Renin angiotensin system (RAS) blockade reduces the progression of chronic kidney disease (CKD) independently of its antihypertensive effect. Ang II-induced fibrosis can be mediated by molecules such as klotho, peroxisome proliferator-activate receptor γ (PPAR-γ), and the Wnt/β-catenin pathway; however, the interaction among these molecules and RAS activation is not completely known. The aim of this study was to investigate a possible link between RAS, PPAR-γ, and Klotho in the 5/6 nephrectomy (NX) animals. NX rats presented hypertension that was blunted by both losartan and propranolol, however, only losartan was able to reduce the expression levels of fibronectin FSP1 and TGF-β in the remnant kidney. The anti-fibrotic Klotho and PPAR-γ were reduced in the remnant kidney, and losartan, but not propranolol, restored their levels. In contrast, the profibrotic Wnt 7a and Wnt 3 were upregulated and losartan prevented the increase in Wnts. In vitro, Ang II induced a decrease in both klotho and in PPAR-γ in Madin-Darby canine kidney (MDCK) cells, and this effect was blunted by losartan. However, klotho expression was increased by pioglitazone, an agonist of PPAR-γ, and suppressed by BADGE, an antagonist of PPAR-γ, suggesting that the effect of Ang II downregulating klotho is mediated by PPAR-γ. These data suggest that activation of the Wnt pathway together with downregulation of PPAR-γ that in turn suppresses klotho contribute to potentiating the profibrotic effect of Ang II.

Background/Aim: Chronic kidney disease (CKD) is an increasing major public health problem worldwide. The sympathetic nervous system and nitric oxide play an important role in the pathogenesis of CKD. Traditional Chinese medicine has accumulated thousands of years of therapeutic experiences. Electroacupuncture (EA) and moxibustion (MO) are two such therapeutic strategies. The aim of this study was to investigate the renal and hemodynamic effects of EA-MO in an experimental model of a CKD. Methods: Male Wistar rats submitted to 5/6th nephrectomy (5/6 NX) were studied for 8 weeks. There were four groups: (1) control, normal rats; (2) NX, 5/6 NX only; (3) NX-AS, 5/6 NX and EA-MO session using sham points, and (4) NX-AM, 5/6 NX and EA-MO session using real acupoints. Biochemical and blood pressure studies, renal sympathetic nerve activity measurements, nitric oxide levels and the histopathological indices were assessed. Results: The EA- and MO-treated group presented significant improvement in all measured functional and histopathological parameters. Conclusion: These findings suggest that EA-MO had beneficial effects on CKD. This effect was probably achieved by the modulation of the renal sympathetic nerve activity and nitric oxide levels, leading to decreased blood pressure, which is associated with less proteinuria.

Background/Aim: Chronic kidney disease is a worldwide public health problem and the prevention of its progression is still a major challenge in nephrology. Specific therapies that inhibit or attenuate this process are neither available nor satisfactory. Traditional Chinese medicine has been increasingly recognized as an effective therapeutic approach in several fields of medicine. The aim of this study was to investigate the effects of electroacupuncture (EA) and moxibustion (MO) in an experimental model of progressive renal disease in rats. Methods: Twenty-one male Wistar rats were submitted to 5/6th nephrectomy (NX) and assessed 8 weeks later and were divided into three groups: NX = only 5/6 NX, NX-AS = 5/6 NX and a 20-min EA-MO session in sham points, and NX-AM = 5/6 NX and a 20-min EA-MO session in three real acupuncture points. The treatment consisted of 16 sessions twice a week. Renal function, urine volume, serum creatinine, 24-hour proteinuria, direct and indirect blood pressure, glomerulosclerosis and tubulointerstitial fibrosis indices were assessed. Results: The NX-AM group showed a significant decrease in all investigated parameters when compared to the control groups. Conclusion: Our results suggest that EA and MO attenuated the progression of renal disease in the experimental model of 5/6 NX.

Traditional Chinese Medicine (TCM) has been increasingly recognized as an effective therapeutic approach in several fields of medicine. Among its therapeutic strategies are electroacunpucture (EA) and moxibustion (MO). The aim of this study was to investigate the renal and hemodynamic effects of EA‐MO in an experimental model of PDR in rats. Male wistar rats were submitted to 5/6 nephrectomy (5/6 nx) for eight weeks and divided in three groups. Control (NX); Sham‐EA‐MO (NX‐AS): 5/6 nx and EA‐MO session in sham‐points; and EA‐MO (NX‐AM): 5/6 nx and EA‐MO session in real points. Biochemical studies, blood pressure (MAP) and renal sympathetic nerve activity (RSNA) measurement and Nitric Oxide Levels (NO) were assessed. Groups 24hproteinuria (mg/24h) MAP (mmHg) Serum NO (μM) RSNA (Hz) NX 153,86±22,93 181,23±20,01 65,02±13,75 207,11±41,82 NXAS 159,37±43,98 174,25±12,17 59,93±14,93 176,52±19,32 NXAM 75,30±8,30* 121,67±15,52* 162,92±42,19* 129,66±10,31* (p<0,05: * vs NX, NX‐AS) Our results suggest that EA‐MO had a benefic effects by the modulation of RSNA and increase NO levels, which contribute to the hypotensive effects and attenuated the PDR in the experimental model of 5/6 nephrectomy.Supported by CNPq

A técnica de Meditação de Atenção Plena (Mindfulness) é definida como um método de atenção na experiência do momento presente de forma receptiva sugerindo uma nova postura por meio de um entendimento consciente do que acontece à sua volta, deste modo, diminuindo os fatores emocionais e fisiológicos, intervindo por meio da reatividade afetiva com benefícios mentais e físicos na saúde. Para isto, foi realizado uma análise quantitativa do controle de estresse com a prática Mindfulness entre duas cidades do Vale do Paraíba visto a escassez de evidencias iniciais na região, o estudo inicial foi realizado em 8 sessões em uma amostra delimitada aleatoriamente de 20 participantes (8 homens e 12 mulheres). Os resultados demonstraram o potencial que a prática possibilitou nas duas amostras avaliadas, com a melhora nos indicadores de estresse após o período da prática (P= 0,022 e P=0,003), além disso, foi possível avaliar o potencial de controle que a prática proporcionou (P= 0,002). Portanto, os resultados obtidos indicam o potencial de melhora nos indicadores analisados e que a prática contínua do método de Atenção Plena- Mindfulness, influencia na qualidade de vida dos indivíduos da sociedade e propicia bem-estar.