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Am J Physiol Renal Physiol 293: F1256-F1261, 2007. First published August 1, 2007; doi:10.1152/ajprenal.00181.2007
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Fructose, but not dextrose, accelerates the progression of chronic kidney disease

Michael S. Gersch,1,2 Wei Mu,1 Pietro Cirillo,1 Sirirat Reungjui,1 Li Zhang,1 Carlos Roncal,1 Yuri Y. Sautin,1 Richard J. Johnson,1 and Takahiko Nakagawa1

1Division of Nephrology, Dialysis, and Transplantation, University of Florida; and 2North Florida/South Georgia Veterans Health System, Gainesville, Florida

Submitted 16 April 2007 ; accepted in final form 27 July 2007

The metabolic syndrome has recently been recognized as a risk factor for kidney disease, but the mechanisms mediating this risk remain unclear. High fructose consumption by animals produces a model of the metabolic syndrome with hypertension, hyperlipidemia, and insulin resistance. The present study was conducted to test the hypothesis that consumption of a high-fructose diet could accelerate the progression of chronic kidney disease. Three groups of 14 male Sprague-Dawley rats were pair fed a specialized diet containing 60% fructose (FRU) or 60% dextrose (DEX) or standard rat chow (CON). After the animals were fed their assigned diet for 6 wk, five-sixths nephrectomy was performed, and the assigned diet was continued for 11 wk. Proteinuria was significantly increased and creatinine clearance was decreased in the FRU group compared with the CON and DEX groups, and blood urea nitrogen was higher in the FRU group than in the CON and DEX groups. Kidneys from the FRU group were markedly larger than kidneys from the CON and DEX groups. Glomerular sclerosis, tubular atrophy, tubular dilatation, and cellular infiltration appeared markedly worse in kidneys from the FRU group than in kidneys from the DEX and CON groups. Monocyte chemoattractant protein-1 (MCP-1) was measured in renal tissue homogenate and found to be increased in the FRU group. In vitro studies were conducted to determine the mechanism for increased renal MCP-1, and fructose stimulation of proximal tubular cells resulted in production of MCP-1. In conclusion, consumption of a high-fructose diet greatly accelerates progression of chronic kidney disease in the rat remnant kidney model.

metabolic syndrome; high-fructose corn syrup; monocyte chemoattractant protein-1



Address for reprint requests and other correspondence: M. S. Gersch, 1600 SW Archer Rd., Rm. CG 98, PO Box 100224, Gainesville, FL 32610-0224 (e-mail: gerscms{at}medicine.ufl.edu)




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