title: Renal function is ameliorated in a diabetic nephropathy rat model through a duodenal-jejunal bypass.
abstract: OBJECTIVE
  Diabetes surgery is growing in popularity and has been shown to have marked effects on diabetes. However, several studies have shown it may induce some renal injury, and, currently, the impact of diabetes surgery on renal function is unclear. In this study, we examined renal function and histological changes in rats with diabetic nephropathy (DN) following a duodeno-jejunal bypass (DJB) operation.
  
  
  METHODS
  Rats with streptozotocin (STZ)-induced diabetes were randomly assigned to 3 groups: DJB group (DJB), Sham-DJB group (S-DJB) and diabetes group (DM). Six age-matched normal rats were assigned as the control group. DJB and sham surgery were performed. Body weight, food intake, glucose levels, lipid parameters, cystatin C (Cys_C) levels, serum and urinary creatinine, 24h urine albumin excretion rate (UAER) and glomerular filtration rate (GFR) were measured. Histological analysis and immunohistochemical studies of renal sections were also performed.
  
  
  RESULTS
  DJB ameliorated renal function by improving UAER, GFR and Cys_C levels 4 and 8 weeks after surgery. It also improved lipid metabolism by decreasing fasting total serum cholesterol (TC) and triglyceride (TG) levels. Immuno-staining of synaptopodin showed podocyte injury was also improved in DJB glomeruli compared with sham and DM groups. Histological analysis showed that the mesangial expansion was not significantly prevented 8 weeks after DJB surgery.
  
  
  CONCLUSIONS
  DJB ameliorated renal function in UAER and GFR but not mesangial expansion in a DN rat model. The improvement of renal function may be attributed to reversing the injury or loss of podocytes after DJB surgery.
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Shandong, China; Department of General Surgery, The Fourth Hospital of Jinan, Shandong, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Zhiqing
authors.affiliation: Department of Pathology, The Fourth Hospital of Jinan, Shandong, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Jing
authors.affiliation: Department of Internal Medicine, Jinan Municipal Hospital of Traditional Chinese Medicine, Shandong, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Haili
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Shandong, China.
authors.forename: Liu
authors.initials: L
authors.lastname: Shaozhuang
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Shandong, China.
authors.forename: Hu
authors.initials: H
authors.lastname: Chunxiao
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Shandong, China.
authors.forename: Han
authors.initials: H
authors.lastname: Haifeng
authors.affiliation: Department of General Surgery, The Fourth Hospital of Jinan, Shandong, China.
authors.forename: Wang
authors.initials: W
authors.lastname: Hui
authors.affiliation: Department of General Surgery, Qilu Hospital of Shandong University, Shandong, China. Electronic address: Husanyuan1962@hotmail.com.
authors.forename: Hu
authors.initials: H
authors.lastname: Sanyuan
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000378:metabolism; D001835:Body Weight; D003921:Diabetes Mellitus, Experimental / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D004386:Duodenum / Q000378:metabolism / Q000601:surgery*; D015390:Gastric Bypass; D007583:Jejunum / Q000378:metabolism / Q000601:surgery*; D007677:Kidney Function Tests; D007678:Kidney Glomerulus / Q000503:physiopathology*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D001786:Blood Glucose
keywords: Diabetic nephropathy; Duodenal-jejunal bypass; Mesangial expansion; Podocyte; Renal function; Type 2 diabetes mellitus