Toad atrial natriuretic peptide : cDNA cloning and functional analysis in isolated perfused kidneys

Complementary DNA (cDNA) encoding Bufo marinus (toad) preproatrial natriuretic peptide (preproANP) was isolated by reverse-transcription polymerase chain reaction. Sequence analysis of toad preproANP cDNA revealed an open reading frame of 150 amino acid residues, which shared 72% and 66% identity with Rana catesbeiana and Xenopus laevis preproANP, respectively. The deduced amino acid sequence of toad ANP that corresponded to ANP 1–24 of R. catesbeiana and Rana ridibunda was identical, but it differed by four residues from that of X. laevis. ANP mRNA transcripts were also shown to be expressed in the toad kidney. Subsequently, the effect of frog ANP (1–24) on renal function in toad was examined using a perfused kidney preparation. The arterial infusion of frog ANP caused a dose-dependent decrease in the arterial perfusion pressure that was associated with an increase in the glomerular filtration rate (GFR) and a renal natriuresis and diuresis. The renal natriuresis and diuresis resulted predominantly from an increased GFR rather than from direct tubular effects. This study demonstrates that ANP can regulate renal function, which suggests it may be involved in overall fluid volume regulation.

A perspective on the role of natriuretic peptides in amphibian osmoregulation

The natriuretic peptide (NP) system is a complex family of peptides and receptors that is primarily linked to the maintenance of osmotic and cardiovascular homeostasis. In amphibians, the potential role(s) of NPs is complicated by the range of osmoregulatory strategies found in amphibians, and the different tissues that participate in osmoregulation. Atrial NP, brain NP, and C-type NP have been isolated or cloned from a number of species, which has enabled physiological studies to be performed with homologous peptides. In addition, three types of NP receptors have been cloned and partially characterised. Natriuretic peptides are always potent vasodilators in amphibian blood vessels, and ANP has been shown to increase the permeability of the microcirculation. In the perfused kidney, ANP causes vasodilation, diuresis and natriuresis that are caused by an increased GFR rather than effects in the renal tubules. These data are supported by the presence of ANP receptors only on the glomeruli and renal blood vessels. In the bladder and skin, the function of NPs is enigmatic because physiological analysis of the effects of ANP on bladder and skin function has yielded conflicting data with no clear role for NPs being revealed. Overall, NPs often have no direct effect, but in some studies they have been shown to inhibit the function of AVT. In addition, there is evidence that ANP can inhibit salt retention in amphibians since it can inhibit the ability of adrenocorticotrophic hormone or angiotensin II to stimulate corticosteroid secretion. It is proposed that an important role for cardiac NPs could be in the control of hypervolaemia during periods of rapid rehydration, which occurs in terrestrial amphibians.

The response of the natriuretic peptide system to water deprivation in the desert rodent, Notomys alexis

Natriuretic peptides (NPs) are regulatory molecules that cause cGMP-mediated diuresis and natriuresis in mammals. Accordingly, it is interesting to consider their role in desert-adapted animals in which water is often limited. This study investigated the response of the natriuretic peptide (NP) system to varying periods of water deprivation (WD) in the Australian desert rodent species, Notomys alexis. It was hypothesised that the expression of the NP system will be down-regulated in water-deprived N. alexis compared to water-replete animals. The plasma levels of ANP were significantly reduced after 3 days of WD, but were unaffected by 7, 14 and 28 days of WD. Water deprivation for 3, 7, 14 days had a variable effect on the mRNA expression of ANP, CNP, NPR-A, NPR-B, and NPR-C, and a uniform down-regulation was not observed. However, after 28 days of WD, mRNA expression was similar to water-replete animals, except for NPR-A. Surprisingly, 7 and 14 days of WD caused an up-regulation in the ability of ANP to stimulate cGMP; this also occurred at 14 days for CNP. Taken together, the mRNA expression and peptide mediated guanylyl cyclase activity data after WD were in the opposite direction to what was predicted. Interestingly, after 28 days of WD, most parameters were similar to those of water-replete animals, which indicates that a down-regulation of the NP system is not part of the physiological response to an absence of free water in N. alexis.

Natriuretic peptides and their receptors in the brain of the amphibian, Bufo marinus

The natriuretic peptides, atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP) and C-type natriuretic peptide (CNP) are members of a family of hormones that play an important role in mammalian fluid and electrolyte balance. In the periphery, natriuretic peptides reduce blood volume and subsequently blood pressure by increasing renal natriuresis and diuresis and relaxation of vascular smooth muscle. The actions of natriuretic peptides are mediated via two membrane-linked guanylate cyclase receptors (NPR-GC); natriuretic peptide receptor-A (NPR-A) which has a high affinity for ANP and BNP; and natriuretic peptide receptor-B (NPR-B)which has the greatest affinity for CNP. A third receptor not linked to guanylate cyclase, natriuretic peptide receptor-C (NPR-C) also exists, which binds to ANP, BNP and CNP with a relatively equal affinity, and is involved with clearance of the peptides from the circulation and tissues. The natriuretic peptides are present in the brain and are particularly predominant in cardiovascular and fluid and electrolyte regulating areas such as the anteroventral third ventricle (AV3V) region. This distribution has led to the suggestion natriuretic peptides play a neuromodulatory role in the central control of fluid homeostasis. Natriuretic peptides in the brain have been observed to inhibit the release of other fluid and electrolyte regulating hormones such as arginine vasopressin (AVP) and angiotensin II (AII). Natriuretic peptides have also been identified in the non-mammalian vertebrates although information regarding the distribution of the peptides and their receptors in the non-mammalian brain is limited. In amphibians, immunohistochemical studies have shown that natriuretic peptides are highly concentrated in the preoptic region of the brain, an area believed to be analogous to the A\T3\ region in mammals, which suggests that natriuretic peptides may also be involved in central fluid and electrolyte regulation in amphibians. To date, CNP is the only natriuretic peptide that has been isolated and cloned from the lower vertebrate brain, although studies on the distribution of CNP binding sites in the brain have only been performed in one fish species. Studies on the distribution of ANP binding sites in the lower vertebrate brain are similarly limited and have only been performed in one fish and two amphibian species. Moreover, the nature and distribution of the natriuretic peptide receptors has not been characterised. The current study therefore, used several approaches to investigate the distribution of natriuretic peptides and their receptors in the brain of the amphibian Bufo marinus. The topographical relationship of natriuretic peptides and the fluid and electrolyte regulating hormone arginine vasotocin was also investigated, in order to gain a greater understanding of the role of the natriuretic peptide system in the lower vertebrate brain. Immunohistochemical studies showed natriuretic peptides were distributed throughout the brain and were highly concentrated in the preoptic region and interpeduncular nucleus. No natriuretic peptide-like immunoreactivity (NP-IR) was observed in the pituitary gland. Arginine vasotocin-like immunoreactivity (AvT-IR) was confined to distinct regions, particularly in the preoptic/hypothalamic region and pituitary gland. Double labelling studies of NP-JR and AvT-IR showed the peptides are not colocalised in the same neural pathways. The distribution of natriuretic peptide binding sites using the ligands 125I-rat ANP (125I-rANP) and 125I-porcine CNP (125I-pCNP) showed different distributions in the brain of B. marinus. The specificity of binding was determined by displacement with unlabelled rat ANP, porcine CNP and C-ANF, an NPR-C specific ligand. 125I-rANP binding sites were broadly distributed throughout the brain with the highest concentration in pituitary gland, habenular, medial pallium and olfactory region. Minimal 125I-rANP binding was observed in the preoptic region. Residual 125I-rANP binding in the presence of C-ANF was observed in the olfactory region, habenular and pituitary gland indicating the presence of both NPR-GC and NPR-C in these regions. 125I-pCNP binding was limited to the olfactory region, pallium and posterior pituitary gland. All 125I-pCNP binding was displaced by C-ANF which suggests that CNP in the brain of B. marinus binds only to NPR-C. Affinity cross-linking and SDS-PAGB demonstrated two binding sites at 136 kDa and 65 kDa under reducing conditions. Guanylate cyclase assays showed 0.1 µM ANP increased cGMP levels 50% above basal whilst a 10-fold higher concentration of CNP was required to produce the same result. Molecular cloning studies revealed a 669 base pair fragment showing 91% homology with human and rat NPR-A and 89% homology with human, rat and eel NPR-B. A 432 base pair fragment showing 67% homology to the mammalian NPR-C and 58% homology with eel NPR-D was also obtained. The results show natriuretic peptides and their receptors are distributed throughout the brain of B. marinus which indicates that natriuretic peptides may participate in a range of regulatory functions throughout the brain. The potential for natriuretic peptides to regulate the release of the fluid and electrolyte regulating hormone AVT also exists due to the high number of natriuretic peptide binding sites in the posterior pituitary gland. At least two populations of natriuretic peptide receptors are present in the brain of B. marinus, one linked to guanylate cyclase and one resembling the mammalian clearance receptor. Furthermore, autoradiography and guanylate cyclase studies suggest ANP may be the major ligand in the brain of B. marinus, even though CNP is the only natriuretic peptide that has been isolated from the lower vertebrate brain to date.

Redução da morbi-mortalidade na síndrome de hellp completa com o uso de altas doses de dexametasona

Objective: To determine the clinical maternal and neonatal outcomes in HELLP syndrome patients treated with dexamethasone who either developed renal injury or renal insufficiency and to identify predictive values of urea and creatinine for the identification of subjects with HELLP syndrome at risk of developing renal insufficiency. Methods: Non-radomized intervention study of dexamethasone use in HELLP syndrome. A total of 62 patients were enrolled at Maternidade Escola Januário Cicco (MEJC). Patients received a total of 30 mg of dexamethasone IV, in three doses of 10 mg every 12 hours. A clinical and laboratory follow up were performed at 24, 48 and 72 hours. Patients were followed up to 6 months after delivery. Patients were grouped in accordance to renal function, i.e, normal and some type of renal lesion. Renal lesion was considered when creatinine was equal or greater than 1.3 mg/dl and diuresis less than 100 ml in 4 hours period and renal insufficiency was defined when dialysis was needed. Results: A total of 1230 patients with preeclampsia were admitted at MEJC. Of those 62 (5%) developed HELLP syndrome. There was no statistical difference in the groups with renal involvement or normal renal function with respect to the demographics, type of anesthesia used and delivery, and weight of the newborn. An improvement in the AST, ALT, LDH, haptoglobine, antithrombine, fibrinogenen and platelets was observed within 72 hours after dexamethosone use. There was a significant increase in the diuresis within the interval of 6 hours before the delivery and 24 hours after it. Of the 62 patients, 46 (74. 2%) had normal renal function and 16 (25.8%) evolved with renal lesion, with 5 (8.1%) needing dialysis. These 5 patients who received dialysis recovered the xi renal function. The delay in administering dexamethasone increased in 4.6% the risk of development of renal insufficiency. Patients with renal insufficiency had received significantly more blood products than subjects without renal lesion (p=0.03). Diuresis, leukocytes, uric acid, urea, creatinine were significantly different between the groups with normal renal function, renal lesion and renal insufficiency. The levels of creatinine 1.2mg/dl and uric acid 51mg/dl, at admission are predictive of subjects who will evolve with renal lesion (p<0.001). Maternal mortality was 3.2%. None of the subjects with renal insufficiency evolved with chronic renal disease. Conclusions: Dexamethasone in patients with HELLP syndrome seems to reduce significantly the hepatic microthrombosis and normalize hemostasis as seen by improvement of liver function. Renal injury can be considered, in HELLP syndrome, when creatinine levels are greater than 1.3 mg/dl and diuresis less than 100 ml/h in interval of 4 hours. The level of creatinine greater than 1.2 mg/dl and urea greater than 51mg/dl are predictive of subjects with HELLP syndrome who will develop renal injury. Patients who receive more red cell packs develop renal insufficiency. Finally, the delay in administering dexamethasone increases the risk of developing renal insufficiency

Study of caffeine urine and saliva of horses subjected to urinary acidification

The study of caffeine in racing horses has been of growing concern in veterinary sports medicine since the Association of Racing Commissioners International (ARCI) stated that it has no valid therapeutic use in racehorses. We examined the kinetic alterations in the urinary excretion and salivary secretion of caffeine in seven horses subjected to urinary acidification using ascorbic acid because this procedure can simulate the acidosis that follows anaerobic exercise. They participated in two treatment groups: the control group (SG) received 500 ml of saline and then 2.0 mg kg(-1) caffeine i.v. 30 min later; and the acidified group (AG) was subjected to urinary acidification with ascorbic acid at a dose of 0.5 g kg(-1) i.v. and then 2.0. mg kg(-1) caffeine i.v. 30 min later. Samples were collected 30 min before caffeine administration, immediately before caffeine administration (time zero) and at 0.25, 0.5, 1, 2, 4, 6, 8, 12, 24, 48 and 72 h afterwards. The samples were assayed by gas chromatography. The mean urinary pH for SG was 8.2, but for AG it was as low as 5.9 at 4 h, extending acidosis for up to 8 h. The kinetic curves for the two groups were similar for urinary excretion and salivary secretion. Differences occurred only in peak excretion and peak secretion in SG obtained at 1 h and 30 min, respectively, and in AG at 2 h and 1 h, respectively. This could be explained, in part, to the diuresis in AG compared with SG, resulting in less concentrated urine in the former group. The large difference between the pK(a) of caffeine and the pH of the medium may be responsible for the similar pharmacokinetics observed for the two groups. Copyright (C) 2004 John Wiley Sons, Ltd.

Early hemodynamic and renal effects of hemorrhagic shock resuscitation with lactated Ringer's solution, hydroxyethyl starch, and hypertonic saline with or without 6% dextran-70

Background. Considering the renal effects of fluid resuscitation in hemorrhaged patients, the choice of fluid has been a source of controversy. In a model of hemorrhagic shock, we studied the early hemodynamic and renal effects of fluid resuscitation with lactated Ringer's (LR), 6% hydroxyethyl starch (HES), and 7.5% hypertonic saline (HS) with or without 6% dextran-70 (HSD).Materials and methods. Forty-eight dogs were anesthetized and submitted to splenectomy. An estimated 40% blood volume was removed to maintain mean arterial pressure (MAP) at 40 mm Hg for 30 min. The dogs were divided into four groups: LR, in a 3:1 ratio to removed blood volume; HS, 6 mL kg(-1); HSD, 6 mL kg(-1); and HES in a 1:1 ratio to removed blood volume. Hemodynamics and renal function were studied during shock and 5, 60, and 120 min after fluid replacement.Results. Shock treatment increased MAP similarly in all groups. At 5 min, cardiac filling pressures and cardiac performance indexes were higher for LR and HES but, after 120 min, there were no differences among groups. Renal blood flow and glomerular filtration rate (GFR) were higher in LR at 60 min but GFR returned to baseline values in all groups at 120 min. Diuresis was higher for LR at 5 min and for LR and HES at 60 min. There were no differences among groups in renal variables 120 min after treatment.Conclusions. Despite the immediate differences in hemodynamic responses, the low-volume resuscitation fluids, HS and HSD, are equally effective to LR and HES in restoring renal performance 120 min after hemorrhagic shock treatment. (c) 2006 Elsevier B.V. All rights reserved.

Efeitos renais e cardiovasculares da infusão de dopamina e da solução de cloreto de sódio a 7,5%: estudo experimental em cães com restrição hídrica

JUSTIFICATIVA E OBJETIVOS: É controvertido o uso da infusão de dopamina na proteção renal. O objetivo desta pesquisa foi estudar o efeito da dopamina, da solução hipertônica e da associação de ambas em cães com restrição hídrica, simulando o jejum pré-operatório. MÉTODO: Foram estudados, em 32 cães anestesiados com tiopental sódico e fentanil, os seguintes parâmetros da função renal: fluxo plasmático efetivo renal (depuração de para-aminohipurato de sódio), ritmo de filtração glomerular (depuração de creatinina) e as depurações de sódio, de potássio e osmolar, excreção fracionária de sódio e potássio, excreção de sódio e potássio e a resistência vascular renal. Os parâmetros cardiovasculares foram: pressão arterial média, freqüência cardíaca, pressão da veia cava inferior, índice cardíaco, hematócrito e índice de resistência vascular periférica. Os animais foram subdivididos, através de sorteio, em 4 grupos experimentais: Grupo 1 - G1 (n = 8) - grupo controle; Grupo 2 - G2 (n = 8) infusão de dopamina (2 µg.kg-1.min-1), Grupo 3 - G3 (n = 8) solução de cloreto de sódio a 7,5% (2 ml.kg-1) e Grupo 4 - G4 (n = 8) - associação de dopamina (2 µg.kg-1.min-1) e cloreto de sódio a 7,5% (2 ml.kg-1). Os grupos tiveram quatro fases experimentais e cada momento com duração de 30 minutos, compreendendo os momentos M1, M2, M3 e M4. RESULTADOS: O grupo da dopamina (G2) apresentou diminuição da pressão arterial média, da resistência vascular renal e da excreção de potássio. O grupo da solução hipertônica de cloreto de sódio (G3) apresentou aumento do índice cardíaco, do volume urinário, da depuração de sódio e de potássio, da excreção urinária de sódio e potássio e da excreção fracionária de sódio. No grupo da solução hipertônica de cloreto de sódio associada à dopamina (G4), ocorreu elevação da freqüência cardíaca, do índice cardíaco, do fluxo plasmático efetivo renal e da excreção urinária de sódio; ocorreu também diminuição do índice de resistência vascular sistêmica e do potássio plasmático. CONCLUSÕES: Deste estudo conclui-se que a solução hipertônica de cloreto de sódio foi capaz de melhorar as condições hemodinâmicas e, conseqüentemente, a função renal de cães sob restrição hídrica de 12 horas. O mesmo não aconteceu com a infusão de 2 µg.kg-1.min-1 de dopamina que, em situação similar, não causou aumento da diurese e da excreção de sódio.

Eficácia da solução de cloreto de sódio a 7,5% com e sem dextran 70 a 6% na preservação da função renal de cães hipovolêmicos submetidos à isquemia-reperfusão

JUSTIFICATIVA E OBJETIVOS: As soluções hipertônicas de cloreto de sódio, associadas ou não a colóides hiperoncóticos, podem ser eficazes em proteger o rim em situações de hipovolemia. O objetivo deste estudo foi verificar, em cães, o real benefício dessas soluções sobre a função renal, em vigência de hipovolemia e isquemia do órgão. MÉTODO: em 24 cães, anestesiados com pentobarbital sódico, submetidos à nefrectomia direita e à expansão volêmica com solução de Ringer (1 ml.kg-1.min-1), foram observadas possíveis alterações renais morfo-funcionais após hemorragia de 20 ml.kg-1 e trinta minutos de total isquemia renal esquerda, com posterior reperfusão, além da repercussão renal da administração de soluções de cloreto de sódio 7,5% (SH) e esta em dextran 70 a 6% (SHD). Atributos estudados: FC, PAM, pressão de veia cava inferior, fluxo sangüíneo renal, resistência vascular renal, hematócrito, Na+, K+, osmolaridade plasmática, PaO2, PaCO2 e pH, depuração (para-aminohipurato de sódio - PAH-1, creatinina, osmolar, água livre, Na+, K+), fração de filtração, volume e osmolaridade urinários, excreções urinárias e fracionárias de Na+ e K+ e exame histopatológico do rim. Os atributos foram estudados em três grupos (G1, G2 e G3) e em cinco momentos. RESULTADOS: Houve elevação estatisticamente significativa da pressão arterial média em G2 e G3, da resistência vascular renal em G1, do fluxo sangüíneo renal e da depuração de PAH em G3, da excreção fracionária de Na+ em G2 e G3, das depurações de creatinina, osmolar, de água livre e de Na+ e K+, da excreção urinária de Na+ e K+ e do volume urinário em G3. CONCLUSÕES: A SHD administrada 15 minutos após hemorragia moderada e 30 minutos antes de insulto isquêmico de 30 minutos foi eficiente em proteger o rim de cães das repercussões da isquemia-reperfusão. Não foi constatada alteração histopatológica renal à microscopia óptica.

Efeitos hemodinâmicos e renais da injeção de doses elevadas de clonidina no espaço peridural do cão

JUSTIFICATIVA E OBJETIVOS: Não existem estudos que relatem as repercussões renais determinadas pela injeção de doses elevadas de clonidina no espaço peridural. O objetivo do estudo foi avaliar os efeitos hemodinâmicos e renais determinados pela injeção de doses elevadas de clonidina no espaço peridural do cão. MÉTODO: Vinte animais anestesiados com tiopental sódico e fentanil foram distribuídos aleatoriamente e de forma duplamente encoberta em dois grupos: Grupo 1 ou placebo (n = 10), que recebeu 0,2 mL.kg-1 de solução fisiológica, e Grupo 2 ou clonidina (n = 10), que recebeu 0,2 mL.kg-1 de uma solução contendo 50 µg.mL-1 de clonidina, no espaço peridural. Foram avaliados os seguintes parâmetros hemodinâmicos: freqüência cardíaca (FC): bat.min-1; pressão arterial média (PAM): mmHg; pressão da artéria pulmonar ocluida (PAOP): mmHg; débito cardíaco (DC): L.min-1; volume sistólico (VS): mL; também, os seguintes parâmetros da função renal foram avaliados: fluxo sangüíneo renal (FSR): mL.min-1; resistência vascular renal (RVR): mmHg.mL-1.min; volume urinário minuto (VUM): mL.min-1; depuração de creatinina (D Cr): mL.min-1; depuração de para-aminohipurato (D PAH): mL.min-1; fração de filtração (FF); depuração de sódio (D Na): mL.min-1; depuração de potássio (D K): mL.min-1; excreção fracionária de sódio (EF Na): %; excreção urinária de sódio (U NaV): µEq.min-1; excreção urinária de potássio (U K V): µEq.min-1. O experimento consistiu em três momentos de 20 minutos cada. Os dados foram coletados aos 10 minutos de cada momento e a diurese, no início e no final de cada momento. Ao término de M1, a clonidina ou a solução fisiológica foi administrada no espaço peridural. Após período de 20 minutos iniciou-se M2 e, em seguida, M3. RESULTADOS: A clonidina na dose de 10 µg.kg-1 no espaço peridural do cão promoveu alterações significativas, com diminuições da freqüência cardíaca e do débito cardíaco e aumento da relação depuração de para-aminohipurato de sódio/débito cardíaco. CONCLUSÕES: Nas condições realizadas e nas doses empregadas, pode-se concluir que a clonidina não promoveu alteração da função renal, mas diminuiu valores hemodinâmicos (freqüência e débito cardíaco).

Efeitos da dexmedetomidina sobre o sistema renal e sobre a concentração plasmática do hormônio antidiurético: estudo experimental em cães

JUSTIFICATIVA E OBJETIVOS: A insuficiência renal aguda peri-operatória é responsável por elevada taxa de morbidade e mortalidade. Os fármacos alfa2-agonistas aumentam o débito urinário e promovem boa estabilidade hemodinâmica nesse período. O objetivo desta pesquisa foi estudar os efeitos renais e sobre a concentração plasmática do hormônio antidiurético (HAD) provocados pela dexmedetomidina no cão anestesiado. MÉTODO: Trinta e seis cães adultos, anestesiados com propofol, fentanil e isoflurano, foram divididos aleatoriamente em três grupos que receberam, de modo encoberto: G1 - injeção de 20 mL de solução de cloreto de sódio a 0,9%, em 10 minutos, seguida de injeção de 20 mL da mesma solução em uma hora; G2 - injeção de 20 mL de solução de cloreto de sódio a 0,9% contendo dexmedetomidina (1 µg.kg-1), em 10 minutos, seguida de injeção de 20 mL da mesma solução, com a mesma dose de dexmedetomidina (1 µg.kg-1), em uma hora e G3 - injeção de 20 mL de solução de cloreto de sódio a 0,9% contendo dexmedetomidina (2 µg.kg-1) em 10 minutos, seguida de injeção de 20 mL da mesma solução, com a mesma dose de dexmedetomidina (2 µg.kg-1), em uma hora. As variáveis renais, hemodinâmicas e a concentração plasmática do HAD foram estudadas em quatro momentos: M1 (controle) - imediatamente após o período de estabilização; M2 - após a injeção inicial de 20 mL da solução em estudo, em 10 minutos, coincidindo com o início da injeção da mesma solução, em uma hora; M3 - 30 minutos após M2 e M4 - 30 minutos após M3. RESULTADOS: A dexmedetomidina reduziu a freqüência cardíaca e promoveu estabilidade hemodinâmica, mantendo constante o débito cardíaco. Houve elevação do débito urinário no G2 e G3, em comparação com o G1. A osmolalidade urinária no G2 e G3 foi menor no M3 e M4 em relação ao M1 e M2. A depuração de água livre aumentou no G3. A concentração plasmática do HAD diminuiu no G3, apresentando valores mais baixos que os observados no G1 e G2 em M2 e M4. CONCLUSÕES: Os cães anestesiados com baixas doses de dexmedetomidina promovem diurese hídrica por inibir a secreção do hormônio antidiurético, havendo potencial para proteção renal em eventos isquêmicos.

Reduction of podocytes number in late diabetic alloxan nephropathy: prevention by glycemic control

OBJETIVO: Avaliar o número de podócitos e espessamento da membrana basal glomerular (MBG) em ratos diabéticos com e sem controle glicêmico com 6 e 12 meses da indução. MÉTODOS: 100 ratos Wistar com 200-300g compuseram 6 grupos: Normal (N6, N12 - 25 animais) Diabético (D6,D12 - 25 animais) e diabético tratado com insulina 1,8 a 3,0 U/Kg e acarbose misturada a ração (50g para cada 100g de ração) (DT6 e DT12 - 25 animais). Aloxana foi ministrada via endovenosa na dose de 42mg/Kg. Peso, ingestão hídrica e diurese de 24 horas e glicemia e glicosúria foram determinados antes da inoculação, 7 e 14 dias após e mensalmente. No 14ª dia foi iniciado o tratamento. Três grupos de animais (N6, D6 e DT6) foram sacrificados no 6° mês e três grupos (N12, D12 e DT12), no 12ª mês sendo o tecido renal processado para estudo à microscopia eletrônica. RESULTADOS: A glicemia dos animais DT6 e DT12 diferiram significativamente, dos ratos D6 e D12, e não diferiram dos grupos N6 e N12. O número de podócitos do grupo DT6 não diferiu de N6 e D6 (mediana=11); o número de podócitos de DT12 (mediana=11) diferiu de D12 (mediana=8) e não diferiu de N12 (mediana=11). O espessamento da MBG de D6 (0,18 micrômetros) foi menor que D12 (0,29 micrômetros); de DT6 (0,16 micrômetros) foi menor que D6 (0,18 micrômetros) e de DT12 (0,26 micrômetros) foi menor que D12 (0,29 micrômetros). CONCLUSÃO: O controle da hiperglicemia preveniu o espessamento da MBG na nefropatia diabética aloxânica precoce (6 meses) e tardia (12 meses), e a diminuição do número de podócitos.

Caracterização de um modelo experimental de Diabetes Mellitus, induzido pela aloxana em ratos: estudo clínico e laboratorial

OBJETIVO: O presente estudo teve por objetivo caracterizar as alterações clínicas e laboratoriais do rato portador de Diabetes Mellitus induzido pela administração endovenosa de aloxana. MÉTODOS: Os animais foram distribuídos, por sorteio, em dois grupos experimentais: Grupo Controle Normal (G1), constituído de 25 animais sadios, e Grupo Diabético (G2), formado por 25 animais diabéticos graves, que foram avaliados em cinco momentos (1, 3, 6, 9 e 12 meses) de seguimento, tendo sido estudados os seguintes parâmetros: evolução clínica (peso, ingestão hídrica, ingestão alimentar e diurese) e exames bioquímicos (glicemia de jejum, glicose urinária, glicosúria, cetonúria, colesterol total, colesterol HDL, triglicérides e lipídios). RESULTADOS: A injeção de aloxana 2% na via endovenosa do rato acompanhou-se de um índice de mortalidade de 39%, tendo produzido diabetes grave também em 39% dos animais. O diabetes foi caracterizado por queda progressiva do peso corporal, elevação substancial da ingestão hídrica, ingestão alimentar e da diurese, com valores glicêmicos acima de 300 mg/dl, glicosúria 3+ e, eventualmente, cetonúria. O diabetes não altera o perfil de colesterol e lípides de ratos a longo prazo. CONCLUSÃO: Nossos estudos revelam que a aloxana produz, no rato, alterações clínicas e laboratoriais características de diabetes grave, as quais possibilitam estudos a longo prazo do diabetes.

Metabolic assessment in patients with urinary lithiasis

INTRODUCTION: Metabolic investigation in patients with urinary lithiasis is very important for preventing recurrence of disease. The objective of this work was to diagnose and to determine the prevalence of metabolic disorders, to assess the quality of the water consumed and volume of diuresis as potential risk factors for this pathology. PATIENTS and METHODS: We studied 182 patients older than 12 years. We included patients with history and/or imaging tests confirming at least 2 stones, with creatinine clearance > 60 mL/min and negative urine culture. The protocol consisted in the collection of 2, 24-hour urine samples, for dosing Ca, P, uric acid, Na, K, Mg, Ox and Ci, glycemia and serum levels of Ca, P, Uric acid, Na, K, Cl, Mg, U and Cr, urinary pH and urinary acidification test. RESULTS: 158 patients fulfilled the inclusion criteria. Among these, 151 (95.5%) presented metabolic changes, with 94 (62.2%) presenting isolated metabolic change and 57 (37.8%) had mixed changes. The main disorders detected were hypercalciuria (74%), hypocitraturia (37.3%), hyperoxaluria (24.1%), hypomagnesuria (21%), hyperuricosuria (20.2%), primary hyperparathyroidism (1.8%) secondary hyperparathyroidism (0.6%) and renal tubular acidosis (0.6). CONCLUSION: Metabolic change was diagnosed in 95.5% of patients. These results warrant the metabolic study and follow-up in patients with recurrent lithiasis in order to decrease the recurrence rate through specific treatments, modification in alimentary and behavioral habits.

Interaction between paraventricular nucleus and medial septal area on the renal effects induced by adrenaline

The aim of the present study was to analyze the role of alpha(1),alpha(2)-adrenoceptors, and the effects of losartan and PD123319 (selective ligands of the AT(1) and AT(2) angiotensin receptors, respectively) injected into the paraventricular nucleus (PVN) on the diuresis, natriuresis, and kaliuresis induced by administration of adrenaline into the medial septal area (MSA). Male Holtzman rats with a stainless steel cannula implanted into the MSA and bilaterally into the PVN were used. The administration of adrenaline into the MSA increased in a dose-dependent manner the urine, sodium, and potassium excretions. The previous administration of prazosin (an alpha(1)-adrenoceptor antagonist) injected into the PVN abolished the above effects of adrenaline, whereas yohimbine (an a-adrenoceptor antagonist) doesn't affect the diuresis, natriuresis, and kaliuresis induced by adrenaline. Pretreatment with losartan into the PVN decreased in a dose-dependent manner the urine, sodium, and potassium excretions induced by MSA administration of adrenaline (50 ng), while PVN PD123319 was without effect. These results indicate that urinary and electrolyte excretion effects induced by adrenaline into the MSA are mediated primarily by PVN AT, receptors. However, the doses of losartan were more effective when combined with the doses of PD123319 than given alone, suggesting that the urinary, natriuretic, and kaliuretic effects of MSA adrenaline may involve activation of multiple angiotensin II receptors subtypes into the PVN. (C) 2004 Elsevier B.V All rights reserved.