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WNK1 (with-no-lysine[K]-1) is a protein kinase of which mutations cause a familial hypertension and hyperkalemia syndrome known as pseudohypoaldosteronism type 2 (PHA2). Kidney-specific (KS) WNK1 is an alternatively spliced form of WNK1 kinase missing most of the kinase domain. KS-WNK1 downregulates the Na + -Cl −  cotransporter NCC by antagonizing the effect of full-length WNK1 when expressed in  Xenopus  oocytes. The physiological role of KS-WNK1 in the regulation of NCC and potentially other Na +  transporters  in vivo  is unknown. Here, we report that mice overexpressing KS-WNK1 in the kidney exhibited renal Na +  wasting, elevated plasma levels of angiotensin II and aldosterone yet lower blood pressure relative to wild-type littermates. Immunofluorescent staining revealed reduced surface expression of total and phosphorylated NCC and the Na + -K + -2Cl −  cotransporter NKCC2 in the distal convoluted tubule and the thick ascending limb of Henle's loop, respectively. Conversely, mice with targeted deletion of exon 4A (the first exon for KS-WNK1) exhibited Na +  retention, elevated blood pressure on a high-Na +  diet and increased surface expression of total and phosphorylated NCC and NKCC2 in respective nephron segments. Thus, KS-WNK1 is a negative regulator of NCC and NKCC2  in vivo  and plays an important role in the control of Na +  homeostasis and blood pressure. These results have important implications to the pathogenesis of PHA2 with  WNK1  mutations.

Downregulation of NCC and NKCC2 cotransporters by kidney-specific WNK1 revealed by gene disruption and transgenic mouse models