Correlation between fluid reabsorption and proximal tubule ultrastructure during development of the rat kidney

Renal adaptive changes and sodium handling in the fetal-to-newborn transition

Appropriate fluid and electrolyte management is critical for optimal care of very low birth weight or sick infants. Delivery of such care requires an understanding of developmental changes in renal water and salt handling that occur with advancing gestational age as well as postnatal age. This review focuses on the principles of sodium homeostasis during fetal and postnatal life. The physiology of renal tubular transport mechanisms, as well as neurohumoral factors impacting renal tubular transport are highlighted. Clinical implications and guidelines to the provision of sodium to this vulnerable population are also discussed.

Lengths of nephron tubule segments and collecting ducts in the CD-1 mouse kidney: an ontogeny study

The kidney continues to mature postnatally, with significant elongation of nephron tubules and collecting ducts to maintain fluid/electrolyte homeostasis. The aim of this project was to develop methodology to estimate lengths of specific segments of nephron tubules and collecting ducts in the CD-1 mouse kidney using a combination of immunohistochemistry and design-based stereology (vertical uniform random sections with cycloid arc test system). Lengths of tubules were determined at postnatal day 21 (P21) and 2 and 12 mo of age and also in mice fed a high-salt diet throughout adulthood. Immunohistochemistry was performed to identify individual tubule segments [aquaporin-1, proximal tubules (PT) and thin descending limbs of Henle (TDLH); uromodulin, distal tubules (DT); aquaporin-2, collecting ducts (CD)]. All tubular segments increased significantly in length between P21 and 2 mo of age (PT, 602% increase; DT, 200% increase; TDLH, 35% increase; CD, 53% increase). However, between 2 and 12 mo, a significant increase in length was only observed for PT (76% increase in length). At 12 mo of age, kidneys of mice on a high-salt diet demonstrated a 27% greater length of the TDLH, but no significant change in length was detected for PT, DT, and CD compared with the normal-salt group. Our study demonstrates an efficient method of estimating lengths of specific segments of the renal tubular system. This technique can be applied to examine structure of the renal tubules in combination with the number of glomeruli in the kidney in models of altered renal phenotype.

Compensatory responses to nephron deficiency: adaptive or maladaptive?

Compensatory renal growth is a characteristic adaptation to reduced renal mass that appears to recapitulate the normal pattern of maturation of the kidney during the postnatal period. Hypertrophy of tubules (predominantly the proximal tubule) and glomeruli is accompanied by increased single nephron glomerular filtration rate and tubular reabsorption of sodium. We propose that the very factors, which contribute to the increase in growth and function of the renal tubular system, are, in the long term, the precursors to the development of hypertension in those with a nephron deficit. The increase in single nephron glomerular filtration rate is dependent on multiple factors, including reduced renal vascular resistance associated with an increased influence of nitric oxide, and a rightward shift in the tubuloglomerular feedback curve, both of which contribute to the normal maturation of renal function. The increased influence of nitric oxide appears to contribute to the reduction in tubuloglomerular feedback sensitivity and facilitate the initial increase in glomerular filtration rate. The increased single-nephron filtered load associated with nephron deficiency may promote hypertrophy of the proximal tubule and so increased reabsorption of sodium, and thus a rightward shift in the pressure natriuresis relationship. Normalization of sodium balance can then only occur at the expense of chronically increased arterial pressure. Therefore, alterations/adaptations in tubules and glomeruli in response to nephron deficiency may increase the risk of hypertension and renal disease in the long-term.

2011 Homer Smith Award: To serve and protect: classic and novel roles for Na+, K+ -adenosine triphosphatase

The ability of cells to maintain sharp ion gradients across their membranes is the foundation for the molecular transport and electrical excitability. Across animal species and cell types, Na(+),K(+)-adenosine triphosphatase (ATPase) is arguably the most powerful contributor to this phenomenon. By producing a steep concentration difference of sodium and potassium between the intracellular and extracellular milieu, Na(+),K(+)-ATPase in the tubules provides the driving force for renal sodium reabsorption. Pump activity is downregulated by natriuretic hormones, such as dopamine, and is upregulated by antinatriuretic hormones, such as angiotensin. In the past decade, studies have revealed a novel and surprising role: that Na(+),K(+)-ATPase is a transducer of signals from extracellular to intracellular compartments. The signaling function of Na(+),K(+)-ATPase is activated by ouabain, a mammalian steroid hormone, at far lower concentrations than those that inhibit pump activity. By promoting growth and inhibiting apoptosis, activation of Na(+),K(+)-ATPase exerts tissue-protective effects. Ouabain-stimulated Na(+),K(+)-ATPase signaling has recently shown clinical promise by protecting the malnourished embryonic kidney from adverse developmental programming. A deeper understanding of the tissue-protective role of Na(+),K(+)-ATPase signaling and the regulation of Na(+),K(+)-ATPase pumping activity is of fundamental importance for the understanding and treatment of kidney diseases and kidney-related hypertension.

Prolactin and dopamine 1-like receptor interaction in renal proximal tubular cells

Prolactin is a natriuretic hormone and acts by inhibiting the activity of renal tubular Na(+)-K(+)-ATPase activity. These effects require an intact renal dopamine system. Here, we have studied by which mechanism prolactin and dopamine interact in Sprague-Dawley rat renal tissue. Na(+)-K(+)-ATPase activity was measured as ouabain-sensitive ATP hydrolysis in microdissected renal proximal tubular segments. Intracellular signaling pathways were studied by a variety of different techniques, including Western blotting using phosphospecific antibodies, immunoprecipitation, and biotinylation assays. We found that dopamine and prolactin regulated Na(+)-K(+)-ATPase activity via similar signaling pathways, including protein kinase A, protein kinase C, and phosphoinositide 3-kinase activation. The cross talk between prolactin and dopamine 1-like receptors was explained by a heterologous recruitment of dopamine 1-like receptors to the plasma membrane in renal proximal tubular cells. Prolactin had no effect on Na(+)-K(+)-ATPase activity in spontaneously hypertensive rats, a rat strain with a blunted response to dopamine. These results further emphasize the central role of the renal dopamine system in the interactive regulation of renal tubular salt balance.

Negative reciprocity between angiotensin II type 1 and dopamine D1 receptors in rat renal proximal tubule cells

Sodium excretion is bidirectionally regulated by dopamine, acting on D1-like receptors (D1R) and angiotensin II, acting on AT1 receptors (AT1R). Since sodium excretion has to be regulated with great precision within a short frame of time, we tested the short-term effects of agonist binding on the function of the reciprocal receptor within the D1R-AT1R complex in renal proximal tubule cells. Exposure of rat renal proximal tubule cells to a D1 agonist was found to result in a rapid partial internalization of AT1R and complete abolishment of AT1R signaling. Similarly, exposure of rat proximal tubule cells and renal tissue to angiotensin II resulted in a rapid partial internalization of D1R and abolishment of D1R signaling. D1R and AT1R were, by use of coimmunoprecipitation studies and glutathione-S-transferase pull-down assays, shown to be partners in a multiprotein complex. Na+-K+-ATPase, the target for both receptors, was included in this complex, and a region in the COOH-terminal tail of D1R (residues 397-416) was found to interact with both AT1R and Na+-K+-ATPase. Results indicate that AT1R and D1R function as a unit of opposites, which should provide a highly versatile and sensitive system for short-term regulation of sodium excretion.

Cellular response to renal hypoxia is different in adolescent and infant rats

Immature renal tubules are more tolerant to ischemia than mature renal tubules. Here we compared the developmental pattern for some cellular responses evoked by hypoxia and reoxygenation in renal proximal tubules from 10- and 40-day-old rats. Redistribution of Na(+)-K(+)-ATPase from the plasma membrane was studied by confocal microscopy techniques in primary cultured renal proximal tubular cells. The developmental expression of Na(+)-K(+)-ATPase, micro-calpain and heme oxygenase-1 was measured by RT-PCR techniques in rat renal cortex. In response to hypoxia Na(+)-K(+)-ATPase redistribution from the plasma membrane was almost 2-fold increased in cells isolated from mature kidneys compared with cells isolated from immature kidneys. Reoxygenation resulted in a complete reestablishment of Na(+)-K(+)-ATPase in the plasma membrane in the immature but not in the mature cells. The dissociation of Na(+)-K(+)-ATPase from the plasma membrane was associated with a reduced activity and a reduced expression of Na(+)-K(+)-ATPase in the mature but not in the immature tubular cells. The expression of micro-calpain, a factor shown to induce ischemic injury to proximal tubular cells, was significantly lower in the immature compared with the mature kidney, whereas the expression of heme oxygenase-1, a factor shown to protect from renal ischemic injury, was significantly higher in the immature kidney. The results help to explain the increased tolerance of the immature kidney to injury caused by ischemia and reperfusion.

Pharmacokinetics in the newborn

In addition to differences in the pharmacodynamic response in the infant, the dose and the pharmacokinetic processes acting upon that dose principally determine the efficacy and/or safety of a therapeutic or inadvertent exposure. At a given dose, significant differences in therapeutic efficacy and toxicant susceptibility exist between the newborn and adult. Immature pharmacokinetic processes in the newborn predominantly explain such differences. With infant development, the physiological and biochemical processes that govern absorption, distribution, metabolism, and excretion undergo significant growth and maturational changes. Therefore, any assessment of the safety associated with an exposure must consider the impact of these maturational changes on drug pharmacokinetics and response in the developing infant. This paper reviews the current data concerning the growth and maturation of the physiological and biochemical factors governing absorption, distribution, metabolism, and excretion. The review also provides some insight into how these developmental changes alter the efficiency of pharmacokinetics in the infant. Such information may help clarify why dynamic changes in therapeutic efficacy and toxicant susceptibility occur through infancy.

Ontogeny of hepatic and renal systemic clearance pathways in infants: part I

Dramatic developmental changes in the physiological and biochemical processes that govern drug pharmacokinetics and pharmacodynamics occur during the first year of life. These changes may have significant consequences for the way infants respond to and deal with drugs. The ontogenesis of systemic clearance mechanisms is probably the most critical determinant of a pharmacological response in the developing infant. In recent years, advances in molecular techniques and an increased availability of fetal and infant tissues have afforded enhanced insight into the ontogeny of clearance mechanisms. Information from these studies is reviewed to highlight the dynamic and complex nature of developmental changes in clearance mechanisms in infants during the first year of life. Hepatic and renal elimination mechanisms constitute the two principal clearance pathways of the developing infant. Drug metabolising enzyme activity is primarily responsible for the hepatic clearance of many drugs. In general, when compared with adult activity levels normalised to amount of hepatic microsomal protein, hepatic cytochrome P450-mediated metabolism and the phase II reactions of glucuronidation, glutathione conjugation and acetylation are deficient in the neonate, but sulfate conjugation is an efficient pathway at birth. Parturition triggers the dramatic development of drug metabolising enzymes, and each enzyme demonstrates an independent rate and pattern of maturation. Marked interindividual variability is associated with their developmental expression, making the ontogenesis of hepatic metabolism a highly variable process. By the first year of life, most enzymes have matured to adult activity levels. When compared with adult values, renal clearance mechanisms are compromised at birth. Dramatic increases in renal function occur in the ensuing postpartum period, and by 6 months of age glomerular filtration rate normalised to bodyweight has approached adult values. Maturation of renal tubular functions exhibits a more protracted time course of development, resulting in a glomerulotubular imbalance. This imbalance exists until adult renal tubule function values are approached by 1 year of age. The ontogeny of hepatic biliary and renal tubular transport processes and their impact on the elimination of drugs remain largely unknown. The summary of the current understanding of the ontogeny of individual pathways of hepatic and renal elimination presented in this review should serve as a basis for the continued accruement of age-specific information concerning the ontogeny of clearance mechanisms in infants. Such information can only help to improve the pharmacotherapeutic management of paediatric patients.

Ontogeny of Na+/H+ antiporter activity in rat proximal convoluted tubules

Neonates have a lower serum bicarbonate level than adults, which is caused by a lower renal threshold for bicarbonate. Eighty percent of bicarbonate reabsorption occurs in the proximal tubule, in which proton secretion is predominantly mediated by a luminal Na+/H+ antiporter. Previous studies have demonstrated that there is a maturational increase in apical membrane rabbit proximal convoluted tubule Na+/H+ antiporter activity. However, in rat brush border membrane vesicles, Na+/H+ activity was higher in neonates than that in adult rats. To examine the maturation of Na+/H+ antiporter activity in rat proximal convoluted tubules, we perfused rat proximal convoluted tubules in vitro. Na+/H+ antiporter activity was assayed as the proton secretory rate on luminal sodium removal. Na+/H+ antiporter activity was 121.2 +/- 18.4 pmol/mm x min in neonatal and 451.8 +/- 40.6 pmol/mm x min in adult proximal convoluted tubules (p < 0.001). We next examined whether the increase in Na+/H+ antiporter activity was associated with changes in renal cortical NHE3 mRNA and brush border membrane NHE3 protein abundance. Adult renal cortical NHE3 mRNA abundance was 10-fold greater than that in 1-d-old neonates (p < 0.001). There was a comparable developmental increase in renal brush border membrane vesicle NHE3 protein abundance (p < 0.001). In summary, this study demonstrates that there is a maturational increase in rat apical membrane Na+/H+ antiporter activity, renal cortical NHE3 mRNA, and brush border membrane vesicle NHE3 protein abundance.

Stereologic methods and their application in kidney research

Stereologic methods are used to obtain quantitative information about three-dimensional structures based on observations from section planes or--to a limited degree--projections. Stereologic methods, which are used in biologic research and especially in the research of normal and pathologic kidneys, will be discussed in this review. Special emphasis will be placed on modern stereologic methods, free of assumptions of the structure, size, and shape, etc., so-called UFAPP (unbiased for all practical purposes) stereologic methods. The basic foundation of all stereology, sampling, will be reviewed in relation to most of the methods discussed. Estimation of error variances and some of the basic problems in stereology will be reviewed briefly. Finally, a few comments will be made about the future directions for stereology in kidney research.

Hepatic and renal expression of senescence marker protein-30 and its biological significance

A novel rat hepatic protein was detected and isolated, the amount of which is down-regulated in an androgen-independent manner with ageing. This protein was designated as senescence marker protein-30 (SMP30). Senescence marker protein-30 turned out to be identical to a hepatic calcium-binding protein called regucalcin (RC). This review gives an overview of SMP30 in its structure, expression and possible physiological function(s). A hypothetical role of SMP30 in ageing and calcium homeostasis is also discussed.

Adenosine receptor mRNA levels during postnatal renal maturation in the rat

Adenosine may affect the pattern of intrarenal blood flow during renal development. It provides an angiogenic stimulus for the growth of new blood vessels and may be involved in compensatory renal growth. It is therefore of interest to investigate the expression of adenosine receptor genes during postnatal renal development. In the present study this was carried out by measuring adenosine receptor mRNA levels in rats aged between 2 and 60 days. The order of abundance of adenosine receptor mRNA levels in 60-day-old rats was A2A > A2B > or = A1 > A3. A1 receptor mRNA levels showed only small changes with increasing age although, by contrast, A3 receptor mRNA increased markedly with age with levels at 60 days twenty-fold greater than at 2 days. A2A receptor mRNA levels declined during renal maturation with transcript numbers four- to fivefold that at 12-18 days compared with numbers at 60 days. By contrast to the A2A receptor, there were no significant changes in the renal levels of A2B receptor mRNA during kidney maturation. During postnatal renal maturation, the levels of mRNA for A2A and A3 adenosine receptor subtypes undergo marked changes which may be related to functional maturation, morphological development, or both.

Gene regulation of senescence marker protein-30 (SMP30): coordinated up-regulation with tissue maturation and gradual down-regulation with aging

Senescence marker protein-30 (SMP30) is a calcium binding protein also called regucalcin. The amounts of SMP30 decrease androgen-independently with aging in the livers of rats. We have studied the expression of SMP30 in livers and kidneys of rats from the embryonic to the senescent stages of life. No transcript was detected in livers or kidneys in day 18 embryos. However, Northern blot analysis showed a marked increase of SMP30 mRNA in livers of neonatal and young rats. The first peak of SMP30 transcript was found in a 5-day-old neonate, in which the amount of mRNA was threefold higher in comparison with 3- to 6.5-month-old adults. The expression of SMP30 protein started to increase from day 7 and rapidly reached a plateau at day 10. The substantial amounts of protein and transcript were maintained in adults up to 3-6.5 months of age. In the kidney, SMP30 mRNA and protein started to increase at day 21 and reached near-maximal levels at day 35. The levels of transcript and protein remained high in adults up to 3 months of age. As the aging process progressed to senescent stages, the levels of transcript and protein decreased significantly in the liver and kidney of aged rats. Therefore, the age-associated decrease of SMP30 in the liver and kidney may be, in a large part, controlled at transcriptional levels. Furthermore, immunohistochemical analysis showed a similar pattern of changes in SMP30 protein expression during neonate, adult and senescent stages in hepatocytes and renal proximal tubular epithelia. The high expression of SMP30 in the tissue-maturing process and adulthood suggests that SMP30 may be required for the maintenance of highly differentiated hepatic and renal functions.

Effect of chronic ethanol consumption on postnatal development of renal (Na + K)-ATPase in the rat

Renal (Na + K)-ATPase was studied to ascertain whether it follows the pattern of adaptation of membrane-bound enzymes that are inhibited by acute ethanol exposure and develop greater activity after chronic ethanol treatment. A colony of rats was given 20 per cent (v/v) ethanol as sole drinking solution throughout gestation, lactation and following weaning. (Na + K)-ATPase and ouabain-insensitive Ca(2+)-ATPase activities were determined; regional distribution of these enzymes was assessed in renal cortex and outer medulla. Control rats drank tap water. (Na + K)-ATPase in whole homogenate of kidney increased with age in controls and ethanol-fed rats, but the latter showed higher values at every age studied. Between 15 and 60 days of age, the control group showed 2-fold increases in cortex and 5-fold in outer medulla, whereas ethanol-fed rats reached a 3-fold increase in the enzyme activity in both renal regions. Ca(2+)-ATPase showed the same time course in developing kidney of both groups. Chronic ethanol treatment of adult rats resulted in an increase of (Na + K)-ATPase activity in cortex and outer medulla, but no change in other ATPases. Since an earlier maturational development of renal (Na + K)-ATPase was displayed by ethanol-fed rats, underlying mechanisms that may account for these results are discussed.

Salt and the newborn kidney

Renal function differs in term infants from that in adults, with lower glomerular filtration rate (GFR) and reduced proximal tubular reabsorption of sodium (Na) and water: nevertheless, it is adequate for their needs. This is not true of very preterm infants in whom hyponatraemia is common. Animal studies have shown that Na+, K(+)-ATPase and the Na+/K+ exchanger are poorly expressed at birth with rapid postnatal rises. Cell receptors for hormones that influence tubular Na transport are less numerous in the premature infant than later in life: intracellular second messenger systems may also be immature. The low GFR is due to vasoconstriction and may be necessary to prevent water and electrolyte wasting due to tubular overload. The hyponatraemia of prematurity could, in principle, be due either to Na loss or water excess and can be prevented either by giving additional Na or by restricting water intake. Na supplementation causes relative volume expansion (VE), water restriction volume contraction (VC); this is demonstrated by the effect of the two approaches on weight gain and on the levels of vasoactive hormones in the blood. We argue that moderate VE is more physiological than VC, both in attempting to simulate intrauterine conditions and in consideration of the infant's nutritional needs. The much less common complication of hypernatraemia is usually due to abnormal water loss and should be prevented by increasing water intake appropriately. The above applies to well, preterm babies: sick preterm infants are much more variable in their Na and water requirements than well infants of comparable gestation and weight and each needs an individually tailored regimen based on frequent clinical assessment and laboratory measurement.

Molecular genetics of Na,K-ATPase

Researchers in the past few years have successfully used molecular-genetic approaches to determine the primary structures of several P-type ATPases. The amino-acid sequences of distinct members of this class of ion-transport ATPases (Na,K-, H,K-, and Ca-ATPases) have been deduced by cDNA cloning and sequencing. The Na,K-ATPase belongs to a multiple gene family, the principal diversity apparently resulting from distinct catalytic alpha isoforms. Computer analyses of the hydrophobicity and potential secondary structure of the alpha subunits and primary sequence comparisons with homologs from various species as well as other P-type ATPases have identified common structural features. This has provided the molecular foundation for the design of models and hypotheses aimed at understanding the relationship between structure and function. Development of a hypothetical transmembrane organization for the alpha subunit and application of site-specific mutagenesis techniques have allowed significant progress to be made toward identifying amino acids involved in cardiac glycoside resistance and possibly binding. However, the complex structural and functional features of this protein indicate that extensive research is necessary before a clear understanding of the molecular basis of active cation transport is achieved. This is complicated further by the paucity of information regarding the structural and functional contributions of the beta subunit. Until such information is obtained, the proposed model and functional hypotheses should be considered judiciously. Considerable progress also has been made in characterizing the regulatory complexity involved in expression of multiple alpha-isoform and beta-subunit genes in various tissues and cells during development and in response to hormones and cations. The regulatory mechanisms appear to function at several molecular levels, involving transcriptional, posttranscriptional, translational, and posttranslational processes in a tissue- or cell-specific manner. However, much research is needed to precisely define the contributions of each of these mechanisms. Recent isolation of the genes for these subunits provides the framework for future advances in this area. Continued application of biochemical, biophysical, and molecular genetic techniques is required to provide a detailed understanding of the mechanisms involved in cation transport of this biologically and pharmacologically important enzyme.

Renal tubular differentiation in mouse and mouse metanephric culture. II. Na-K-ATPase activity

Sodium-potassium adenosine triphosphatase (Na-K-ATPase) activity was measured by microassay, and the surface density of basolateral membranes was measured morphometrically in postglomerular segments of single tubules isolated from normally developing, intact mouse kidneys and from transfilter metanephric cultures. Proximal tubule Na-K-ATPase activity was 1092 +/- 480 pmol/mm per hour in newborn mice, increasing to 2462 +/- 258 in 1-week-old and 3470 +/- 578 pmol/mm per hour in adult mice. The Na-K-ATPase activity in newborn mice was approximately one-third of the activity in adult mice. Tubular Na-K-ATPase in transfilter metanephric culture was 972 +/- 536 pmol/mm per hour, a mean value almost identical to that in newborn mice. The surface density of basolateral cell membranes was 1.36 +/- 0.60 microns2/microns3 in newborn mice and 1.34 +/- 0.45 microns2/microns3 in 1-week-old mice, increasing to 2.70 +/- 0.98 microns2/microns3 in 4-week-old mice and 2.89 +/- 0.51 microns2/microns3 in adult mice. The surface density of tubular basolateral cell membranes in transfilter metanephric culture was 1.13 +/- 0.51 microns2/microns3, not significantly different from the surface density in newborn mice. The calculated mean surface area of basolateral membranes per unit tubular length was greater in cultures than in newborns, however, because total epithelial volume per unit length was significantly larger in the cultured tubules. Membrane surface area in intact mice increased with age, the surface area per unit length of tubule in adults being 4.6 times the area in newborn animals.(ABSTRACT TRUNCATED AT 250 WORDS)

Studies of terminal differentiation of electrolyte transport in the renal proximal tubule using short-term primary cultures

There are several lines of indirect evidence suggesting that the renal tubule cells have not yet reached terminal differentiation at birth. Methods used in cell biology can now be applied to study renal ontogeny. This review describes how primary cultures of proximal tubule cells from rats can be used to investigate developmental changes in Na permeability and Na-K-ATPase-mediated transport.

Studies on terminal differentiation of rat renal proximal tubular cells in culture: ouabain-sensitive K and Na transport

We have studied the ontogeny of Na-K ATPase-mediated Na and K transport in rat renal proximal tubular cells using electron probe analysis. The cells were cultured from kidneys of 10-day-old, young (Y), and 40-day-old, adult (A) rats. Before an experiment cells were Na-loaded and K-depleted by incubation in K-free medium. The maximum rate of ouabain-sensitive Na and K transport was measured after reactivating the Na-K pump by transferring the cells from K-free medium to medium containing 5 mM K. In cells cultured for 2 days, ouabain-sensitive Na and K net initial transport rates were significantly higher in A than in Y cells. Between 2 and 4 days in culture there was a significant decrease in ouabain-sensitive Na and K transport rates in both Y and A cells. From 2 to 4 days of culture there was, in Y but not in A cells, a significant decrease in K/Na ratio. The decrease in K/Na ratio was due to a significant increase in Na content. After incubation in K-free medium, net intracellular solute accumulation was observed in A and Y cells cultured for 4 days but not in A and Y cells cultured for 2 days. In conclusion, maximal Na- and K-pump-mediated transport increases during terminal differentiation. This increase can be measured in cells cultured for 2 days. With longer time in culture, Na-K pump activity decreases and the difference between A and Y cells is not measurable.(ABSTRACT TRUNCATED AT 250 WORDS)

Postnatal maturation of the rabbit cortical collecting duct

The mature, fully differentiated cortical collecting duct plays a major role in the final renal regulation of Na+, K+ and H+ transport. To characterize the growth of this segment, we measured the outer diameter and the dry weight of cortical collecting ducts isolated from newborn, 1-month-old, and adult rabbits. During the 1st month of life no significant changes were observed; however, there was a 60% increase in both parameters after the 4th week of life. Growth-related accretion of K+ was demonstrated by showing tubular K+ content to increase by 60% with maturation. Concomitant with the increase in tubular size, total cell number per millimeter of tubular length rose by 30%. Approximately 50% of the observed increment in tubular size could be accounted for by cell hyperplasia, with the remaining increase resulting from cell hypertrophy. Hypertrophy of principal cells was confirmed by scanning electron microscopy, which demonstrated a doubling of the circumferential width without any change in longitudinal length. Hyperplasia was confirmed, using a fluorescent chromatin stain, by our finding of a mitotic frequency of 3/1000 cells in the neonatal mid-cortical collecting duct; the observed number of mitoses was 10-fold higher at the most cortical end (ampulla). The number of intercalated cells per millimeter of tubule length, identified by bright green fluorescence after cortical collecting ducts were stained with 6-carboxyfluorescein diacetate, was found to double during maturation, the increase being significant only after the 4th postnatal week. We conclude that maturation of the mid-cortical collecting duct results from both cellular hyperplasia and hypertrophy. It is unlikely that this segment plays a major role in regulating Na+, K+, and H+ transport in the neonatal kidney.

Structural and functional development of outer versus inner cortical proximal tubules

The concept of centrifugal renal development is based on renal embryogenesis. It implies a relationship between nephron age and nephron position along a cortical to medullary axis. In common usage, however, it often also implies a relationship between nephron age or position and nephron maturity. We consider here whether the ideas of centrifugal development and centrifugal maturation should in fact be considered as separate and distinct concepts. That is, we consider the possibility that nephron maturity does not necessarily correlate with nephron age. Unfortunately, pertinent reported data give no clear answer. We conclude only that further study will be required before definitive conclusions about renal developmental stages can be stated with certainty.

The effect of antenatal dexamethasone administration on glomerular filtration rate and renal sodium excretion in premature infants

Creatinine clearance (Ccr) and renal sodium (Na+) excretion were measured in 10 premature infants (gestational age less than 34 weeks) whose mothers had received dexamethasone before delivery (group D) and in 11 whose mothers were not so treated (control, group C). Babies were studied twice: on days 2-5 (study 1. all infants) and days 6-10 (study 2, six infants in each group). In study 1, absolute and fractional Na+ excretion were significantly lower (P less than 0.01) and urinary K+:Na+ ratio significantly higher (P less than 0.025) in group D than in group C, while Cr did not differ between groups. In study 2, Ccr in group D had increased compared both with values obtained in the same babies in study 1 (P less than 0.05) and with group C babies in study 2 (P less than 0.05), but significant differences between groups in urinary Na+ excretion and urinary K+:Na+ ratio were no longer found. We conclude that exogenous glucocorticoids accelerate maturation of renal function in immature human infants, probably by inducing tubular Na+. K(+)-ATPase activity. Our findings support the view that endogenous glucocorticoid hormones may play an important part in the normal maturation process.

Studies on final differentiation of rat renal proximal tubular cells in culture

The ontogeny of effective Na and K permeability has been studied in renal epithelial cells isolated from the outermost superficial cortex from adult and young (10-15 days) rats. The cells were cultured for 2-4 days and exhibited phloridzin-inhibitable alpha-methylglucoside uptake, characteristic of renal proximal tubular cells (RPTC). Intracellular concentrations of K, Na, Cl, and P and kinetics of changes in intracellular ionic content after inhibition of Na-K-ATPase with 1 mM ouabain (or by incubation in low-K medium) were measured in individual cells using electron probe analysis. Intracellular concentrations of K, Na, Cl, and P were equivalent in young and adult rat RPTC. Adult rat and young rat cells preincubated in K-free medium rapidly recovered normal intracellular K and Na contents when returned to 5.5 mM K medium. The recovery was almost immediately blocked by ouabain. Effective permeabilities measured as half time of K efflux and Na influx after ouabain inhibition of Na-K-ATPase were higher in adult than in young RPTC cultured for less than 4 days. Effective K and Na permeabilities decreased significantly with increasing time in culture in adult but not in young rat RPTC. Among young rat RPTC, half times of Na and K fluxes were significantly correlated to age. Effective K and Na permeabilities were lower in both young and adult rat RPTC that had been serum deprived for 24 h than in cells that had been continuously cultured in serum. In cells cultured for 3 days and serum deprived for 1 day, the addition of serum significantly increased K and Na permeability both in young and adult RPTC, but the effect was more pronounced in young RPTC where permeability reached the same high values as in adult RPTC continuously cultured in serum. In conclusion, effective Na and K permeabilities and serum activation of "permeability units" change during ontogeny. These ontogenic changes might be blunted after a few days in culture due to dedifferentiation of adult rat RPTC.

Induced development of proximal tubular NaKATPase, basolateral cell membranes and fluid reabsorption

We have previously demonstrated that adrenal corticoid hormones (ACH) induce NaK-ATPase activity in immature proximal tubular (PT) cells in rats. We have now determined the effect of betamethasone (beta) and aldosterone (aldo) on the size of PT basal and lateral cell membranes (BLM), PT fluid reabsorption (J v (a] measured in vivo with the split drop technique and PT NaKATPase activity in 20-day-old (young) and 40-day-old (adult) rats. Serum levels of ACH were the same in young and in adult rats, but adrenalectomy caused a significantly larger fall in NaKATPase activity in young than in adult rats. BLM surface area (micron 2/micron -3 cell volume), J v (a) and NaKATPase were significantly lower in young than in adult rats. Three-day treatment with high doses of beta (60 micrograms X 100 g-1 or aldo (40 micrograms X 100 g-1) significantly increased BLM surface area. J v (a) and NaKATPase activity in young but not in adult rats. Three days after adrenalectomy, J v (a) was significantly depressed in adult rats. There was a significant correlation between the ACH-dependent changes in NaKATPase activity and J v (a). Short-term treatment (2-3 hours) with high doses of ACH did not significantly increase NaKATPase activity and J v (a) in young rats.

Physiologic basis for the maintenance of glomerulotubular balance in young growing rats

To examine the physiologic basis of preservation of glomerulotubular balance in young growing animals, we measured the various determinants for fluid transfer across the glomerular and postglomerular capillaries in young (approximately 40 days, N = 8) and adult (N = 8) male Munich-Wistar rats under mild volume expansion. The single nephron (SN) GFR increased by approximately 2.5-fold from young to adult animals. The increase in SNGFR was due to marked rises in both glomerular plasma flow rate (QA) and ultrafiltration coefficient (Kf). The increase in QA was associated with a nearly 60% reduction in afferent and efferent arteriolar resistances. As with SNGFR, the absolute proximal reabsorption rate (APR) increased by some 2.5-fold, indicating preservation of perfect glomerulotubular balance. Of the factors determining peritubular capillary uptake of APR, the mean oncotic pressure difference across the peritubular capillary was similar in young and adult animals. The mean hydraulic pressure difference was also comparable in the two groups. By contrast, the peritubular capillary reabsorption coefficient (Kr) rose markedly and accounted entirely for the increase in peritubular capillary uptake of APR during growth. These results obtained under mild volume expansion indicate that the maintenance of glomerulotubular balance in the growing rat requires harmonious growth of renal microcirculation, that is, glomerular capillary (Kf) and arteriolar (QA) maturation balances the development of peritubular capillary (Kr).

Lithium-induced uremia in rats - a new model of chronic renal failure

Three groups of new-born rats were studied: Group Li/Li treated with Li for 16 weeks, group Li/C treated for 8 weeks followed by 8 weeks without Li, and Group C/C 16 weeks old controls. Both Li-treated groups showed severe reduction of renal function, particularly group Li/Li, where the mean GFR was reduced by 80%. Plasma urea, creatinine, and osmolality were increased, blood hemoglobin and hematocrit were reduced, whereas plasma Na, K, and standard bicarbonate were unchanged. Na clearance was maintained and fractional Na excretion thus increased. Fractional Li excretion was also increased, indicating inhibition of proximal tubular salt and water reabsorption. Renal concentrating ability was markedly reduced. When Li was withdrawn, plasma urea levels remained unchanged or continued to rise, and the concentrating defect persisted. The results demonstrate that Li administration to new-born rats causes irreversible chronic renal failure which may progress even in the absence of Li. This model of chronic renal failure has several characteristics in common with chronic renal failure in humans.

Structural and functional development of the nephron

The present review deals with structural and functional relationships during the development of the nephron. Ultrastructural morphometric technique has been used to obtain quantitative data on structural observations in order to make correlations between structure and function possible. The area of the glomerular basement membrane was found to increase by a factor 1.7 when relating the change in glomerular basement surface area to kidney weight. Furthermore it is suggested that a permeability change of the glomerular basement membrane occurs during development and that this change probably is the result of an increased area of endothelial pores and epithelial slits. The increased capacity of different nephron segments to transport Na and fluid is directly correlated to the increase in the area of the basal and lateral cell membranes as well as the amount of Na-K-ATPase. This suggests a significant contribution of these factors to the maturation of solute and fluid transport through the tubular wall.

Severe functional and structural changes caused by lithium in the developing rat kidney

Lithium (Li) was administered to rats during maternal pregnancy and/or 8 weeks post-natally, to study the effects on renal function and structure in the developing kidney. Plasma Li was 0.5-1.0 mmol/l 3 and 8 weeks post-natally. Functionally, post-natal Li leads to growth retardation, polyuria with lowering of renal concentration ability, and uremia associated with as much as 80% lowering of the normal glomerular filtration rate (GFR). Pre-natal Li alone did not affect the concentrating ability but caused a 20% increase in GFR when evaluated 8 weeks post-natally. Post-natal Li caused very severe structural changes, consisting of up to 3 mm cortical cysts (= dilated distal convoluted tubules), extensive interstitial fibrosis with cell infiltration, and atrophy of the cortical collecting ducts. Morphometric measurements showed a significant reduction in the volume of the proximal tubular cells. Pre-natal Li caused only slight structural changes, and animals treated both pre- and post-natally were less affected than animals treated post-natally only. The structural changes caused by post-natal Li were unrelated to changes in the concentrating ability but showed a significant correlation with the lowering of the GFR. It is concluded that the post-natally developing rat kidney is particularly sensitive to the nephrotoxic effects of Li, which in low concentrations causes impairment of renal function, leading to uremia. Pre-natal Li exposure by maternal lithium treatment had little effect on renal function and structure when evaluated post-natally.

The role of the kidney in sodium homeostasis during maturation

Evidence is presented that the retention of sodium observed during development is consequent primarily to enhanced tubular reabsorption rather than to low rates of glomerular filtration. The enhanced transport of sodium occurs in nephron segments located beyond the proximal tubule, apparently under the stimulation of the high plasma concentration of aldosterone. This adaptive mechanism may account for the fact that the infant thrives on a rather low intake of sodium, as prevails during the period of breast-feeding. The renin-angiotensin-aldosterone system cannot be fully inhibited even by intravascular volume expansion and this may account for the blunted natriuretic response of the developing animal and human to the acute infusion of saline or albumin solutions. Conversely, the renal sodium loss and the hyponatremia often encountered in premature babies appear to be due to an insufficient rise in aldosterone secretion or to a limited responsiveness of the distal tubule to aldosterone stimulation.

The development of cell junction during nephrogenesis

The differentiation and distribution of intercellular junctions especially during the early development stages of the rabbit nephron was studied by freeze-fracture electron microscopy. Metanephrogenic cells were found to be connected by sporadic focal tight junctions. During the formation of the renal vesicle similar tight junctions occurred on the periphery as well as near the developing lumen. These focal tight junction increased in size and coalesced to broad zonulae occludentes lining the vesicular lumen at a later stage. Broad occluding junctions were also observed in the different nephron segments of the S-shaped stage. Ultrastructurally, these early maculae and zonulae occludentes consisted of beaded rows of particles. As development progressed, continuous tight junctions formed, whereas the number of strands decreased with the exception of the distal tubule. In contrast to the parietal glomerular epithelium, the initial occluding zonules of the visceral glomerular cells were gradually reduced to maculae occludentes, and finally disappeared. These results suggest that zonulae occludentes appear synchronously with the establishing lumen; the ultrastructural differentiation of tight junction strands seems to be completed with the onset of glomerular filtration.

Effect of isotonic volume expansion on proximal tubular reabsorption of Na and fluid in the developing rat kidney

Young rats (aged 22-24 days) and adult rats (aged 40-42 days) were studied during hydropenia (HP) and during volume expansion (VE) in order to clarify the role of the proximal tubule of the immature kidney in the blunted natriuretic response seen in young mammals during VE. The position of the last accessible site for micropuncture of the proximal tubular segment was determined. The disadvantages of using lissamine green as a marker of different tubular segments were investigated. Tubular function was ascertained by micropuncture of superficial proximal nephrons. Measurements of tubular length were made from latex casts of the proximal tubule. No side-effects of lissamine green were detected, when small quantities were used (20-30 microliter) and at least 20 min elapsed between the infusions of the dye and tubular samplings. The last accessible proximal tubule available for micropuncture was found to be similarly located in young and adult rats. Fractional reabsorption during HP remained constant during development. An equivalent degree of VE induced an increase in tubular load in both age groups, but it was more marked among younger rats. Absolute proximal reabsorption in both young and old rats in HP paralleled that of the tubular load. Fractional reabsorption, however, decreased slightly during VE but to the same extent in both age groups. This indicates a great flexibility in the immature proximal tubular under various tubular loads although it had been thought that this part of the nephron was in the later stages of development. The results simply that the proximal tubule does not create the blunted sodium response in the immature kidney during VE.

Beta-2-microglobulin, an indicator of renal tubular maturation and dysfunction in the newborn

The urinary excretion and proximal tubular reabsorption of beta-2-microglobulin was studied in 17 healthy newborn infants in relation to gestational and post-natal age. The effect of IRDS and non-conjugated hyperbilirubinemia on the tubular reabsorption of the protein was evaluated in 10 IRDS infants and 14 infants with non-conjugated hyperbilirubinemia. The urinary excretion of beta-2-microglobulin was determined under standardized conditions. When GFR was determined, the single injection clearance method was used. The filtered load of beta-2-microglobulin was found to increase with increasing gestational age. This was due to a rise in plasma beta-2-microglobulin concentration as well as to a rise in the GFR. Although the smallest filtered load was recorded in infants with a mean GA of 32.4 weeks, these infants had a lower fractional reabsorption of the protein (88%) than infants with a mean GA of 35.0 weeks or more (98%). In infants with a GA of 35 weeks or more a glomerulo-tubular balance for beta-2-microglobulin apparently was established. In these infants the filtered load of beta-2-microglobulin increased rapidly during the first days of life. This was paralleled by an increase in the reabsorptive capacity for the protein. In infants with IRDS and in infants with non-conjugated hyperbilirubinemia the fractional reabsorption of beta-2-microglobulin was lower than in control infants of a corresponding gestational and postnatal age. This indicates, that in the neonatal period, the proximal tubular transporting capacity is more vulnerable than the glomerular filtration rate in states of hypoxia and hyperbilirubinemia.