Document Detail

The combination of ACE inhibition plus sympathetic denervation is superior to ACE inhibitor monotherapy in the rat renal ablation model.
MedLine Citation:
PMID:  17347582     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The blood pressure-independent renoprotective actions of the blockade of the renin-angiotensin and the sympathetic nervous system are well documented, but monotherapies fail to completely abrogate progression. We investigated whether combined inhibition of the two systems provides additive renoprotection. METHODS: After subtotal nephrectomy (SNX) or sham operation, rats underwent resection of dorsal roots, i.e. rhizotomy or sham rhizotomy. Subsequently, they received tap water or quinapril in drinking water for 16 weeks (n = 18/group). Albuminuria, blood pressure and kidneys were assessed (morphometry, immunohistochemistry). RESULTS: At the end of the study telemetric blood pressure in SNX was 118 +/- 16 mm Hg, in SNX + rhizotomy 110 +/- 10 mm Hg, in SNX + quinapril 103 +/- 9 mm Hg and in SNX + quinapril + rhizotomy 95 +/- 7 mm Hg. Albuminuria in the respective groups was 169 +/- 75, 86 +/- 45, 15 +/- 23 and 5 +/- 4 mg/24 h. The glomerulosclerosis index was 1.40 +/- 0.6, 0.80 +/- 0.23, 0.37 +/- 0.16 and 0.31 +/- 0.15 (p < 0.001). Only combined intervention caused significant reduction of the glomerular volume and podocyte hypertrophy. The lowest indices for nitrotyrosine, NOS-1 (nNOS), TGF-beta and interstitial collagen were seen with combined interventions (p < 0.05). CONCLUSION: In angiotensin-converting enzyme inhibitor-treated SNX animals, abrogation of sympathetic overactivity provides additional renoprotection and less nitro-oxidative stress of podocytes than single interventions. The added benefits were partially blood pressure independent.
Peter Hamar; Gabor Kokeny; Peter Liptak; Jan Krtil; Marcin Adamczak; Kerstin Amann; Eberhard Ritz; Marie-Luise Gross
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-03-07
Journal Detail:
Title:  Nephron. Experimental nephrology     Volume:  105     ISSN:  1660-2129     ISO Abbreviation:  Nephron Exp. Nephrol.     Publication Date:  2007  
Date Detail:
Created Date:  2007-03-28     Completed Date:  2007-04-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101159770     Medline TA:  Nephron Exp Nephrol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  e124-36     Citation Subset:  IM    
Copyright Information:
Copyright 2007 S. Karger AG, Basel.
Institute of Pathophysiology, Semmelweis University, Budapest, Hungary.
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MeSH Terms
Angiotensin-Converting Enzyme Inhibitors / administration & dosage*
Combined Modality Therapy
Disease Models, Animal*
Kidney Failure, Chronic / pathology,  physiopathology*,  prevention & control*
Rats, Sprague-Dawley
Sympathectomy / methods*
Treatment Outcome
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors

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