Division of Nephrology, Department of Internal Medicine, Kawasaki Medical School, Kurashiki, Japan.
Microcirculation. 2010 Feb;17(2):103-12. doi: 10.1111/j.1549-8719.2009.00010.x.
Knowledge of glomerular structural and hemodynamic changes in vivo is still limited under diabetic conditions. In this study, we examined the alterations in glomerular structure and permeability of macromolecules and the effects of telmisartan using a confocal laser microscope.
Diabetes was induced by injecting streptozotocin. After 4 and 8 weeks, the filtration and permeability of differently sized compounds across the glomerular capillaries were visualized using a confocal laser microscope by injecting 500-kilodalton and 40-kilodalton dextran. At 7 weeks, some diabetic rats were treated with telmisartan for 1 week. The permeation of the 40-kilodalton dextran across the glomerular capillaries into Bowman's space was quantified. Glomerular volume, diameters of the afferent and efferent arterioles, and glomerular permeability were compared.
Glomerular volume was significantly increased in the diabetic rats, and there was heterogeneity in the glomerular volumes. The diameter ratio of the afferent to efferent arterioles significantly increased, and there was increased glomerular permeability in the diabetic rats compared with the control rats. Telmisartan treatment reduced glomerular permeability without affecting glomerular volume.
These data showed that glomerular hyperfiltration started from the early phase of diabetes, accompanied by dilatation of afferent arterioles and glomerular hypertrophy.
在糖尿病状态下,对体内肾小球结构和血流动力学变化的认识仍然有限。本研究采用共聚焦激光显微镜检查肾小球结构和大分子通透性的改变,并观察替米沙坦的作用。
通过注射链脲佐菌素诱导糖尿病。4 周和 8 周后,通过注射 500 千道尔顿和 40 千道尔顿葡聚糖,用共聚焦激光显微镜观察不同大小化合物穿过肾小球毛细血管的滤过和通透性。7 周时,一些糖尿病大鼠用替米沙坦治疗 1 周。定量分析 40 千道尔顿葡聚糖穿过肾小球毛细血管进入鲍曼氏囊的渗透情况。比较肾小球体积、入球小动脉和出球小动脉直径以及肾小球通透性。
糖尿病大鼠的肾小球体积明显增加,且肾小球体积存在异质性。入球小动脉与出球小动脉的直径比显著增加,与对照组相比,糖尿病大鼠的肾小球通透性增加。替米沙坦治疗可降低肾小球通透性,而不影响肾小球体积。
这些数据表明,肾小球高滤过始于糖尿病早期,伴入球小动脉扩张和肾小球肥大。