Why the study?
Hypertension and diabetes mellitus commonly overlap as major causes of chronic kidney disease, necessitating new preventive or therapeutic approaches.
Absolute Event Rate: 0.72% vs 0.98%
p-value: p=<0.05
Macitentan exerts protective and antioxidant effects on the kidney in a hypertensive and diabetic preclinical model, suggesting potential utility in slowing diabetic nephropathy.
Hypertension and Diabetes mellitus are the two main causes of chronic kidney disease that culminate in the final stage of kidney disease. Since these two risk factors are common and can overlap, new approaches to prevent or treat them are needed. Macitentan (MAC) is a new non-selective antagonist of the endothelin-1 (ET-1) receptor. This study aimed to evaluate the effect of chronic blockade of ET-1 receptor with MAC on the alteration of renal function observed in hypertensive and hyperglycemic animals. Genetically hypertensive rats were divided into control hypertensive (HT-CTL) group, hypertensive and hyperglycemic (HT+DIAB) group, and hypertensive and hyperglycemic group that received 25 mg/kg macitentan (HT-DIAB+MAC25) via gavage for 60 days. Kidney function and parameters associated with oxidative and nitrosative stress were evaluated. Immunohistochemistry for neutrophil gelatinase-associated lipocalin (NGAL), ET-1, and catalase in the renal cortex was performed. The HT+DIAB group showed a decrease in kidney function and an increase in NGAL expression in the renal cortex, as well as an increase in oxidative stress. MAC treatment was associated with attenuated ET-1 and NGAL production and increases in antioxidant defense (catalase expression) and nitric oxide production. In addition, MAC prevented an increase in oxidant injury (as measured by urinary hydroperoxide and lipid peroxidation), thus improving renal function. Our results suggest that the antioxidant effect of the ET-1 receptor antagonist MAC is involved in the improvement of kidney function observed in hypertensive and hyperglycemic rats.
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Caires et al. (2019) studied Hypertension and hyperglycemia-induced chronic kidney injury (n=30). Macitentan vs. Vehicle (untreated hypertensive and hyperglycemic rats) was evaluated on Plasma creatinine at 60 days (p=<0.05).
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