Physiological and hygienic basis of potassium norm in drinking water: Theoretical and practical implications
2 Karolinska Institute, Stockholm, Sweden
3 Novosibirsk Research Institute of Hygiene Rospotrebnadzor, Novosibirsk, Russian Federation
4 Novosibirsk State Pedagogical University
Introduction. At present, there are no physiological and hygienic studies to substantiate the optimal (OHN) and permissible (PHN) hygienic norms of potassium in drinking water. The potassium standard for drinking water, 12 mg / dm3, established by the European Community directive 98 / 83EC, has no experimental justification, that makes unproven teaching this topic in the sections “Physiology of water-salt balance” and “Water supply hygiene”. This was the aim of this work: to consider the physiology of potassium metabolism in the body, on the basis of which experimentally to justify its hygienic norms in drinking water.
Materials and Methods. To justify the hygienic norm of potassium content in drinking water, a physiological and hygienic approach based on the theoretical and experimental study of potassium homeostasis in the body of higher animals and humans, as well as on the analysis of physiological responses of the body to long-term dose-dependent effects of potassium loads was used. This made it possible to integrate the results of the study into the system of standards for this cation in drinking water.
Results. It is shown, that regulation of potassium balance is provided as a direct action of cation surplus on kidneys in a case of hyperkalemia, and the reflex mechanism which involves following the potassium absorption from a digestive tract. This conclusion is based on experimental data, that potassium-regulating reflex is presented by liver selective receptors, afferent pathways as a part of vagal nerves, the hypothalamic centres and hormones (renin-angiotensin-aldosterone system, vasopressin, insulin), causing changes of kidney functions – the main homeostatic organ, and potassium tissue depot (skeletal muscles and a liver).
The second part describes the results of a 9-month chronic experiment in rats receiving drinking water with different potassium concentrations and its effect on kidney functions. It is shown, that cation concentration in water of 5,0 mg/dm3 did not cause changes of the renal response on water and potassium loadings in comparison with the control (potassium concentration in drinking water was 1,0 ± 0,2 mg/dm3), whereas water with the potassium concentration 50 mg/dm3 led to pressure of ionic balance regulation mechanisms in comparison with the control. It was expressed in increase of potassium and sodium excretion after water loading and their decrease after potassium loading.
Conclusions. The obtained data allow to conclude, that a hygienic optimum of potassium ion concentration in drinking water is the dose of 1-5 mg/dm3, the threshold dose causing functional pressure of potassium regulation mechanisms is 50 mg/dm3, and the acceptable hygienic range of potassium in drinking water is 0,8–12,5 mg/dm3.
Potassium homeostasis regulation; Kidney function; Potassium loadings; Potassium concentration in drinking water
73.563 Potassium Channels | Sesame Syndrome | Hyperkalemia
https://www.scopus.com/record/display.uri?src=s&origin=cto&ctoId=CTODS_1...
- Aizman R., Grahnquist L., Celsi G. Potassium homeostasis: ontogenic aspects. Acta Pediatrica, 1998, vol. 87, issue 6, pp. 609–617. DOI: https://doi.org/10.1080/080352598750013987
- Aizman R. I. Regulation of potassium homeostasis: age-specific features. Nephrology and Dialysis, 2001, vol. 3, no. 3, pp. 318–325. (In Russian) URL: https://elibrary.ru/item.asp?id=24766806
- Sun H., Sun M. Age- and gender-dependent associations of blood pressure and serum sodium and potassium-renal and extrarenal regulations. Journal of the American Society of Hypertension,2018, vol. 12, issue 5, pp. 392–401. DOI: https://doi.org/10.1016/j.jash.2018.03.005
- Palmer B. F. Regulation of potassium homeostasis. Clinical Journal of the American Society of Nephrology, 2015, vol. 10, issue 6, pp. 1050–1060. DOI: https://doi.org/10.2215/CJN.08580813
- Rodan A. R. Potassium: Friend or foe?. Pediatric Nephrology, 2017, vol. 32, issue 7, pp. 1109–1121. DOI: https://doi.org/10.1007/s00467-016-3411-8
- Leurs L. J., Schouten L. J., Mons M. N., Goldbohm R. A., van den Brandt P. A. Relationship between tap water hardness, magnesium and calcium concentration and mortality due to ischemic heart disease or stroke in the Netherlands. Environmental Health Perspective, 2010, vol. 118, no. 3, pp. 414–420. DOI: https://doi.org/10.1289/ehp.0900782
- Talukder M. R. R., Rutherford S., Huang C., Phung D., Islam M. Z., Chu C. Drinking water salinity and risk of hypertension: A systematic review and meta-analysis. Archives of Environmental and Occupational Health, 2017, vol. 72, issue 3, pp. 126–138. DOI: https://doi.org/10.1080/19338244.2016.1175413
- Talukder M. R. R., Rutherford S., Phung D., Islam M. Z., Chu C. The effect of drinking water salinity on blood pressure in young adults of coastal Bangladesh. Environmental Pollution, 2016, vol. 214, pp. 248–254. DOI: https://doi.org/10.1016/j.envpol.2016.03.074
- Rylander R.Magnesium in drinking water – a case for prevention?. Journal of Water and Health, 2013, vol. 12, no. 1, pp. 34–40. DOI: https://doi.org/10.2166/wh.2013.110
- Davies B. E. The UK geochemical environment and cardiovascular diseases: magnesium in food and water. Environmental Geochemistry and Health, 2015, vol. 37, issue 3, pp. 411–427. DOI: https://doi.org/10.1007/s10653-014-9671-y
- Gianfredi V., Bragazzi N. L., Nucci D., Villarini M., Moretti M. Cardiovascular diseases and hard drinking waters: From a systematic review with meta-analysis of case-control studies. Journal of Water and Health, 2016, vol. 15, issue 1, pp. 31–40. DOI: https://doi.org/10.2166/wh.2016.131
- Şener Ş., Şener E., Davraz A. Assessment of groundwater quality and health risk indrinking water basin using GIS. Journal of Water and Health, 2016, vol. 15, issue 1, pp. 112–132. DOI: https://doi.org/10.2166/wh.2016.148
- Youn J. H., McDonough A. A. Recent advances in understanding integrative control of potassium homeostasis. Annual Review of Physiology, 2009, vol. 71, pp. 381–401. DOI: https://doi.org/10.1146/annurev.physiol.010908.163241
- Rabinowitz L., Aizman R. I. The central nervous system in potassium homeostasis. Frontiers in Neuroendocrinology, 1993, vol. 14, issue 1, pp. 1–26. DOI: https://doi.org/10.1006/frne.1993.1001
- Borovets E. N., Aizman R. I. Age features of potassium transport in the distal colon of rats. Nephrology and Dialysis, 2003, vol. 5, no. 3, pp. 226–227. (In Russian) URL: https://elibrary.ru/item.asp?id=25523669
- Youn J. H. Gut sensing of potassium intake and its role in potassium homeostasis. Seminars in Nephrology, 2013, vol. 33, issue 3, pp. 248–256. DOI: https://doi.org/10.1016/j.semnephrol.2013.04.005
- Garty H., Karlish S. J. D. Role of FXYD proteins in ion transport. Annual Review of Physiology, 2006, vol. 68, pp. 431–459. DOI: https://doi.org/10.1146/annurev.physiol.68.040104.131852
- Garty H., Lindzen M., Scanzano R., Aizman R., Füzesi M., Goldshleger R., Farman N., Blostein R., Karlish S. J. D. A functional interaction between CHIF and Na-K-ATPase: Implication for regulation by FXYD proteins. American Journal of Physiology. Renal Physiology, 2002, vol. 283, issue 4, pp. F607–F615. DOI: https://doi.org/10.1152/ajprenal.00112.2002
- Rabinowitz L. Aldosterone and potassium homeostasis. Kidney International, 1996, vol. 49, issue 6, pp. 1738–1742. DOI: https://doi.org/10.1038/ki.1996.258
- DuBose Jr. T. D. Regulation of potassium homeostasis in CKD. Advances in Chronic Kidney Disease, 2017, vol. 24, issue 5, pp. 305–314. DOI: https://doi.org/10.1053/j.ackd.2017.06.002
- Gilligan S., Raphael K. L. Hyperkalemia and hypokalemia in CKD: Prevalence, risk factors, and clinical outcomes. Advances in Chronic Kidney Disease, 2017, vol. 24, issue 5, pp. 315–318. DOI: https://doi.org/10.1053/j.ackd.2017.06.004
- Geibel J. P. Role of potassium in acid secretion. World Journal of Gastroenterology, 2005, vol. 11, pp. 5259–5265. PMCID: PMC4622792 DOI https://doi.org/10.3748/wjg.v11.i34.5259
- Arin R. M., Gorostidi A., Navarro-Imaz H., Rueda Y., Fresnedo O., Ochoa B. Adenosine: Direct and indirect actions on gastric acid secretion. Frontiers in Physiology, 2017, vol. 8, pp. 737. DOI: https://doi.org/10.3389/fphys.2017.00737
- Elkova N. G., Aizman R. I. Age changes in water and electrolyte content in tissues. New Research on Age Physiology, 1988, no. 1, pp. 35–39. (In Russian) URL: https://elibrary.ru/item.asp?id=26097260
- Finkinshtein Ya. D., Aizman R. I., Terner A. Ya., Pantuhin I. V. Reflex mechanism of potassium homeostasis regulation. Sechenov Physiological Journal of the USSR, 1973, vol. 59, no. 9, pp. 1429–1436. (In Russian) URL: https://elibrary.ru/item.asp?id=26097780
- Aizman R. I., Subotyalov M. A. Formation and development of scientific views about physiology of kidneys and water-balance in Novosibirsk. MOJ Anatomy and Physiology, 2017, vol. 4 (3), pp. 308–309. DOI: https://doi.org/10.15406/mojap.2017.04.00136
- Aizman R. I., Finkinshtein Ya. D. Osmo- and ionic liver receptors. Sechenov Physiological Journal of the USSR, 1976, vol. 62, no. 1, pp. 128–136. (In Russian) URL: https://elibrary.ru/item.asp?id=26097680
- Bourque C. W., Oliet S. H. R., Richard D. Osmoreceptors, osmoreception, and osmoregulation. Frontiers in Neuroendocrinology, 1994, vol. 15, issue 3, pp. 231–274. DOI: https://doi.org/10.1006/frne.1994.1010