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| MODULATION OF GLOMERULAR HYPERTENSION DEFINES SUSCEPTIBILITY TO PROGRESSIVE GLOMERULAR INJURY |
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| Author(s): SIMONS JL, PROVOOST AP, ANDERSON S, RENNKE HG, TROY JL, BRENNER BM |
| Source: KIDNEY INTERNATIONAL Volume: 46 Issue: 2 Pages: 396-404 Published: AUG 1994 |
| Times Cited: 73 References: 45 |
| Abstract: The fawn-hooded rat constitutes a spontaneous model for chronic renal failure with early systemic and glomerular hypertension, proteinuria(UpV) and high susceptibility to development of focal and segmental glomerular sclerosis (FGS). It has been argued that uninephrectomy (UNX) accelerates the development of glomerular injury by aggravation of glomerular hypertension and by an independent effect to promote glomerular enlargement. The present study was performed to further delineate the importance of these parameters for the development of FGS. At the age of eight weeks male rats were UNX and randomly assigned to either control (CON), enalapril (ENA) or N-w-nitro L-arginine methyl ester (NAME) treatment. In all groups glomerular hemodynamic studies were performed four weeks post-UNX. Systemic blood pressure and UpV were monitored for 4 to 12 weeks post-UNX. Kidneys were then prepared for morphologic study. ENA treatment achieved control of both systemic and glomerular hypertension, maintenance of glomerular hyperfiltration and hyperperfusion, increased ultrafiltration coefficient(K-f), and long-term protection against UpV and FGS. NAME rats showed aggravation of both systemic and glomerular hypertension, decreased renal perfusion and filtration with reduced K-f, and high filtration fraction. The incidence of FGS in NAME and CON groups was similar at 8 and 12 weeks post-UNX, respectively. Glomerular enlargement was present in CON and ENA rats, but did not correlate with injury, while glomerular tuft size was lowest in NAME rats, which displayed prominent glomerular injury. Systemic blood pressure correlated strongly with glomerular capillary pressure. We conclude that systemic and glomerular hypertension govern the development of UpV and FGS. Renal protection with converting enzyme inhibition is achieved by controlling glomerular hypertension in this highly susceptible model. |
| Document Type: Article |
| Language: English |
Addresses:
1. ERASMUS UNIV ROTTERDAM, DEPT PEDIAT SURG, SURG LAB, 3000 DR ROTTERDAM, NETHERLANDS
2. HARVARD UNIV, BRIGHAM & WOMENS HOSP, SCH MED, HARVARD CTR STUDY KIDNEY DIS, DIV RENAL, BOSTON, MA 02115 USA
3. HARVARD UNIV, BRIGHAM & WOMENS HOSP, SCH MED, HARVARD CTR STUDY KIDNEY DIS, DEPT PATHOL, BOSTON, MA 02115 USA |
| Publisher: BLACKWELL SCIENCE INC, 238 MAIN ST, CAMBRIDGE, MA 02142 |
| Subject Category: Urology & Nephrology |
| IDS Number: NX941 |
| ISSN: 0085-2538 |
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| | | | | | | | | Record from Web of Science® | | | | | | | | | |