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Increase of Total Nephron Albumin Filtration and Reabsorption in Diabetic Nephropathy.

Abstract
The amount of albumin filtered through the glomeruli and reabsorbed at the proximal tubules in normal and in diabetic kidneys is debated. The megalin/cubilin complex mediates protein reabsorption, but genetic knockout of megalin is perinatally lethal. To overcome current technical problems, we generated a drug-inducible megalin-knockout mouse line, megalin(lox/lox);Ndrg1-CreERT2 (iMegKO), in which megalin expression can be shut off at any time by administration of tamoxifen (Tam). Tam administration in adult iMegKO mice decreased the expression of renal megalin protein by 92% compared with that in wild-type C57BL/6J mice and almost completely abrogated renal reabsorption of intravenously injected retinol-binding protein. Furthermore, urinary albumin excretion increased to 175 μg/d (0.46 mg albumin/mg creatinine) in Tam-treated iMegKO mice, suggesting that this was the amount of total nephron albumin filtration. By comparing Tam-treated, streptozotocin-induced diabetic iMegKO mice with Tam-treated nondiabetic iMegKO mice, we estimated that the development of diabetes led to a 1.9-fold increase in total nephron albumin filtration, a 1.8-fold increase in reabsorption, and a significant reduction in reabsorption efficiency (86% efficiency versus 96% efficiency in nondiabetic mice). Insulin treatment normalized these abnormalities. Akita;iMegKO mice, another model of type 1 diabetes, showed equivalent results. Finally, nondiabetic iMegKO mice had a glomerular sieving coefficient of albumin of 1.7×10-5, which approximately doubled in diabetic iMegKO mice. This study reveals actual values and changes of albumin filtration and reabsorption in early diabetic nephropathy in mice, bringing new insights to our understanding of renal albumin dynamics associated with the hyperfiltration status of diabetic nephropathy.
AuthorsKeita P Mori, Hideki Yokoi, Masato Kasahara, Hirotaka Imamaki, Akira Ishii, Takashige Kuwabara, Kenichi Koga, Yukiko Kato, Naohiro Toda, Shoko Ohno, Koichiro Kuwahara, Tomomi Endo, Kazuwa Nakao, Motoko Yanagita, Masashi Mukoyama, Kiyoshi Mori
JournalJournal of the American Society of Nephrology : JASN (J Am Soc Nephrol) Vol. 28 Issue 1 Pg. 278-289 (Jan 2017) ISSN: 1533-3450 [Electronic] United States
PMID27382987 (Publication Type: Journal Article)
CopyrightCopyright © 2016 by the American Society of Nephrology.
Chemical References
  • Albumins
  • Lipocalin-2
  • Low Density Lipoprotein Receptor-Related Protein-2
Topics
  • Albumins (metabolism)
  • Albuminuria (genetics)
  • Animals
  • Diabetic Nephropathies (genetics, metabolism)
  • Kidney Glomerulus (metabolism)
  • Lipocalin-2 (urine)
  • Low Density Lipoprotein Receptor-Related Protein-2 (genetics)
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Nephrons (metabolism)
  • Renal Reabsorption

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