Renal ischemia-reperfusion leads to hypertension and changes in proximal tubule Na+ transport and renin-angiotensin-aldosterone system: Role of NADPH oxidase

Life Sci. 2021 Feb 1:266:118879. doi: 10.1016/j.lfs.2020.118879. Epub 2020 Dec 10.

Abstract

Acute renal injury (AKI) is a risk factor for the development of hypertension, which involves oxidative stress, changes in Na+ handling, and the intrarenal renin-angiotensin-aldosterone system (RAAS) as underlying mechanisms. We investigated in rats whether renal ischemia-reperfusion (IR) leads to changes in the proximal tubule ATP-dependent Na+ transport and the intrarenal content of RAAS components, as well as the role of NADPH oxidase. Rats weighing 300-350 g were submitted to AKI by bilateral IR (n = 25). After IR injury, the animals were followed up for 4 weeks. One part (n = 7) received daily treatment with the NADPH oxidase inhibitor apocynin (100 mg/kg, drinking water), while another part (n = 9) received apocynin 24 h before and after IR. One group was submitted to sham surgery (n = 8). Four weeks after IR, the rats presented elevated systolic blood pressure, as well as increased lipid peroxidation, NADPH oxidase activity, (Na++K+)ATPase activity, and upregulation of type 1 angiotensin II receptor in the renal cortex. On the other hand, there was a decrease in Na+-ATPase activity and downregulation of the isoforms 1 and 2 of the angiotensin-converting enzyme, type 2 angiotensin II receptor, and of the α and ε isoforms of protein kinase C. Most of these alterations was prevented by both apocynin treatment protocols. Thus, we conclude that AKI-induced by IR may induce changes in proximal tubule ATPases and RAAS components compatible with renal Na+ retention and hypertension. These data also indicate that the NADPH oxidase represents a key factor in the origin of these alterations.

Keywords: Acute kidney injury; Hypertension; Ischemia-reperfusion; NADPH oxidase; Renin-angiotensin-aldosterone system.

MeSH terms

  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / metabolism
  • Acute Kidney Injury / pathology
  • Aldosterone / metabolism
  • Animals
  • Hypertension / enzymology
  • Hypertension / etiology
  • Hypertension / pathology*
  • Kidney Tubules, Proximal / metabolism
  • Kidney Tubules, Proximal / pathology*
  • Male
  • NADPH Oxidases / metabolism*
  • Oxidative Stress
  • Rats
  • Rats, Wistar
  • Renin-Angiotensin System*
  • Reperfusion Injury / complications*
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / pathology
  • Sodium / metabolism*

Substances

  • Aldosterone
  • Sodium
  • NADPH Oxidases