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1 Renal Division, Department of Clinical Medicine, Faculty of Medicine, University of Sao Paulo, Sao Paulo, SP, Brazil
* To whom correspondence should be addressed. E-mail: rzatz{at}usp.br.
Chronic nitric oxide (NO) inhibition and salt overload (HS) promote severe hypertension
and renal injury, which regress quickly, though not completely, upon treatment withdrawal.
We investigated whether renal function and structure remain stable six months after
ceasing these treatments. Adult male Munich-Wistar rats were distributed among 3
groups: HS, receiving 3.1% Na diet; HS+N, receiving HS and the NO inhibitor N
-L-nitroarginine
methylester (L-NAME), 30 mg/kg/day orally; and HS+N+L, receiving HS+N
and the angiotensin II (AII) blocker, losartan (L), 50 mg/kg/day orally. In studies performed
after 20 days of treatment (Protocol 1), Group HS+N exhibited severe glomerular and
systemic hypertension, massive albuminuria, glomerular and interstitial injury, and
infiltration by macrophages and cells expressing AII. These abnormalities were largely
prevented in Group HS+N+L. A second cohort (Protocol 2) received HS+N for 20 days,
followed by conventional (0.5% Na) diet and no L-NAME treatment during the subsequent
30 days. At this time, systemic and glomerular pressure, along with parameters of renal
injury and inflammation, were still higher than in HS or HS+N+L, although differences
were much smaller than in Protocol 1. Six months after 20-day L-NAME/salt overload
treatment was ceased (Protocol 3), severe albuminuria, hypertension and renal injury
developed in Group HS+N. Again, losartan prevented most of these changes.
Conclusions: 1) Short-term HS+N treatment triggers the autonomous development of
progressive GS; 2) This process may involve activation of the AT1 receptor; 2) Temporary
HS+N treatment may represent a new model of slowly progressive chronic nephropathy.
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