title: Aldosterone antagonists in monotherapy are protective against streptozotocin-induced diabetic nephropathy in rats.
abstract: Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) are the standard clinical therapy of diabetic nephropathy (DN), while aldosterone antagonists are only used as adjuncts. Previously in experimental DN we showed that Na/K ATPase (NKA) is mislocated and angiotensin II leads to superimposed renal progression. Here we investigated the monotherapeutic effect of aldosterone blockers on the progression of DN and renal NKA alteration in comparison to ACEi and ARBs. Streptozotocin-diabetic rats developing DN were treated with aldosterone antagonists; ACEi and ARB. Renal function, morphology, protein level and tubular localization of NKA were analyzed. To evaluate the effect of high glucose per se; HK-2 proximal tubular cells were cultured in normal or high concentration of glucose and treated with the same agents. Aldosterone antagonists were the most effective in ameliorating functional and structural kidney damage and they normalized diabetes induced bradycardia and weight loss. Aldosterone blockers also prevented hyperglycemia and diabetes induced increase in NKA protein level and enzyme mislocation. A monotherapy with aldosterone antagonists might be as, or more effective than ACEi or ARBs in the prevention of STZ-induced DN. Furthermore the alteration of the NKA could represent a novel pathophysiological feature of DN and might serve as an additional target of aldosterone blockers.
authors: 1st Department of Pediatrics, Semmelweis University, Budapest, Hungary.
authors: Nora F
authors: NF
authors: Banki
authors: Agota
authors: A
authors: Ver
authors: Laszlo J
authors: LJ
authors: Wagner
authors: Adam
authors: A
authors: Vannay
authors: Peter
authors: P
authors: Degrell
authors: Agnes
authors: A
authors: Prokai
authors: Renata
authors: R
authors: Gellai
authors: Lilla
authors: L
authors: Lenart
authors: Dorottya-Nagy
authors: DN
authors: Szakal
authors: Eva
authors: E
authors: Kenesei
authors: Klara
authors: K
authors: Rosta
authors: Gyorgy
authors: G
authors: Reusz
authors: Attila J
authors: AJ
authors: Szabo
authors: Tivadar
authors: T
authors: Tulassay
authors: Chris
authors: C
authors: Baylis
authors: Andrea
authors: A
authors: Fekete
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002478:Cells, Cultured; D003928:Diabetic Nephropathies / Q000517:prevention & control*; D006339:Heart Rate / Q000187:drug effects; D006943:Hyperglycemia / Q000201:enzymology; D007687:Kidney Tubules, Proximal / Q000201:enzymology; D000451:Mineralocorticoid Receptor Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D051381:Rats; D000254:Sodium-Potassium-Exchanging ATPase / Q000378:metabolism; D013311:Streptozocin
chemical_list: D000451:Mineralocorticoid Receptor Antagonists; D013311:Streptozocin; D000254:Sodium-Potassium-Exchanging ATPase