Journal
KIDNEY & BLOOD PRESSURE RESEARCH
Volume 43, Issue 2, Pages 329-349Publisher
KARGER
DOI: 10.1159/000487902
Keywords
Chronic kidney disease; 5/6 nephrectomy; Hypertension; Renin-angiotensin system; Epoxyeicosatrienoic acids; Soluble epoxide hydrolase
Funding
- Ministry of Health of the Czech Republic [15-28671A, 00023001]
- National Institute of Health [DK103616]
- NIEHS [R01 ES002710]
- Superfund Research Program [P42 ES004699]
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Background/Aims: We found recently that increasing renal epoxyeicosatrienoic acids (EETs) levels by blocking soluble epoxide hydrolase (sEH), an enzyme responsible for EETs degradation, shows renoprotective actions and retards the progression of chronic kidney disease (CKD) in Ren-2 transgenic hypertensive rats (TGR) after 5/6 renal ablation (5/6 NX). This prompted us to examine if additional protection is provided when sEH inhibitor is added to the standard renin-angiotensin system (RAS) blockade, specifically in rats with established CKD. Methods: For RAS blockade, an angiotensin-converting enzyme inhibitor along with an angiotensin II type receptor blocker was used. RAS blockade was compared to sEH inhibition added to the RAS blockade. Treatments were initiated 6 weeks after 5/6 NX in TGR and the follow-up period was 60 weeks. Results: Combined RAS and sEH blockade exhibited additional positive impact on the rat survival rate, further reduced albuminuria, further reduced glomerular and tubulointerstitial injury, and attenuated the decline in creatinine clearance when compared to 5/6 NX TGR subjected to RAS blockade alone. These additional beneficial actions were associated with normalization of the intrarenal EETs deficient and a further reduction of urinary angiotensinogen excretion. Conclusion: This study provides evidence that addition of pharmacological inhibition of sEH to RAS blockade in 5/6 NX TGR enhances renoprotection and retards progression of CKD, notably, when applied at an advanced stage. (C) 2018 The Author(s) Published by S. Karger AG, Basel.
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