Hydronephrosis is associated with elevated plasmin in urine in pediatric patients and rats and changes in NCC and γ-ENaC abundance in rat kidney.

Abstract

Obstruction of urine flow at the level of the pelvo-ureteric junction (UPJO) and subsequent development of hydronephrosis is one of the most common congenital renal malformations. UPJO is associated with development of salt-sensitive hypertension, which is set by the obstructed kidney, and with a stimulated renin-angiotensin-aldosterone system (RAAS) in rodent models. This study aimed at investigating the hypothesis that 1) in pediatric patients with UPJO the RAAS is activated before surgical relief of the obstruction; 2) in rats with UPJO the RAAS activation is reflected by increased abundance of renal aldosterone-stimulated Na transporters; and 3) the injured UPJO kidney allows aberrant filtration of plasminogen, leading to proteolytic activation of the epithelial Na channel γ-subunit (γ-ENaC). Hydronephrosis resulting from UPJO in pediatric patients and rats was associated with increased urinary plasminogen-to-creatinine ratio. In pediatric patients, plasma renin, angiotensin II, urine and plasma aldosterone, and urine soluble prorenin receptor did not differ significantly before or after surgery, or compared with controls. Increased plasmin-to-plasminogen ratio was seen in UPJO rats. Intact γ-ENaC abundance was not changed in UPJO kidney, whereas low-molecular cleavage product abundance increased. The Na-Cl cotransporter displayed significantly lower abundance in the UPJO kidney compared with the nonobstructed contralateral kidney. The Na-K-ATPase α-subunit was unaltered. Treatment with an angiotensin-converting enzyme inhibitor (8 days, captopril) significantly lowered blood pressure in UPJO rats. It is concluded that the RAAS contributes to hypertension following partial obstruction of urine flow at the pelvo-ureteric junction with potential contribution from proteolytic activation of ENaC.

• Authors: Rikke Zachar, Ammar Al-Mashhadi, Henrik Dimke, Per Svenningsen, Boye L Jensen, Mattias Carlström
• Journal: American journal of physiology. Renal physiology (Am J Physiol Renal Physiol) Vol. 315 Issue 3 Pg. F547-F557 (09 01 2018) ISSN: 1522-1466 [Electronic] United States
• PMID: 29767556 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Antihypertensive Agents
• Epithelial Sodium Channels
• Scnn1g protein, rat
• Slc12a3 protein, rat
• Solute Carrier Family 12, Member 3
• Captopril
• Sodium
• Fibrinolysin

Topics

• Albuminuria (etiology, physiopathology, urine)
• Angiotensin-Converting Enzyme Inhibitors (pharmacology)
• Animals
• Antihypertensive Agents (pharmacology)
• Blood Pressure (drug effects)
• Captopril (pharmacology)
• Case-Control Studies
• Disease Models, Animal
• Epithelial Sodium Channels (metabolism)
• Fibrinolysin (urine)
• Humans
• Hydronephrosis (etiology, physiopathology, urine)
• Hypertension (drug therapy, etiology, physiopathology, urine)
• Kidney (drug effects, metabolism)
• Male
• Rats, Sprague-Dawley
• Renin-Angiotensin System (drug effects)
• Sodium (urine)
• Solute Carrier Family 12, Member 3 (metabolism)
• Up-Regulation
• Ureteral Obstruction (complications)