Impaired tubular uptake explains albuminuria in early diabetic nephropathy.
Understanding the pathogenesis of albuminuria in diabetic nephropathy is important to improve methods for early diagnosis and treatment. In this study, we addressed whether albuminuria in diabetes results from altered glomerular filtration and/or altered processing of filtered albumin by the proximal tubule. Type 1 diabetic Munich Wistar rats developed albuminuria after 12 wk of diabetes. Intravital two-photon microscopy revealed similar glomerular permeability in the diabetic and control animals, assessed using both albumin-Alexa568 and 69-kD FITC-dextran; however, diabetic animals demonstrated significantly less filtered fluorescent albumin in renal proximal tubule (PT) cells compared with control animals. We also observed increased albumin-derived urinary peptide excretion in diabetic animals, and hyperglycemia modulated this peptideuria. In conclusion, in the early stages of diabetic nephropathy, the PT plays a major role in the development of albuminuria, which may be preceded by peptideuria.
Russo
Leileata M
LM
Program in Membrane Biology, Division of Nephrology, Massachusetts General Hospital/Harvard Medical School, Simches Research Center, Boston, MA 02114, USA. leileata.russo@receptor.mgh.harvard.edu
Sandoval
Ruben M
RM
Campos
Silvia B
SB
Molitoris
Bruce A
BA
Comper
Wayne D
WD
Brown
Dennis
D
D000419:Albuminuria / Q000209:etiology* / Q000503:physiopathology*; D000818:Animals; D003921:Diabetes Mellitus, Experimental / Q000150:complications / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000209:etiology* / Q000503:physiopathology*; D007678:Kidney Glomerulus / Q000503:physiopathology; D007687:Kidney Tubules, Proximal / Q000503:physiopathology*; D008297:Male; D036641:Microscopy, Fluorescence, Multiphoton; D051381:Rats; D017207:Rats, Sprague-Dawley; D017208:Rats, Wistar