title: Microcirculation: nexus of comorbidities in diabetes.
abstract: Generalized capillary dysfunction is a morbid element in the metabolic syndrome, and it is likely involved in its complications. We tested the hypothesis that vast amounts of serum albumin previously observed in kidneys of rats with the metabolic syndrome were caused, in part, by leakage from renal peritubular capillaries. We report herein large scale leaks of plasma fluid in peritubular capillaries of rats with the metabolic syndrome. This finding was directly demonstrated in vivo, and the presence of leftover albumin residue confirmed the leak in postmortem kidney specimens. Moreover, renal interstitial fibrosis and tubular atrophy were found in a distribution similar to the leaked renal albumin in obese rats. We suggest that there is an important link between peritubular capillary damage and interstitial fibrosis, represented as tubulointerstitial disease in the metabolic syndrome. We propose that maintenance of the peritubular microcirculation may improve renal outcomes in diabetes and the metabolic syndrome.
authors.affiliation: Department of Medicine, Indiana University, Indianapolis, USA.
authors.forename: Constance
authors.initials: C
authors.lastname: Temm
authors.forename: Jesus H
authors.initials: JH
authors.lastname: Dominguez
mesh_terms: D000418:Albumins / Q000378:metabolism; D000818:Animals; D001562:Benzimidazoles; D002199:Capillary Permeability / Q000502:physiology; D048909:Diabetes Complications / Q000473:pathology*; D003929:Diabetic Neuropathies / Q000473:pathology; D005355:Fibrosis; D005455:Fluorescent Antibody Technique; D007668:Kidney / Q000473:pathology; D008297:Male; D024821:Metabolic Syndrome / Q000378:metabolism; D008833:Microcirculation / Q000473:pathology*; D018613:Microscopy, Confocal; D009765:Obesity / Q000473:pathology; D051381:Rats; D011918:Rats, Inbred SHR; D011924:Rats, Zucker; D015899:Tomography, Emission-Computed, Single-Photon; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D000418:Albumins; D001562:Benzimidazoles; D014841:von Willebrand Factor; C017807:bisbenzimide ethoxide trihydrochloride