Acute and chronic effects of SGLT2 blockade on glomerular and tubular function in the early diabetic rat

Am J Physiol Regul Integr Comp Physiol. 2012 Jan 1;302(1):R75-83. doi: 10.1152/ajpregu.00357.2011. Epub 2011 Sep 21.

Abstract

Tubuloglomerular feedback (TGF) stabilizes nephron function from minute to minute and adapts to different steady-state inputs to maintain this capability. Such adaptation inherently renders TGF less efficient at buffering long-term disturbances, but the magnitude of loss is unknown. We undertook the present study to measure the compromise between TGF and TGF adaptation in transition from acute to chronic decline in proximal reabsorption (Jprox). As a tool, we blocked proximal tubule sodium-glucose cotransport with the SGLT2 blocker dapagliflozin in hyperglycemic rats with early streptozotocin diabetes, a condition in which a large fraction of proximal fluid reabsorption owes to SGLT2. Dapagliflozin acutely reduced proximal reabsorption leading to a 70% increase in early distal chloride, a saturated TGF response, and a major reduction in single nephron glomerular filtration rate (SNGFR). Acute and chronic effects on Jprox were indistinguishable. Adaptations to 10-12 days of dapagiflozin included increased reabsorption by Henle's loop, which caused a partial relaxation in the increased tone exerted by TGF that could be explained without desensitization of TGF. In summary, TGF contributes to long-term fluid and salt balance by mediating a persistent decline in SNGFR as the kidney adapts to a sustained decrease in Jprox.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Benzhydryl Compounds
  • Diabetes Mellitus, Experimental / chemically induced
  • Diabetes Mellitus, Experimental / physiopathology*
  • Disease Models, Animal
  • Feedback, Physiological / drug effects
  • Feedback, Physiological / physiology
  • Glomerular Filtration Rate / drug effects
  • Glomerular Filtration Rate / physiology
  • Glucosides / pharmacology
  • Homeostasis / drug effects
  • Homeostasis / physiology
  • Kidney Glomerulus / drug effects
  • Kidney Glomerulus / physiology*
  • Kidney Tubules / drug effects
  • Kidney Tubules / physiology*
  • Male
  • Rats
  • Rats, Wistar
  • Sodium-Glucose Transporter 2 / physiology
  • Sodium-Glucose Transporter 2 Inhibitors*
  • Streptozocin / adverse effects

Substances

  • Benzhydryl Compounds
  • Glucosides
  • Slc5a2 protein, rat
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • dapagliflozin
  • Streptozocin