Cisplatin nephrotoxicity: site of functional disturbance and correlation to loss of body weight.

We have investigated the effect of an intraperitoneal cisplatin injection (5 mg/kg body weight) into male Wistar rats on: (1) body weight; (2) proximal tubular transport of D-glucose and sulfate across the luminal membrane; (3) transport of p-aminohippuric acid (PAH) and sulfate across the contraluminal membrane; (4) urinary excretion of inulin; (5) urinary excretion and tissue accumulation of sulfofluorescein, and (6) effect of the 'protecting substances', N-Methyl-D-glucamine-dithiocarbamate (NaG), diethyldithiocarbamate, mercaptosuccinate (MS), probenecid, and glycine on parameters 1, 4 and 5. Five days after intraperitoneal application of cisplatin the following effects were observed: (1) body weight was reduced on average by 11% as compared to a 12% increase in control animals; (2) luminal sulfate and D-glucose transport was inhibited correlating with the degree of weight loss; (3) contraluminal PAH transport was also decreased in correlation to the loss of body weight, while contraluminal sulfate transport was not inhibited by cisplatin; (4) inulin excretion was reduced by 45%, the pattern for protection was the same as for the prevention of weight loss; (5) sulfofluorescein (SF) excretion in the urine was reduced by 43%, and (6) accumulation of SF into cortical tissue was augmented. Protecting substances prevented or mitigated weight loss, fall of urinary inulin and SF excretion as well as SF accumulation in cortical tissue with a similar pattern: N-glucamine-dithiocarbamate > mercaptosuccinate approximately probenecid approximately glycine. The data indicate: (1) that luminal (glucose and sulfate) and contraluminal (PAH) transport processes are affected by cisplatin; (2) that contraluminal transport (sulfate) can be unaffected or less affected than luminal transport processes (SF); (3) our method (SF) gives the possibility to monitor the balance between luminal and contraluminal transport steps in vivo; and (4) the correlation of body weight loss with decay of certain renal transport functions and their prevention with similar protecting patterns indicates that a simple index might be useful to monitor the cytotoxic status of an individual.

Tissue concentration and urinary excretion pattern of sulfofluorescein by the rat kidney.

In order to find a fluorescein analog that is excreted in a way similar to p-aminohippurate (PAH) and is suitable to register excretion into the urine and also to monitor continuously the concentration within cortical tissue, the interference of fluorescein, sulfofluorescein (SF), and fluorescein-5(6)-sulfonate with the contraluminal transport systems of PAH, succinate, and sulfate and with the luminal transport system of sulfate and lactate was evaluated. All three substances exerted a strong inhibitory potency against contraluminal PAH uptake (apparent Ki, 0.06 to 0.1 mmol/L) and also showed a moderate to small inhibitory potency against contraluminal sulfate transport (apparent Ki, 0.7 to 5.3 mmol/L). None of the three substrates interacted with the contraluminal dicarboxylate transport. Luminally, fluorescein and SF interacted with the lactate transporter (apparent Ki, approximately 3.0 mmol/L), whereas SF and fluorescein-5(6)-sulfonate had a very weak inhibitory potency against luminal sulfate transport (apparent Ki, 30 to 40 mmol/L). Because of its relatively low interference with the contraluminal sulfate transport, we preferred SF in the following study (protein binding, 88%) over fluorescein-5(6)-sulfonate (protein binding, 43.3%) and fluorescein (protein binding, 77.3%). A bolus injection of SF was given together with [14C]inulin into the jugular vein to rats in mannitol diuresis. Excretion of both substances in the urine was measured in 5-min samples. Fluorescence of the kidney surface was monitored at the exposed kidney with a photocell (excitation light, 470 nm; emission light, 530 nm). The effect of interfering substances was evaluated by their application 1 min before, simultaneously, or 1 min after SF bolus injection. PAH < probenecid < apalcillin inhibited SF excretion in the urine and, to a similar degree, SF fluorescence in cortical tissue. Inhibition was strongest when the substances were given simultaneously with SF. With the injection of alpha-ketoglutarate, glutarate, and succinate, an increase of SF excretion in the urine and, partially also, of SF content in tissue was seen. Tetrafluorosuccinate and mercaptosuccinate inhibited urinary SF excretion and tissue fluorescence strongly. Therefore, SF secretion is completely inhibited whereas filtration remained unaffected. The injection of acetate, lactate, and pyruvate as well as of 2-chloropropionate and thiosulfate did not change urinary excretion and tissue fluorescence of SF significantly. In SF-preloaded animals, the injection of probenecid, apalcillin, tetrafluorosuccinate, and mercaptosuccinate caused an immediate decrease of cellular SF content, whereas the injection of glutarate caused an increase. SF fluorescence in tissue was linearly related to urinary excretion of SF, whereas urinary excretion of inulin was barely affected.(ABSTRACT TRUNCATED AT 400 WORDS)