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Hofrichter J, Sempert K, Kerkhoff C, Breitrück A, Wasserkort R, Mitzner S. Phosphate restriction using a processed clay mineral reduces vascular pathologies and microalbuminuria in rats with chronic renal failure. BMC Nephrol 2022; 23:162. [PMID: 35484519 PMCID: PMC9052552 DOI: 10.1186/s12882-022-02743-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 02/25/2022] [Indexed: 11/10/2022] Open
Abstract
Background The progression of chronic kidney disease (CKD) is associated with an increasing risk of cardiovascular morbidity and mortality due to elevated serum phosphate levels. Besides low phosphate diets and hemodialysis, oral phosphate binders are prescribed to treat hyperphosphatemia in CKD patients. This study reports on a processed clay mineral as a novel and efficient phosphate sorbent with comparable efficacy of a clinically approved phosphate binder. Methods 5/6 nephrectomized rats, which develop chronic renal failure (CRF), received a high phosphate and calcium diet supplemented with either a processed Montmorillonite-Illite clay mineral (pClM) or lanthanum carbonate (LaC) for 12 weeks. Levels of plasma uremic toxins, glomerular filtration rates and microalbuminuria were determined and the histomorphology of blood vessels and smooth muscle cells was analyzed. Results 5/6 nephrectomy induced an increase in plasma uremic toxins levels and progressive proteinuria. Treatment of CRF rats with pClM decreased observed vascular pathologies such as vascular fibrosis, especially in coronary vessels. The transition of vascular smooth muscle cells from a contractile to a secretory phenotype was delayed. Moreover, pClM administration resulted in decreased blood creatinine and urea levels, and increased glomerular filtration rates, reduced microalbuminuria and eventually the mortality rate in CRF rats. Conclusion Our study reveals pClM as a potent phosphate binding agent with beneficial impacts on pathophysiological processes in an animal model of CKD. pClM effectively attenuates the progression of vascular damage and loss of renal function which are the most severe consequences of chronic renal failure. Supplementary Information The online version contains supplementary material available at 10.1186/s12882-022-02743-5.
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Affiliation(s)
- Jacqueline Hofrichter
- Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany. .,Rostock University Medical Center, Center for Internal Medicine, Nephrology Section, Schillingallee 35, 18057, Rostock, Germany.
| | - Kai Sempert
- Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany.,Present address: Queensland Brain Institute, University of Queensland, St. Lucia, 4071, Australia
| | - Claus Kerkhoff
- Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany.,Department of Biomedical Sciences, University of Osnabrück, Institute of Health Research and Education, Barbarastraße 22c, 49076, Osnabrück, Germany
| | - Anne Breitrück
- Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany.,Rostock University Medical Center, Center for Internal Medicine, Nephrology Section, Schillingallee 35, 18057, Rostock, Germany
| | - Reinhold Wasserkort
- Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany.,Rostock University Medical Center, Center for Internal Medicine, Nephrology Section, Schillingallee 35, 18057, Rostock, Germany
| | - Steffen Mitzner
- Department of Extracorporeal Therapy Systems, Fraunhofer Institute for Cell Therapy and Immunology, Schillingallee 68, 18057, Rostock, Germany.,Rostock University Medical Center, Center for Internal Medicine, Nephrology Section, Schillingallee 35, 18057, Rostock, Germany
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St. Peter WL, Wazny LD, Weinhandl ED. Phosphate-Binder Use in US Dialysis Patients: Prevalence, Costs, Evidence, and Policies. Am J Kidney Dis 2018; 71:246-253. [DOI: 10.1053/j.ajkd.2017.09.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/19/2017] [Indexed: 01/15/2023]
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