Low sodium intake induces an increase in renal monoamine oxidase activity in the rat. Involvement of an angiotensin II dependent mechanism

AIMS

The interplay between natriuretic dopamine and antinatriuretic angiotensin II represents an important mechanism for the regulation of renal sodium and water excretion. Monoamine oxidase is the main metabolizing pathway for dopamine in the renal cortex. In this study, we have analysed the effect of low sodium feeding and AT1 receptor blockade on renal dopamine metabolism by monoamine oxidase.

METHODS

Four groups of rats were studied: 1, normal salt diet (NS); 2, low salt diet (LS); 3, NS receiving Losartan (Los, specific AT1 receptor antagonist, 20 mg kg(-1) bwt day(-1), NS + Los); 4, LS receiving Los (LS + Los).

RESULTS

Urinary dopamine excretion was lower in LS than in NS rats (543 +/- 32 vs. 680 +/- 34 ng day(-1) 100 g(-1) bwt, P < 0.05). When treated with Los, DOPAC excretion and urinary DOPAC/dopamine ratio fell significantly in the LS + Los group as compared with the LS group (1199 +/- 328 vs. 3081 +/- 681 ng day(-1) 100 g(-1) bwt and 1.90 +/- 0.5 vs. 5.7 +/- 1.2, respectively, both P < 0.02). Losartan increased hydroelectrolyte excretion in the LS group. No changes were found in the NS + Los group. Aromatic L-amino acid decarboxylase activity in cortex was similar in NS and LS rats. Instead, monoamine oxidase activity was higher in cortical homogenates from LS rats (in nmol mg tissue(-1) h(-1): NS 7.66 +/- 0.52; LS 9.82 +/- 0.59, P < 0.05) and this difference was abolished in LS + Los rats (7.34 +/- 0.49 nmol mg tissue(-1) h(-1), P < 0.01, vs. LS).

CONCLUSIONS

We have concluded that low levels of dopamine in the urine of LS rats are because of an increase in the activity of renal monoamine oxidase and that angiotensin II mediates this increase through stimulation of AT1 receptors.

Depressed eruption dental rate in rats with hemodynamically-mediated acute renal failure

The effects of acute renal failure on the impeded (IER) and unimpeded (UER) eruption dental rate and attrition rate (AR) were investigated. Adult female Wistar rats were injected with 125 mg/kg b.w of human methemoglobin (M-Hb) in order to induce a first episode of hemodynamically-mediated acute renal failure (H-ARF). Ten days after the injection of M-Hb, other groups of rats received another equal dose of the drug in order to induce a second episode of H-ARF. A group of six animals was pair-fed daily and individually with rats of M-Hb groups. Evaluation of renal function, histopathology studies, IER, UER, food intake (FI), AR and body weight gains was performed at different times after the first and second injections, of M-Hb. Treatment induced transient increases in plasma urea concentration and urine volume, and significant depression in urine osmolality, body weight gains, IER, UER and AR. In every case, the maximal effect of the first injection of M-Hb on the individual parameters was always greater than that of the second injection. Histologic sections showed interstitial cellular infiltration, desquamation of the proximal tubular epithelium and collapse or dilation of the tubular lumen. The functional values of kidney, histologic findings, IER, UER and AR of the pair-fed rats were not significantly different from control values. The results of the present study indicate that dental eruption rate (IER and UER) is relatively low in uremic rats with kidney tubule lesions and that both parameters are related.

Isolated polycystic liver disease not linked to polycystic kidney disease 1 and 2

Autosomal dominant polycystic liver disease occurs commonly in association with autosomal dominant polycystic kidney disease, types 1 and 2. It may also exist as a separate entity, genetically distinct from autosomal dominant polycystic kidney disease types 1 and 2, as has been recently established to exist in a Belgian family. We report here a large Argentinian family of Spanish-Belgian ancestry with autosomal dominant polycystic liver disease, where proximal and distal markers for both polycystic kidney disease 1 and 2 failed to demonstrate genetic linkage. The data support the notion that polycystic liver disease and autosomal dominant polycystic kidney disease may have separate chromosomal loci.

Regulation of cell cyclic AMP in medullary thick ascending limb of Henle in a rat model of chronic renal failure

Chronic renal failure (CRF) is accompanied by adaptive changes in electrolyte reabsorption in the thick ascending limb of Henle of surviving nephrons. To study the cellular mechanism of this adaptation, we measured intracellular cAMP in micro-dissected medullary thick ascending limb (mTAL) segments in rats with CRF. mTAL exhibited in CRF an increase of basal cAMP from 25.6 +/- 10.0 in controls to 65.8 +/- 11.3 fmol mm-1 tubule in CRF (P < 0.05). Vasopressin and calcitonin stimulated mTAL adenylate-cyclase in a dose-dependent manner in controls but failed to stimulate in CRF. Likewise, maximal stimulation with 10(-3) M 3-isobutyl-1-methylxanthine (IBMX) plus 10(-5) M forskolin increased cAMP in controls to 63.0 +/- 16.0 but not in CRF, where maximal stimulated values remained at 63.1 +/- 18.8 fmol mm-1 tubule (P NS). Alpha2-adrenoreceptor activation with clonidine at concentrations ranging from 10(-8) to 10(-6) M diminished cAMP production by 37% in CRF (P < 0.05), whereas no differences were found in controls. Thus, the basal intracellular cAMP is increased in rat mTAL in CRF. The finding that neither forskolin nor vasopressin were able to further augment intracellular cAMP would suggest that stimulatory pathways of the adenylate-cyclase system are activated in the basal state. However, mTAL cells in CRF seem to retain the response of normal epithelium to inhibitory pathways such as the one mediated by alpha2-adrenoreceptors.

Changes in glomerular filtration rate and renal plasma flow in cirrhotic rats during converting enzyme inhibition

During the development of cirrhosis ascites-edema, peripheral vasodilatation, hypotension and an increase of the plasma concentration of several neurohormones are frequently observed. Such complex changes in the hormonal profile hinders the assessment of the relative role of each in the pathophysiology of this disease. The purpose of this work was to evaluate in a rat model of experimental cirrhosis (phenobarbital/CCl4) the role of the renin-angiotensin system in the pre-ascitic stage of the disease using the converting enzyme inhibitor captopril. Cirrhotic rats showed diminished renal and hepatic perfusion. Compared to normal rats, glomerular filtration rate in cirrhotic rats was reduced from 0.75 +/- 0.11 to 0.42 +/- 0.06 mL/min/100 g BW, and renal plasma flow was reduced from 2.37 +/- 0.28 to 1.58 +/- 0.16 mL/min/100 g BW; the indocyanine green slope changed from -0.095 +/- 0.028 to -0.057 +/- 0.01; the plasma sodium concentration fell from 144 +/- 1.5 to 131 +/- 5.40 mEq/L (all < .05). The mean arterial pressure was not reduced in the cirrhotic rats. There was no ascites. Both the acute (25 mg i.v.) and chronic (25 mg i.p. daily plus 25 mg/L in drinking water) administration of captopril to cirrhotic rats induced an increase in glomerular filtration rate and renal plasma flow along with a steeper slope in indocyanine green decay (p < .05 for all three parameters) when compared to non-treated cirrhotic animals. No changes were observed in controls. In the balance studies, an increase in urinary volume along with a decrease in urinary osmolality was recorded in cirrhotic rats on chronic captopril treatment. In conclusion, our results show an activation of the renin-angiotensin system in these rats, as disclosed by the inhibition of the converting enzyme, as well as a possible interaction with ADH.

Genetic heterogeneity of autosomal dominant polycystic kidney disease in Argentina

Autosomal dominant polycystic kidney disease (ADPKD) is an inherited disorder with genetic heterogeneity. Up to three loci are involved in this disease, PKD1 on chromosome 16p13.3, PKD2 on 4q21, and a third locus of unknown location. Here we report the existence of locus heterogeneity for this disease in the Argentinian population by performing linkage analysis on 12 families of Caucasian origin. Eleven families showed linkage to PKD 1 and one family showed linkage to PKD2. Two recombinants in the latter family placed the locus PKD2 proximal to D4S1563, in agreement with data recently published on the cloning of this gene. Analysis of clinical data suggests a milder ADPKD phenotype for the PKD2 family.

Is the increase in renal papillary phospholipid biosynthesis a protective mechanism against injury?

Mercuric chloride (HgCl2) is a well-known renal toxic that causes acute renal failure. The effect of HgCl2 treatment and the protection by thyroxine were studied in rat renal papilla (P), outer medullary inner stripe (OMIS), outer medullary outer stripe (OMOS) and cortical phospholipids (PhLs). HgCl2 brought about an increase in the total phospholipid content in P and OMIS but a drop in OMOS and cortex. Only phosphatidylcholine (PtdCho) and phosphatidylethanolamine (PtdEtn) accounted for such changes. Thyroxine, injected on HgCl2-treated rats, partially reversed the effect of the toxic metal in P and OMIS while completely reversed the PtdCho drop in OMOS and cortex. However, the hormone failed to recover the sphingomyelin increase in P, the PtdEtn shortage in OMIS, OMOS and partially reversed the drop in the cortex. When thyroxine was injected without toxic treatment, no effect was observed in the phospholipid content of any kidney zone. Results obtained by using 32P as a precursor to study the PhL de novo synthesis were consistent with those of the phospholipid content. Thus a radioactivity increase--associated with PtdCho and PtdEtn--was observed in the kidney zones where said endogenous PhLs had risen. But in OMOS and cortex, where PtdCho and PtdEtn had dropped, they were also accompanied by a decrease in radioactivity. The thyroxine-induced recovery phase also paralleled the phospholipid content results with those of the de novo synthesis. We suggest that the decrease in the renal phospholipid de novo synthesis may constitute one biochemical explanation of the selective renal toxic effect exerted by HgCl2 and that the increase observed in the renal phospholipid metabolism--induced by the toxic treatment in OMIS and P--may represent a protective mechanism of these zones against toxic injury. Moreover, recovery promoted by thyroxine treatment in OMOS and cortex was accompanied by the reversion of the corresponding PtdCho decrease induced by HgCl2.

Accelerated recovery from toxic acute renal failure with thyroxin: stimulation of renal phospholipid biosynthesis

Thyroxine (T4) seems to accelerate recovery from various forms of acute renal failure. The mechanisms of this effect are still debated. We decided to evaluate if thyroxine enhances the recovery of HgCl2 renal failure through an increment in the mitotic activity or through an increase in membrane phospholipid biosynthesis of the regenerating tubular cells. Male Wistar rats were allocated to four groups: one group received 0.4 mg/100 g BW HgCl2 SC and saline IP (HgCl2 group); the second received the toxin and 24 and 48 h after it, T4 15 micrograms/100 g BW IP (HgCl2 + T4 group); a third group received saline SC and T4 IP (T4 group), and the last group received saline SC and IP (control group). On the third day GFR was evaluated by 24-h creatinine clearance and afterward rats were sacrificed and the kidneys removed. Some of them were studied histologically, evaluating the severity of the tubular lesion using a semiquantitative score (0-4) and the mitotic index (N mitotic figures per 10 high-power fields). In the other kidneys we studied phospholipid synthesis through the incorporation of 32 P into the different renal phospholipids of the several kidney regions. The T4-treated group had a better recovery of GFR after the toxin (HgCl2 + T4: 0.44 +/- .09 vs. HgCl2: 0.23 +/- .06, p < .05). Both HgCl2-treated groups had similar lesional scores and mitotic indexes.(ABSTRACT TRUNCATED AT 250 WORDS)

Portal pressure, renal function and hormonal profile after acute and chronic captopril treatment in cirrhosis

The acute effects of captopril in cirrhosis are well known but there are few descriptions of the pattern of response to chronic administration of captopril in this disease. Nine nonuraemic cirrhotic patients with ascites and portal hypertension were studied after 1 week on fixed sodium and water intake (balance diet) and following acute and chronic treatment with captopril (three doses of 25 mg every 30 min and 75 mg.day-1 for three weeks, respectively). Whilst on the balance diet, 7/9 patients were unable to excrete the amount of sodium ingested. After the acute administration of captopril, a significant reduction was seen in arterial blood pressure (86.9 vs 77 mm Hg), with no change in the intra-hepatic pressures (free suprahepatic pressure, FSHP: 15.0 vs 12.1 mm Hg and wedged suprahepatic pressure, WSHP: 22.9 vs 20.7 mm Hg). After chronic captopril treatment, a drop was observed in portal pressure (FSHP: 9.4 mm Hg and WSHP 18.8 mm Hg, NS) and the arterial pressure returned to its basal level. The plasma aldosterone concentration decreased, whilst noradrenaline and dopamine increased significantly, the latter more than the former, leading to a reduction in the noradrenaline/dopamine ratio (14.5 vs 5.0). Seven out of nine patients showed enhanced natriuresis and the remaining two, who previously had had a positive sodium balance failed to do so. These haemodynamic, hormonal and renal changes were interpreted as evidence of blockade of angiotensin II generation by captopril, and also as a homoeostatic response by the sympathetic nervous system.

Growth of the skeletal units of the rat mandible in acute renal failure experimental model

A study of the effect of acute renal failure (ARF) on the growth of the skeletal units of the mandible was performed. Male Wistar rats weighing 35-40 g were assigned to three groups. One of the groups received a basal choline-deficient diet ad libitum. A second group was pair-fed with the first one and was given a basal diet supplemented with 0.35 g choline chloride/100 g of diet. The third group was fed a basal diet plus 0.35 g choline chloride/100 g of diet ad libitum and used as the normal control. Body length, renal function parameters and measurements of the mandible were recorded at the end of a 12-day period on the different diets. Food intake and body weight were recorded every day. Plasma urea and creatinine concentrations markedly increased over the first 12 days of exposure to a choline-deficient diet. Significant increases in urine volume and significant depressions in urine osmolality were also observed. The average body weight and body length gains for rats given the choline-deficient diet were lower than those of control rats. There were no significant differences between the average body weight and body length of pair-fed and normal rats. All skeletal measurements of the mandible of the choline-deficient group differed significantly from those of the control group. These differences varied between 7% and 30%. The skeletal units of the mandible of the pair-fed group did not differ significantly from ad libitum controls. This study suggests that this rat model can be used for the investigation of the different alterations observed in uremia.(ABSTRACT TRUNCATED AT 250 WORDS)

Focal glomerulosclerosis in children: an Argentinian experience

Twenty-six children presenting with idiopathic nephrotic syndrome and a histological diagnosis of focal glomerulosclerosis were studied retrospectively to evaluate their response to treatment, outcome and clinicopathological correlations. Twenty-two patients (84.6%) were steroid resistant; of these, 8 of the 19 with focal segmental glomerulosclerosis and 2 of the 3 with focal global glomerulosclerosis responded to cyclophosphamide (CY) within 16 weeks of starting therapy. Seven patients relapsed after a CY-induced remission, but 5 of them became steroid responsive. After an average follow-up of 83 months, 17 patients are in remission with normal renal function, 3 patients have persistent nephrotic range proteinuria and 6 patients are in chronic renal failure. Persistence of proteinuria, a high percentage of segmentally sclerotic glomeruli and diffuse mesangial proliferation were indicators of poor prognosis. We believe longer courses of CY therapy than those traditionally utilized are responsible for the relatively good results in our patients.

Renal response to a protein meal in children with single kidneys

The renal response of healthy adults to an oral protein load results in a significant increase of renal plasma flow (RPF) and glomerular filtration rate (GFR) 100 to 150 min after the meal. The renal response to protein loading of single kidney adults is unclear and it has not been evaluated yet in children. Therefore, we studied 8 children 10.2 +/- 1.1 years old, 6.7 +/- 1.41 years after nephrectomy (SK) and 4 healthy children (C). RPF was estimated by para-amino-hippurate clearance (Cpah) and GFR by inulin clearance (Cin) before and after an oral protein load of 1.5 g protein/kg body wt and expressed in ml/min/1.73 m2 BSA. Mean baseline Cin were similar in SK and in C (90 +/- 8 vs 103 +/- 12) while baseline Cpah was lower in SK (339 +/- 19 vs 481 +/- 36, p less than 0.005). After the meal GFR and RPF increased significantly in C (155 +/- 18 and 783 +/- 68, p less than 0.005 and p less than 0.05 vs baseline values, respectively) whereas no significant GFR and RPF changes were seen in SK (81 +/- 9 and 350 +/- 42, respectively). However, the 3 SK children with lower protein intake showed a mild vasodilating response. We conclude that in single kidney children hyperfiltration occurs at baseline conditions and the renal response to acute protein loading is partially or completely blunted, being modulated by protein intake.

Voltage dependence and barium sensitivity of colonic K secretion in renal failure

Net colonic K secretion (JKnet) is increased in rats and humans with chronic renal failure (CRF). To study whether transepithelial potential difference (PD), active transport forces and/or luminal K conductance play a role in this adaptation, experiments were performed in the colon of control, K-adapted, and CRF rats. Under basal conditions the PD in vivo in CRF was greater than in controls and not different from K-adapted rats. JKnet was comparable in vivo in CRF and K-adapted rats and was greater than in controls. Amiloride (10 microM) reduced PD and JKnet in K-adapted and CRF rats to levels comparable to controls. Under in vitro short-circuited conditions serosal-to-mucosal K flux (JKs----m) in distal colon was significantly increased in K-adapted and CRF animals compared with control, whereas barium caused a significant reduction in JKs----m in all groups of animals. The barium-sensitive component of K secretion was greater, however, in the two experimental groups (-0.2 +/- 0.02 and -0.2 +/- 0.07 in K-adapted and CRF animals, respectively, vs. -0.08 +/- 0.02 microeq.h-1.cm-2 in controls, P less than 0.05). However, luminal barium failed to completely inhibit the increase in K secretion observed in the experimental groups. These data suggest that an increase in PD that results in a rise in luminal negativity, stimulation of active transport, and an increase in barium-sensitive K channels and barium-insensitive pathways in apical membrane of distal colon participate in the mechanism by which net K secretion is increased in the large intestine of subjects with CRF.

Mechanism of enhanced transcellular potassium-secretion in man with chronic renal failure

Previous studies from our laboratory demonstrated that net K secretion in human rectum was 2.5-fold higher in patients with chronic renal failure than in controls. The present study was performed to determine whether K secretion in human large intestine involves an active process and whether an active transport process accounts, at least in part, for the rise in net K secretion in patients with renal insufficiency. Studies were performed under conditions when net water and electrolyte transport approached zero, and the observed distribution of K and Na across the rectal mucosa was compared to expected equilibrium values. In control subjects an active transport of 27.6 +/- 2.6 mV was observed for K and 63 +/- 4.2 mV for Na. Similar values were demonstrated in patients with chronic renal failure. The results of these studies demonstrated that net secretion of K and absorption of Na are governed, at least in part, by active transport processes, and suggest that, since active K secretion is not impaired, the rise in net K secretion in patients with renal insufficiency is caused by active secretion as well as by passive driving forces.

Failure of potassium adaptation in vivo in the colon of aldosterone-deficient rats

Prolonged potassium loading results in an adaptive change in colonic epithelium that increases the capacity for potassium excretion. We evaluated the role of aldosterone in colonic potassium adaptation, because potassium loading also increases the production of aldosterone. Experiments were performed in intact animals and in adrenalectomized rats with a high potassium intake replaced over a prolonged period with low physiologic amounts of corticosterone to provide a stable plasma level of 3 to 5 micrograms/dl. Net electrolyte movement and transmural potential difference were measured by an in vivo luminal perfusion technique. Compared with the rate of potassium secretion of -3.6 +/- 0.5 mu Eq/min/gm dry weight in potassium-loaded rats with intact adrenal glands, net secretion was significantly impaired (P less than 0.025) in potassium-loaded adrenalectomized animals with only corticosterone replacement (-1.1 +/- 0.5 mu Eq/min/gm dry weight). The rate in adrenalectomized animals, however, was comparable to that in intact animals receiving a normal potassium intake (0.3 +/- 0.2 mu Eq/min/gm dry weight). In addition, in intact animals prolonged potassium loading significantly increased transmural potential difference to -68 +/- 6 mV (P less than 0.005), compared with that in adrenalectomized, corticosterone-replaced, potassium-loaded animals (-30 +/- 4 mV) and intact animals with a normal intake of potassium (-25 +/- 7 mV). Net sodium absorption was reduced in aldosterone-deficient animals compared with the value in control and potassium-loaded animals with intact adrenal glands. These data indicate, therefore, that potassium adaptation is not induced in the absence of aldosterone and suggest that hyperaldosteronism plays an important role in induction of colonic potassium adaptation.

Increased secretion of potassium in the rectum of humans with chronic renal failure

Previous studies have shown that the intestinal excretion of potassium increases in patients with renal failure and serves to guard against severe potassium retention. It is not known, however, whether the rise in intestinal potassium excretion occurs because of an increase in intestinal potassium secretion or a reduction in potassium absorption. Therefore, studies were performed to evaluate the rate of potassium secretion in the human rectum of controls and subjects with renal insufficiency, using a dialysis bag technique. The results demonstrate that net potassium secretion was increased in subjects with renal failure (-5.2 +/- 0.9 microEq X min-1) compared with the control value of -2.0 +/- 0.4 microEq (P less than .05). This change in intestinal secretion of potassium was shown to be independent of the passive effects of plasma potassium. The rise in potassium secretion, however, correlated directly with an increase in transepithelial potential difference (lumen-negative). Although plasma aldosterone levels were higher in patients than in controls, the scatter of data precludes an assessment of the role of aldosterone in the mechanism of the rise in potassium secretion. These data suggest that augmented intestinal potassium excretion in patients with chronic renal insufficiency is caused by increased net potassium secretion in the large intestine, and highlight the role of the intestine in maintaining potassium balance.

Relationship between severity of renal damage and erythropoietin production in uranyl nitrate-induced acute renal failure

Adult female Wistar rats were injected with 1 mg/kg body weight of uranyl nitrate (UN). Evaluation of renal function, histopathology studies, and determination of plasma erythropoietin (Ep) titers after exposure to 456 mb for 16 h were performed at 1, 2, 7, 10, 15, and 21 days after drug injection. Plasma urea and creatinine concentrations markedly increased during the first seven days after injection, reaching maximal values on day 7 and decreasing thereafter. Significant increases in urine volume and significant depressions in urine osmolality also were observed; both alterations were most marked on day 7 after injection. A coagulative necrosis of the epithelium of proximal convoluted tubules, desquamation of the necrotic cells, and dilation or collapse of the tubular lumen were observed; the lesions were more marked on day 7. Plasma Ep levels in UN-treated rats exposed to hypobaria were markedly lower than in noninjected controls similarly exposed. Measurements were performed one, two, and seven days after UN injection, with maximal depression observed on day 7. These observations indicate that there is a correlation between the extent of both tubule damage and degree of renal dysfunction and plasma Ep production during exposure to hypoxia in UN-treated rats. This suggests that the renal Ep component is derived primarily from tubular cells.