Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya 663-8501, Japan.
J Hypertens. 2013 Jun;31(6):1203-13. doi: 10.1097/HJH.0b013e328360381d.
Iron accumulation is associated with the pathogenesis of chronic kidney disease (CKD). However, little is known about the effects of isolated iron restriction against CKD. We have recently reported that iron restriction prevents the development of renal damage in the well established 5/6 nephrectomy rat model of CKD. Herein, we investigated the therapeutic effects of iron restriction on preexisting hypertension and renal damage in a rat model of CKD.
CKD was induced by 5/6 nephrectomy in Sprague-Dawley rats. After surgery, 5/6 nephrectomized rats were given an iron-restricted diet from 1 day to 16 weeks for prevention protocol or from 8 to 16 weeks for rescue protocol. Other CKD rats were given a normal diet.
At 16 weeks after surgery, CKD rats developed hypertension and renal damage. Early intervention with iron restriction prevented the development of hypertension and vascular remodeling. By contrast, late intervention with iron restriction did not remarkably ameliorate preexisting hypertension and vascular remodeling in CKD rats. On the contrary, late intervention with iron restriction prevented further progression of preexisting renal damage in CKD rats. Interestingly, iron restriction led to increased urinary sodium and decreased urinary potassium excretions in CKD rats. Moreover, iron restriction markedly attenuated renal expression of nuclear mineralocorticoid receptor and Rac1 activity in CKD rats.
Iron restriction prevented further deterioration of preexisting renal damage. The beneficial effects of iron restriction on renal damage seem to be associated with inhibition of renal mineralocorticoid receptor signaling.
铁蓄积与慢性肾脏病(CKD)的发病机制有关。然而,关于单独限制铁摄入对 CKD 的影响知之甚少。我们最近报道,铁限制可预防 5/6 肾切除大鼠 CKD 模型中肾损伤的发展。在此,我们研究了铁限制对 CKD 大鼠模型中既有高血压和肾损伤的治疗作用。
采用 5/6 肾切除术诱导 CKD,在手术后第 1 天至 16 周给予铁限制饮食进行预防方案,或在第 8 周至 16 周给予铁限制饮食进行挽救方案,5/6 肾切除大鼠给予铁限制饮食。其他 CKD 大鼠给予正常饮食。
术后 16 周,CKD 大鼠出现高血压和肾损伤。早期铁限制干预可预防高血压和血管重塑的发生。相比之下,晚期铁限制干预对 CKD 大鼠的既有高血压和血管重塑并无明显改善作用。相反,晚期铁限制干预可防止 CKD 大鼠既有肾损伤的进一步进展。有趣的是,铁限制导致 CKD 大鼠的尿钠排泄增加和尿钾排泄减少。此外,铁限制显著降低 CKD 大鼠肾脏核激素受体和 Rac1 活性的表达。
铁限制可防止既有肾损伤的进一步恶化。铁限制对肾损伤的有益作用似乎与抑制肾脏激素受体信号有关。