Cardiac remodeling and dysfunction in nephrotic syndrome

Kidney Int. 2007 Jun;71(12):1240-8. doi: 10.1038/sj.ki.5002204. Epub 2007 Apr 25.

Abstract

There is an increased incidence of heart disease in patients with chronic nephrotic syndrome (NS), which may be attributable to the malnutrition and activated inflammatory state accompanying the sustained proteinuria. In this study, we evaluated renal function, cardiac morphometry, contractile function, and myocardial gene expression in the established puromycin aminonucleoside nephrosis rat model of NS. Two weeks after aminonucleoside injection, there was massive proteinuria, decreased creatinine clearance, and a negative sodium balance. Skeletal and cardiac muscle atrophy was present and was accompanied by impaired left ventricular (LV) hemodynamic function along with decreased contractile properties of isolated LV muscle strips. The expression of selected cytokines and proteins involved in calcium handling in myocardial tissue was evaluated by real time polymerase chain reaction. This revealed that the expression of interleukin-1beta, tumor necrosis factor-alpha, and phospholamban were elevated, whereas that of cardiac sarco(endo)plasmic reticulum calcium pump protein was decreased. We suggest that protein wasting and systemic inflammatory activation during NS contribute to cardiac remodeling and dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Pressure
  • Calcium-Binding Proteins / genetics
  • Down-Regulation
  • Gene Expression
  • Heart Ventricles / metabolism
  • Heart Ventricles / pathology*
  • Heart Ventricles / physiopathology
  • Interleukin-1beta / genetics
  • Male
  • Muscle Contraction
  • Muscle, Skeletal / pathology
  • Muscular Atrophy / etiology*
  • Muscular Atrophy / pathology*
  • Myocardium / metabolism
  • Myocardium / pathology*
  • Nephrotic Syndrome / chemically induced
  • Nephrotic Syndrome / complications*
  • Puromycin Aminonucleoside / toxicity
  • Rats
  • Rats, Sprague-Dawley
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases / genetics
  • Sodium / metabolism
  • Stroke Volume
  • Tumor Necrosis Factor-alpha / genetics
  • Up-Regulation
  • Water-Electrolyte Balance

Substances

  • Calcium-Binding Proteins
  • Interleukin-1beta
  • Tumor Necrosis Factor-alpha
  • phospholamban
  • Puromycin Aminonucleoside
  • Sodium
  • Sarcoplasmic Reticulum Calcium-Transporting ATPases