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Mannon EC, Muller PR, Sun J, Bush WB, Coleman A, Ocasio H, Polichnowski AJ, Brands MW, O'Connor PM. NaHCO3 loading causes increased arterial pressure and kidney damage in rats with chronic kidney disease. Clin Sci (Lond) 2024; 138:189-203. [PMID: 38300615 DOI: 10.1042/cs20231709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/02/2024]
Abstract
Sodium bicarbonate (NaHCO3) is commonly utilized as a therapeutic to treat metabolic acidosis in people with chronic kidney disease (CKD). While increased dietary sodium chloride (NaCl) is known to promote volume retention and increase blood pressure, the effects of NaHCO3 loading on blood pressure and volume retention in CKD remain unclear. In the present study, we compared the effects of NaCl and NaHCO3 loading on volume retention, blood pressure, and kidney injury in both 2/3 and 5/6 nephrectomy remnant kidney rats, a well-established rodent model of CKD. We tested the hypothesis that NaCl loading promotes greater volume retention and increases in blood pressure than equimolar NaHCO3. Blood pressure was measured 24 h daily using radio telemetry. NaCl and NaHCO3 were administered in drinking water ad libitum or infused via indwelling catheters. Rats were housed in metabolic cages to determine volume retention. Our data indicate that both NaHCO3 and NaCl promote hypertension and volume retention in remnant kidney rats, with salt-sensitivity increasing with greater renal mass reduction. Importantly, while NaHCO3 intake was less pro-hypertensive than equimolar NaCl intake, NaHCO3 was not benign. NaHCO3 loading significantly elevated blood pressure and promoted volume retention in rats with CKD when compared with control rats receiving tap water. Our findings provide important insight into the effects of sodium loading with NaHCO3 in CKD and indicate that NaHCO3 loading in patients with CKD is unlikely to be benign.
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Affiliation(s)
- Elinor C Mannon
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - P Robinson Muller
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Jingping Sun
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Weston B Bush
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Alex Coleman
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Hiram Ocasio
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Aaron J Polichnowski
- Department of Biomedical Sciences, Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, U.S.A
| | - Michael W Brands
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
| | - Paul M O'Connor
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, Georgia, U.S.A
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Høgild ML, Hjelholt AJ, Hansen J, Pedersen SB, Møller N, Wojtaszewski JFP, Johannsen M, Jessen N, Jørgensen JOL. Ketone Body Infusion Abrogates Growth Hormone-Induced Lipolysis and Insulin Resistance. J Clin Endocrinol Metab 2023; 108:653-664. [PMID: 36240323 DOI: 10.1210/clinem/dgac595] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/10/2022] [Indexed: 11/19/2022]
Abstract
CONTEXT Exogenous ketone body administration lowers circulating glucose levels but the underlying mechanisms are uncertain. OBJECTIVE We tested the hypothesis that administration of the ketone body β-hydroxybutyrate (βOHB) acutely increases insulin sensitivity via feedback suppression of circulating free fatty acid (FFA) levels. METHODS In a randomized, single-blinded crossover design, 8 healthy men were studied twice with a growth hormone (GH) infusion to induce lipolysis in combination with infusion of either βOHB or saline. Each study day comprised a basal period and a hyperinsulinemic-euglycemic clamp combined with a glucose tracer and adipose tissue and skeletal muscle biopsies. RESULTS βOHB administration profoundly suppressed FFA levels concomitantly with a significant increase in glucose disposal and energy expenditure. This was accompanied by a many-fold increase in skeletal muscle content of both βOHB and its derivative acetoacetate. CONCLUSION Our data unravel an insulin-sensitizing effect of βOHB, which we suggest is mediated by concomitant suppression of lipolysis.
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Affiliation(s)
- Morten Lyng Høgild
- Medical Research Laboratory, Department of Clinical Medicine, Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
| | - Astrid Johannesson Hjelholt
- Medical Research Laboratory, Department of Clinical Medicine, Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
| | - Jakob Hansen
- Department of Forensic Medicine, Aarhus University, Aarhus N 8200, Denmark
| | - Steen Bønløkke Pedersen
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
| | - Niels Møller
- Medical Research Laboratory, Department of Clinical Medicine, Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
- Department of Forensic Medicine, Aarhus University, Aarhus N 8200, Denmark
| | - Jørgen F P Wojtaszewski
- August Krogh Section for Molecular Physiology, University of Copenhagen, Copenhagen 2100, Denmark
| | - Mogens Johannsen
- Department of Forensic Medicine, Aarhus University, Aarhus N 8200, Denmark
| | - Niels Jessen
- Department of Clinical Pharmacology, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
- Steno Diabetes Centre Aarhus, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
- Department of Biomedicine, Aarhus University, Aarhus 8000, Denmark
| | - Jens Otto Lunde Jørgensen
- Medical Research Laboratory, Department of Clinical Medicine, Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus N, Region Midtjylland 8200, Denmark
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Bodine SC, Brooks HL, Coller HA, Domingos AI, Frey MR, Goodman BE, Kleyman TR, Lindsey ML, Morty RE, Petersen OH, Ramírez JM, Schaefer L, Thomsen MB, Yosten GLC. An American Physiological Society cross-journal Call for Papers on "The Physiology of Obesity". Am J Physiol Lung Cell Mol Physiol 2022; 323:L593-L602. [PMID: 36223636 PMCID: PMC9665636 DOI: 10.1152/ajplung.00335.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/10/2022] [Accepted: 10/10/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Sue C Bodine
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Heddwen L Brooks
- Department of Physiology, University of Arizona College of Medicine, Tucson, Arizona
| | - Hilary A Coller
- Department of Molecular, Cell and Developmental Biology, University of California, Los Angeles, California
- Molecular Biology Institute, University of California, Los Angeles, California
- Department of Biological Chemistry at the David Geffen School of Medicine, University of California, Los Angeles, California
| | - Ana I Domingos
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, United Kingdom
| | - Mark R Frey
- The Saban Research Institute, Children's Hospital Los Angeles, University of Southern California Keck School of Medicine, Los Angeles, California
- Department of Pediatrics, University of Southern California Keck School of Medicine, Los Angeles, California
- Department of Biochemistry and Molecular Medicine, University of Southern California Keck School of Medicine, Los Angeles, California
| | - Barbara E Goodman
- Division of Basic Biomedical Sciences, Sanford School of Medicine of the University of South Dakota, Vermillion, South Dakota
| | - Thomas R Kleyman
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Cell Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Merry L Lindsey
- School of Graduate Studies and Research, Meharry Medical College, Nashville, Tennessee
- Research Service, Nashville VA Medical Center, Nashville, Tennessee
| | - Rory E Morty
- Department of Translational Pulmonology and the Translational Lung Research Center Heidelberg, University Hospital Heidelberg, member of the German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Lung Development and Remodelling, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Ole H Petersen
- School of Biosciences, Cardiff University, Cardiff, United Kingdom
| | - Jan-Marino Ramírez
- Department of Neurological Surgery, University of Washington Medical Center, Seattle, Washington
- Center on Human Development and Disability, University of Washington, Seattle, Washington
- Center for Integrative Brain Research at the Seattle Children's Research Institute, University of Washington, Seattle, Washington
| | - Liliana Schaefer
- Institute of Pharmacology and Toxicology, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Morten B Thomsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gina L C Yosten
- Department of Pharmacology and Physiology, Saint Louis University School of Medicine, St. Louis, Missouri
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Adam RJ, Williams AC, Kriegel AJ. Comparison of the Surgical Resection and Infarct 5/6 Nephrectomy Rat Models of Chronic Kidney Disease. Am J Physiol Renal Physiol 2022; 322:F639-F654. [PMID: 35379002 DOI: 10.1152/ajprenal.00398.2021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The 5/6 nephrectomy rat remnant kidney model is commonly employed to study chronic kidney disease (CKD). This model requires removal of one whole kidney and two-thirds of the other. The two most common ways of producing the remnant kidney are surgical resection of poles, known as the polectomy (Pol) model, or ligation of upper and lower renal arterial branches, resulting in pole infarction (Inf). These models have much in common, but also major phenotypic differences, and thus respectively model unique aspects of human CKD. The purpose of this review is to summarize phenotypic similarities and differences between these two models and their relation to human CKD, while emphasizing their vascular phenotype. In this article we review studies that have evaluated arterial blood pressure, the renin-angiotensin-aldosterone-system (RAAS), autoregulation, nitric oxide, single nephron physiology, angiogenic and anti-angiogenic factors, and capillary rarefaction in these two models. Phenotypic similarities: both models spontaneously develop hallmarks of human CKD including uremia, fibrosis, capillary rarefaction, and progressive renal function decline. They both undergo whole-organ hypertrophy, hyperfiltration of functional nephrons, reduced renal expression of angiogenic factor VEGF, increased renal expression of the anti-angiogenic thrombospondin-1, impaired renal autoregulation, and abnormal vascular nitric oxide physiology. Key phenotypic differences: the Inf model develops rapid-onset, moderate-to-severe systemic hypertension, and the Pol model early normotension followed by mild-to-moderate hypertension. The Inf rat has a markedly more active renin-angiotensin-aldosterone-system. Comparison of these two models facilitates understanding of how they can be utilized for studying CKD pathophysiology (e.g., RAAS dependent or independent pathology).
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Affiliation(s)
- Ryan J Adam
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States.,Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Adaysha C Williams
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Alison J Kriegel
- Department of Physiology, Medical College of Wisconsin, Milwaukee, WI, United States.,Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, United States.,Cardiovascular Center, Medical College of Wisconsin, Milwaukee, WI, United States.,Center of Systems Molecular Medicine, Medical College of Wisconsin, Milwaukee, WI, United States
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