Psychiatry (P.Z., B.B.), University of Munich, Germany; Dr Margarete Fischer Bosch Institute of Clinical Pharmacology (E.S., M.S.), Stuttgart, Germany; Department of Biochemistry (S.A.-P.), University of Ghana Medical School, Accra.

Correspondence to Dr Florian Lang, Department of Physiology, University of Tübingen, Gmelinstr 5, D-72076 Tübingen, Germany. E-mail florian.lang{at}uni-tuebingen.de

The chloride channel ClC-Kb is expressed in the basolateral cell membrane of the distal nephron and participates in renal NaCl reabsorption. Loss-of-function mutations of ClC-Kb lead to classic Bartter syndrome, a rare salt-wasting disorder. Recently, we identified the ClC-Kb^T481S polymorphism, which confers a strong gain-of-function effect on the ClC-Kb chloride channel. The present study has been performed to explore the prevalence of the mutation and its functional significance in renal salt handling and blood pressure regulation. As evident from electrophysiological analysis with the 2-electrode voltage-clamp technique, heterologous expression of ClC-Kb^T481S in Xenopus oocytes gave rise to a current that was 7-fold larger than the current produced by wild-type ClC-Kb. The prevalence of the mutant allele was significantly higher in an African population from Ghana (22%) than in whites (12%). As tested in 1 white population, carriers of ClC-Kb^T481S were associated with significantly higher systolic (by 6.0 mm Hg) and diastolic (by 4.2 mm Hg) blood pressures and significantly higher prevalence (45% versus 25%) of hypertensive (140/90 mm Hg) blood pressure levels. Individuals carrying ClC-Kb^T481S had significantly higher plasma Na⁺ concentrations and significantly decreased glomerular filtration rate. In conclusion, the mutation ClC-Kb^T481S of the renal epithelial Cl^– channel ClC-Kb strongly activates ClC-Kb chloride channel function in vitro and may predispose to the development of essential hypertension in vivo.

Key Words: blood pressure • ethnic groups • genes • glomerular filtration rate • hypertension, genetic • ion transport • kidney

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