Renal sympathetic nervous system hyperactivity in early streptozotocin‐induced diabetic kidney disease

Salman, Ibrahim M.; Ameer, Omar Z.; Sattar, M. A.; Abdullah, Nor Azizan; Yam, Mun F.; Abdullah, Ghassan Zuhair; Abdulkarim, Muthanna; Khan, Abdul Hye; Johns, Edward J.

doi:10.1002/nau.21007

Cited by 17 publications

(7 citation statements)

References 34 publications

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“…Recently it was suggested that renal sympathetic innervation plays a role in the pathogenesis of diabetic nephropathy implying early enhancement in renal sensitivity to intrarenal norepinephrine on diabetic renal injury [ 15 ]. Since STZ-diabetes requires several months to determine structural autonomic denervation of the gastrointestinal tract [ 16 ] and of the heart [ 17 ], and no data are available on renal denervation induced by diabetes, we propose surgical renal denervation in SHR injected with STZ to evaluate the effects of renal denervation on cardiovascular reflexes and markers of diabetic nephropathy.…”

Section: Introductionmentioning

confidence: 99%

Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

Dias

Casali

Leguisamo

et al. 2011

Cardiovasc Diabetol

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BackgroundThe effects of renal denervation on cardiovascular reflexes and markers of nephropathy in diabetic-hypertensive rats have not yet been explored.MethodsAim: To evaluate the effects of renal denervation on nephropathy development mechanisms (blood pressure, cardiovascular autonomic changes, renal GLUT2) in diabetic-hypertensive rats. Forty-one male spontaneously hypertensive rats (SHR) ~250 g were injected with STZ or not; 30 days later, surgical renal denervation (RD) or sham procedure was performed; 15 days later, glycemia and albuminuria (ELISA) were evaluated. Catheters were implanted into the femoral artery to evaluate arterial pressure (AP) and heart rate variability (spectral analysis) one day later in conscious animals. Animals were killed, kidneys removed, and cortical renal GLUT2 quantified (Western blotting).ResultsHigher glycemia (p < 0.05) and lower mean AP were observed in diabetics vs. nondiabetics (p < 0.05). Heart rate was higher in renal-denervated hypertensive and lower in diabetic-hypertensive rats (384.8 ± 37, 431.3 ± 36, 316.2 ± 5, 363.8 ± 12 bpm in SHR, RD-SHR, STZ-SHR and RD-STZ-SHR, respectively). Heart rate variability was higher in renal-denervated diabetic-hypertensive rats (55.75 ± 25.21, 73.40 ± 53.30, 148.4 ± 93 in RD-SHR, STZ-SHR- and RD-STZ-SHR, respectively, p < 0.05), as well as the LF component of AP variability (1.62 ± 0.9, 2.12 ± 0.9, 7.38 ± 6.5 in RD-SHR, STZ-SHR and RD-STZ-SHR, respectively, p < 0.05). GLUT2 renal content was higher in all groups vs. SHR.ConclusionsRenal denervation in diabetic-hypertensive rats improved previously reduced heart rate variability. The GLUT2 equally overexpressed by diabetes and renal denervation may represent a maximal derangement effect of each condition.

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Section: Introductionmentioning

confidence: 99%

Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

Dias

Casali

Leguisamo

et al. 2011

Cardiovasc Diabetol

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“…Ang-II exerts complex hemodynamic and nonhemodynamic actions which contribute to DN, namely, induction of systemic vasoconstriction, increased glomerular arteriolar resistance and capillary pressure, increased glomerular capillary permeability, reduction in the filtration surface area, stimulation of ECM proteins, and renal proliferation [14–16]. It is also an important regulator of fluid and electrolyte balance, stimulates aldosterone production, activates the sympathetic nervous system, and increases sodium reabsorption [17, 18]. …”

Section: Approaches To the Treatment Of Dnmentioning

confidence: 99%

New Insight into the Molecular Drug Target of Diabetic Nephropathy

Soetikno

Arozal

Louisa

et al. 2014

International Journal of Endocrinology

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Diabetic nephropathy (DN) lowered quality of life and shortened life expectancy amongst those affected. Evidence indicates interaction between advanced glycation end products (AGEs), activated protein kinase C (PKC) and angiotensin II exacerbate the progression of DN. Inhibitors of angiotensin-converting enzyme (ACEIs), renin angiotensin aldosterone system (RAAS), AGEs, and PKC have been tested for slowing down the progression of DN. The exact molecular drug targets that lead to the amelioration of renal injury in DN are not well understood. This review summarizes the potential therapeutic targets, based on putative mechanism in the progression of the disease.

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“…[ 10 ] In the present case, due to the long-term complication of diabetes mellitus, the patient's renal autonomic nervous system was thought to be overactivated. [ 11 ] In addition, similar to the findings observed in unilateral renal artery stenosis, [ 12 ] unilateral ureteral obstruction stimulates renin secretion from obstructed kidneys and thus activates the renin-angiotensin system. [ 4 ] Consequently, in the present case, such neural and humoral abnormalities may have caused reflex vascular constriction and ureteral spasm in the contralateral kidneys.…”

Section: Discussionmentioning

confidence: 67%

Postrenal acute kidney injury in a patient with unilateral ureteral obstruction caused by urolithiasis

Kazama

Nakajima²

2017

Medicine

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Rationale:In patients with bilateral ureteral obstruction, the serum creatinine levels are often elevated, sometimes causing postrenal acute kidney injury (AKI). In contrast, those with unilateral ureteral obstruction present normal serum creatinine levels, as long as their contralateral kidneys are preserved intact. However, the unilateral obstruction of the ureter could affect the renal function, as it humorally influences the renal hemodynamics.Patient concerns:A 66-year-old man with a past medical history of hypertension and diabetes mellitus came to our outpatient clinic because of right abdominal dullness.Diagnoses:Unilateral ureteral obstruction caused by a radio-opaque calculus in the right upper ureter and a secondary renal dysfunction.Interventions:As oral hydration and the use of calcium antagonists failed to allow the spontaneous stone passage, extracorporeal shock wave lithotripsy (ESWL) was performed.Outcomes:Immediately after the passage of the stone, the number of red blood cells in the urine was dramatically decreased and the serum creatinine level almost returned to the normal range with the significant increase in glomerular filtration rate.Lessons:Unilateral ureteral obstruction by the calculus, which caused reflex vascular constriction and ureteral spasm in the contralateral kidney, was thought to be responsible for the deteriorating renal function.

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Renal sympathetic nervous system hyperactivity in early streptozotocin‐induced diabetic kidney disease

Cited by 17 publications

References 34 publications

Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

Renal denervation in an animal model of diabetes and hypertension: Impact on the autonomic nervous system and nephropathy

New Insight into the Molecular Drug Target of Diabetic Nephropathy

Postrenal acute kidney injury in a patient with unilateral ureteral obstruction caused by urolithiasis

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