Key result
Oral heparan sulphate achieves 100% survival in nephrectomized rats alongside improved renal function.
Why the study?
Heparins protect residual renal function but their anticoagulant action and parenteral administration limit use in chronic renal failure patients; oral heparan sulphate effects were evaluated.
Does oral heparan sulphate improve renal function and survival in subtotally nephrectomized rats?
Does oral heparan sulphate improve renal function and survival in subtotally nephrectomized rats?
Oral heparan sulphate exerts antiproteinuric and renoprotective effects in a rat model of chronic renal failure, suggesting potential clinical utility without anticoagulant drawbacks.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating in a rat CKD model; human trials needed before any clinical consideration.
Heparins are useful for the protection of residual renal function in several nephropathies, but the anticoagulant action and the need of parenteral administration are two main drawbacks limiting their use in chronic renal failure patients. Heparan sulphate (HS) is a heparin-like mucopolysaccharide devoid of anticoagulant action and active orally. In this study, the effects of HS oral administration have been evaluated in 18 subtotally nephrectomized rats;18 untreated remnant kidney rats served as control. No mortality was observed in the HS-treated rats, whereas in the control rats the survival rate was 72.2% at 18 weeks. At the end of the study, HS-treated rats showed lower urinary protein excretion (44 +/- 22 vs. 80 +/- 54 mg/24 h, p < 0.01), lower urea plasma levels (75 +/- 34 vs. 134 +/- 105 mg/dl, p < 0.01) and higher creatinine clearance (66 +/- 15 vs. 47 +/- 21 ml/min. 10(2), p < 0.05) than control rats. Remnant kidney weight (2.3 +/- 1.1 vs. 1.3 +/- 0.2 g, p < 0.01) and heart weight (1.3 +/- 0.2 vs. 1.1 +/- 0.1 g, p < 0.05) were greater in the control than in the HS-treated rats, as well as the systemic blood pressure values (167 +/- 19 vs. 115 +/- 32 mm Hg, respectively, p < 0.001). The remnant kidney histological examination in the HS-treated rats showed a lower prevalence of glomerular sclerosis, mesangial proliferation, and a much less evident tubulointerstitial damage than in controls. The antiproliferative and anti-inflammatory actions of HS together with its protective action on the endothelium are the putative mechanisms that could account for our findings. In conclusion, the present study supports evidence of an antiproteinuric and a renoprotective effect of orally administered HS in subtotally nephrectomized rats. This is in keeping with the well-known effects exerted also by other heparins, but the effectiveness of an orally available heparin-like product in this animal model could suggest the possibility of a clinical use also in progressing chronic renal failure patients.
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Barsotti et al. (1999) studied Subtotally nephrectomized (remnant kidney model) (n=36). Heparan sulphate (oral) vs. Untreated control was evaluated on Survival rate at 18 weeks. Oral administration of heparan sulphate in subtotally nephrectomized rats resulted in 100% survival at 18 weeks compared to 72.2% in untreated controls, alongside improved renal function.
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