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2015 ; 11
(8
): 892-900
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Mild ischemic injury leads to long-term alterations in the kidney: amelioration
by spironolactone administration
#MMPMID26157344
Barrera-Chimal J
; Pérez-Villalva R
; Ortega JA
; Sánchez A
; Rodríguez-Romo R
; Durand M
; Jaisser F
; Bobadilla NA
Int J Biol Sci
2015[]; 11
(8
): 892-900
PMID26157344
show ga
Administration of the mineralocorticoid receptor antagonist spironolactone
prevents the development of chronic kidney disease (CKD) after a severe ischemic
injury. However, whether brief periods of ischemia lead to CKD and whether
spironolactone administration after ischemia may be a useful therapeutic strategy
to prevent the gradual deterioration of structure and function remains
unexplored. Nineteen male Wistar rats were divided into four groups: rats that
underwent renal bilateral ischemia for 10, 20, or 45 min were compared with sham
operated rats. Additionally, thirteen male Wistar rats that underwent renal
bilateral ischemia for 20 min were divided into an untreated ischemic group (I)
and two groups receiving spironolactone, 20 mg/kg by gavage, at either 0 (Sp0) or
1.5-h after ischemia (Sp1.5). The rats were followed up and studied after 9
months. Mild (20 min) and severe (45 min) ischemia induced a progressive increase
in proteinuria at varying magnitudes, whereas minor ischemia (10 min) did not
modify proteinuria. CKD induced by moderate ischemia was characterized by renal
hypertrophy and tubulointerstitial fibrosis. These effects were associated with
activation of the transforming growth factor ? (TGF?) signaling pathway and
up-regulation of endothelin receptor A (ETA) and alpha smooth muscle actin
(?SMA). Spironolactone treatment immediately or 1.5-h after the ischemic insult
prevented the onset of these disorders. Our results show that moderate ischemic
insult leads to long-term structural and molecular changes that may compromise
renal function in later stages. Additionally, we demonstrate that spironolactone
administration after mild ischemia prevents this detrimental effect.