Experimental rat model of diabetic nephropathy: RAGE detection and effect of spironolactone monotherapy

The glycation process results in formation of advanced glycation end products [AGEs], which accumulate in different organs at an accelerated rate in diabetes, resulting in alteration of both structure and function. This effect is via the receptor for AGES [RAGE], which is a signaling receptor leading to profibrotic reactions. The renin angiotensin aldosterone system [RAAS] is activated in diabetic nephropathy [DN] and leads to more renal damage. This is inhibited by angiotensin converting enzyme inhibitors [ACEIs] and angiotensin receptor blockers [ARBs] and mineralocorticoid receptor blockers [MRBs]. To show the monotherapeutic effect of spironolactone in diabetic nephropathy and to detect RAGE. Diabetes was induced in rats by streptozotocin. Three weeks after,spironolactone [SPL] was given for 4 weeks. Then, control, diabetic and treated rats were sacrificed. The results of blood chemistry at the end of 4 weeks showed statistical increase in serum sodium, potassium and urea with no effect on serum creatinine or blood glucose. Kidney pathological injuries were attenuated by SPL also, RAGE deposition compared to the diabetics. The study showed RAGE deposition in the experimental DN and confirmed the beneficial effects of MRB in DN

Carotid intima media thickness, left ventricular hypertrophy and weekly averaged blood pressure in hemodialysis patients

Undoubtedly, cardiovascular complications are the leading cause of mortality and morbidity in haemodialysis [HD] patients, and hypertension plays an important role in development of cardiovascular disorders in them. The present study evaluated the weekly averaged blood pressure with its relation to carotid intima media thickness and left ventricular mass index in HD patients. The study included 112 HD patients [85 males and 27 females]. We used daily home blood pressure [HBP] monitoring to record a total of 20 points of BP over a period of 1 week, including measurements of the wake-up and night BPs; in addition to the BP recorded before and after each HD session that occurred three times a week. The average of 20 BP measurements was defined as the weekly averaged blood pressure [WAB]. Also, the relationship between WAB and left ventricular hypertrophy [LVH] or carotid intima media thickness and carotid intima media thickness and left ventricular hypertrophy were evaluated. The results showed that systolic WAB [144.26 +/- 7.39 mmHg] and diastolic WAB [75.84 +/- 5.15 mmHg] were almost consistent with the wake-up BP on the day after the midweek dialysis session [R2=0.628 and 0.684, respectively]. The WAB showed significant positive correlations with the left ventricular mass index [LVMI] [R=0.387, P<0.0003] and carotid intima media thickness [R=0.226, P<0.0034], whereas the predialysis systolic BP showed a significant positive correlation with the CIMT and non-significant correlation with LVMI. There was a significant positive correlation between CIMT and LVMI