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This Article Full Text Full Text (PDF) All Versions of this Article: 293/2/F486    most recent 00503.2006v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Temm, C. Articles by Dominguez, J. H. Search for Related Content PubMed PubMed Citation Articles by Temm, C. Articles by Dominguez, J. H.

Microcirculation: nexus of comorbidities in diabetes

Department of Medicine, Indiana University School of Medicine, and Veterans Administration, Indianapolis, Indiana

Submitted 18 December 2006 ; accepted in final form 22 April 2007

Generalized capillary dysfunction is a morbid element in the metabolic syndrome, and it is likely involved in its complications. We tested the hypothesis that vast amounts of serum albumin previously observed in kidneys of rats with the metabolic syndrome were caused, in part, by leakage from renal peritubular capillaries. We report herein large scale leaks of plasma fluid in peritubular capillaries of rats with the metabolic syndrome. This finding was directly demonstrated in vivo, and the presence of leftover albumin residue confirmed the leak in postmortem kidney specimens. Moreover, renal interstitial fibrosis and tubular atrophy were found in a distribution similar to the leaked renal albumin in obese rats. We suggest that there is an important link between peritubular capillary damage and interstitial fibrosis, represented as tubulointerstitial disease in the metabolic syndrome. We propose that maintenance of the peritubular microcirculation may improve renal outcomes in diabetes and the metabolic syndrome.

diabetic nephropathies; capillary permeability

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