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NDT Advance Access published online on July 24, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn411
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Over-expression of colonic K+ channels associated with severe potassium secretory diarrhoea after haemorrhagic shock

Marion Simon1, Jean-Paul Duong2, Vincent Mallet3, Raymond Jian1, Kenneth A. MacLennan4, Geoffrey I. Sandle5 and Philippe Marteau1

1 Gastroenterology Unit, European Hospital G. Pompidou, APHP, Paris, France 2 Cytology Unit, European Hospital G. Pompidou, APHP, Paris, France 3 Intensive Care Unit, Cochin Hospital, AP-HP, Paris, France 4 Cancer Research UK Clinical Cancer Centre 5 Institute of Molecular Medicine, St. James's University Hospital, Leeds, UK

Correspondence and offprint requests to: Marion Simon, Department of Digestive Diseases, Saint Louis Hospital, 1 Avenue Claude Vellefaux, 75010 Paris, France. Tel: +33-1-42499546; Fax: +33-1-42499168; E-mail: marion.simon3{at}free.fr



  Abstract

A 67-year-old woman with end-stage renal disease (ESRD) was referred with chronic diarrhoea, severe hypokalaemia and recurrent colonic pseudo-obstructions following haemorrhagic shock. The cause of secretory diarrhoea was uncertain, but an ileostomy identified the colon as the source of the watery diarrhoea and potassium (K+) losses, and symptoms only resolved after colectomy. Immunohistochemistry of the colon revealed over-expression of high conductance K+ (BK) channel protein in surface colonocytes and crypt cells compared with controls and other patients with ESRD. We hypothesize that colonic ischaemia during haemorrhagic shock led to increased BK channel expression and thus enhanced colonic K+ and water secretion, resulting in severe hypokalaemia and colonic pseudo-obstruction.

Keywords: colonic K+ channel; colonic K+ secretion; ischaemic colitis; secretory diarrhoea

Received for publication: 20. 5.08
Accepted in revised form: 27. 6.08


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