Aldosterone antagonists in monotherapy are protective against streptozotocin-induced diabetic nephropathy in rats

Nora F. Banki, Agota Ver, Laszlo J. Wagner, Adam Vannay, Peter Degrell, Agnes Prokai, Renata Gellai, Lilla Lenart, Dorottya Nagy Szakal, Eva Kenesei, Klara Rosta, Gyorgy Reusz, Attila J. Szabo, Tivadar Tulassay, Chris Baylis, Andrea Fekete

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Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) are the standard clinical therapy of diabetic nephropathy (DN), while aldosterone antagonists are only used as adjuncts. Previously in experimental DN we showed that Na/K ATPase (NKA) is mislocated and angiotensin II leads to superimposed renal progression. Here we investigated the monotherapeutic effect of aldosterone blockers on the progression of DN and renal NKA alteration in comparison to ACEi and ARBs. Streptozotocin-diabetic rats developing DN were treated with aldosterone antagonists; ACEi and ARB. Renal function, morphology, protein level and tubular localization of NKA were analyzed. To evaluate the effect of high glucose per se; HK-2 proximal tubular cells were cultured in normal or high concentration of glucose and treated with the same agents. Aldosterone antagonists were the most effective in ameliorating functional and structural kidney damage and they normalized diabetes induced bradycardia and weight loss. Aldosterone blockers also prevented hyperglycemia and diabetes induced increase in NKA protein level and enzyme mislocation. A monotherapy with aldosterone antagonists might be as, or more effective than ACEi or ARBs in the prevention of STZ-induced DN. Furthermore the alteration of the NKA could represent a novel pathophysiological feature of DN and might serve as an additional target of aldosterone blockers.

Original languageEnglish
Article numbere39938
JournalPloS one
Issue number6
Publication statusPublished - Jun 28 2012


ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

Cite this

Banki, N. F., Ver, A., Wagner, L. J., Vannay, A., Degrell, P., Prokai, A., Gellai, R., Lenart, L., Szakal, D. N., Kenesei, E., Rosta, K., Reusz, G., Szabo, A. J., Tulassay, T., Baylis, C., & Fekete, A. (2012). Aldosterone antagonists in monotherapy are protective against streptozotocin-induced diabetic nephropathy in rats. PloS one, 7(6), [e39938].