Medical College of Wisconsin
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Angiotensin II infusion exacerbates radiation nephropathy. J Lab Clin Med 1999 Sep;134(3):283-91

Date

09/11/1999

Pubmed ID

10482314

DOI

10.1016/s0022-2143(99)90209-3

Scopus ID

2-s2.0-0033199474 (requires institutional sign-in at Scopus site)   26 Citations

Abstract

We hypothesized that angiotensin II will exacerbate radiation nephropathy in a time-specific manner. Experimental radiation nephropathy is treatable with angiotensin-converting enzyme inhibition or angiotensin II (AII) receptor blockers. These interventions are particularly important between 3 and 10 weeks after irradiation. We therefore undertook studies in which AII infusions were given at particular intervals after irradiation. Rats received total body irradiation (TBI) plus syngeneic bone marrow transplantation followed (or not) by AII infusion at 200 or 400 ng/kg/min. Infusions were given from 0 to 4 or 4 to 8 weeks after irradiation. An additional group was unirradiated but infused at 800 ng/kg/min for 8 weeks. Kidney function was assessed over 26 weeks, and histology was evaluated after the animals were killed. AII infusion alone did not cause azotemia. There was transient hypertension during AII infusion at 800 ng/kg/min but only minor histologic injury. Irradiation caused azotemia and hypertension, which were not exacerbated by AII infusion at 200 ng/kg/min. Irradiation plus AII infusion at 400 ng/kg/min from 4 to 8 weeks after TBI caused significantly greater azotemia than irradiation alone or irradiation with AII infusion from 0 to 4 weeks. The blood pressure was higher in irradiated rats infused with AII from 4 to 8 weeks. Arteriolar fibrinoid necrosis was a prominent feature in kidneys of rats infused with AII from 4 to 8 weeks after TBI. The worsening of radiation nephropathy by AII infusion from 4 to 8 weeks after irradiation strongly supports the idea of specific and sequential events in the pathogenesis of kidney failure in this model. Hypertension may play a role in these events in addition to the effect of AII alone. The occurrence of arteriolar fibrinoid necrosis in the irradiated, 4-to-8-week-infused animals suggests that vascular injury during that interval determines later outcome.

Author List

Cohen EP, Fish BL, Moulder JE



MESH terms used to index this publication - Major topics in bold

Angiotensin II
Animals
Blood Pressure
Bone Marrow Transplantation
Infusions, Parenteral
Kidney
Male
Nephritis
Radiation Injuries, Experimental
Rats
Rats, Inbred Strains
Renin-Angiotensin System
Time Factors
Transplantation, Isogeneic
Whole-Body Irradiation