Hypertension is one of the most prevalent diseases worldwide, and a major risk factor for renal failure and cardiovascular disease. The role of albuminuria, a common feature of hypertension and robust predictor of cardiorenal disorders, remains incompletely understood. The goal of this study was to investigate the mechanisms leading to albuminuria in the kidney of a rat model of hypertension, the Dahl salt-sensitive (SS) rat. To determine the relative contributions of the glomerulus and proximal tubule (PT) to albuminuria, we applied intravital two-photon-based imaging to investigate the complex renal physiological changes that occur during salt-induced hypertension. Following a high salt diet, SS rats exhibited elevated blood pressure, increased glomerular sieving of albumin (GSCalb=0.0686), relative permeability to albumin (+∆16%) and impaired volume hemodynamics (-∆14%). Serum albumin, but not serum globulins or creatinine, concentration was decreased (-0.54g/dL), which was concomitant with increased filtration of albumin (3.7 vs 0.8 g per day normal diet). Pathologically, hypertensive animals had significant tubular damage as indicated by increased prevalence of granular casts, expansion and necrosis of PT epithelial cells (+∆2.20score/image), progressive augmentation of red blood cell velocity (+∆269µm/s) and micro vessel diameter (+∆4.3µm), and increased vascular injury (+∆0.61leakage/image). Therefore, development of salt-induced hypertension can be triggered by fast and progressive pathogenic remodeling of PT epithelia, which can be associated with changes in albumin handling. Collectively, these results indicate that both the glomerulus and the PT contribute to albuminuria and dual treatment of glomerular filtration and albumin reabsorption may represent an effective treatment of salt-sensitive hypertension.
- proximal tubule
- chronic kidney disease
- Copyright © 2016, American Journal of Physiology-Renal Physiology