Impact of mineralocorticoid receptor polymorphisms on urinary electrolyte excretion with and without diuretic drugs

Pharmacogenomics. 2015 Jan;16(2):115-27. doi: 10.2217/pgs.14.163.

Abstract

Aim: Polymorphisms in the mineralocorticoid receptor may affect urinary sodium and potassium excretion. We investigated polymorphisms in the MR gene in relation to urinary electrolyte excretion in two separate studies.

Patients & methods: The genotype-phenotype association was studied in healthy volunteers after single doses of bumetanide, furosemide, torsemide, hydrochlorothiazide, triamterene and after NaCl restriction.

Results: High potassium excretion under all conditions except torsemide, and high NaCl excretion after bumetanide and furosemide were associated with the A allele of the intron-3 polymorphism (rs3857080). This polymorphism explained 5-10% of the functional variation and in vitro, rs3857080 affected DNA binding of the transcription factor LHX4.

Conclusion: rs3857080 may be a promising new candidate for research in cardiac and renal disorders and on antialdosteronergic drugs like spironolactone.

Keywords: LHX4; NR3C2; aldosterone; antihypertensive agents; hydrochlorothiazide; loop diuretics; mineralocorticoid receptor; pharmacogenetics; polymorphisms; triamterene.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Bumetanide / pharmacology
  • Cross-Over Studies
  • Diuretics / pharmacology*
  • Electrolytes / urine*
  • Furosemide / pharmacology
  • Genetic Association Studies
  • Humans
  • Hydrochlorothiazide / pharmacology
  • Male
  • Middle Aged
  • Polymorphism, Genetic / genetics*
  • Polymorphism, Single Nucleotide / genetics
  • Potassium / urine
  • Receptors, Mineralocorticoid / drug effects
  • Receptors, Mineralocorticoid / genetics*
  • Single-Blind Method
  • Sodium Chloride / urine
  • Sulfonamides / pharmacology
  • Torsemide
  • Triamterene / pharmacology
  • Young Adult

Substances

  • Diuretics
  • Electrolytes
  • Receptors, Mineralocorticoid
  • Sulfonamides
  • Hydrochlorothiazide
  • Bumetanide
  • Sodium Chloride
  • Furosemide
  • Potassium
  • Torsemide
  • Triamterene