Key result
UT antagonist SB-611812 delays blood pressure and albuminuria rise but fails to prevent renal progression.
Why the study?
Urotensin II is upregulated in later stages of CKD, particularly in dialysis patients, but it is unclear if UT receptor antagonism can slow CKD progression.
Does UT antagonism with SB-611812 slow the progression of renal dysfunction in a rat model of chronic kidney disease?
Does UT antagonism with SB-611812 slow the progression of renal dysfunction in a rat model of chronic kidney disease?
Urotensin II receptor antagonism can slow but not prevent the progression of chronic kidney disease in a rat model, suggesting a role for urotensin II in renal function decline.
Should not change practice for hypertensive renal disease; leaves open whether sustained UT antagonism alters progression.
New Findings What is the central question of this study? Urotensin II is upregulated in patients in the later stages of chronic kidney disease (CKD), particularly in individuals requiring dialysis. Could treatment with a urotensin II receptor antagonist slow progression of renal disease? What is the main finding and its importance? In the rat, expression of urotensin II and its receptor increased, extending into cortical structures as CKD progressed towards end‐stage renal failure. Subchronic treatment with a urotensin receptor antagonist slowed but did not prevent progression of CKD. This suggests that urotensin II contributes to the decline in renal function in CKD. Abstract Elevated serum and urine urotensin II (UII) concentrations have been reported in patients with end‐stage chronic kidney disease (CKD). Similar increases in UII and its receptor, UT, have been reported in animal models of CKD, but only at much earlier stages of renal dysfunction. The aim of this study was to characterize urotensin system expression as renal disease progresses to end‐stage failure in a ⅚ subtotal nephrectomy (SNx) rat model. Male Sprague–Dawley rats underwent SNx or sham surgery and were killed at 8 weeks postsurgery [early (E)] or immediately before end‐stage renal failure [30 ± 3 weeks postsurgery; late (L)]. Systolic blood pressure, urinary albumin:creatinine ratio and glomerulosclerosis index were all increased in SNx‐E rats compared with sham‐E by 8 weeks postsurgery. These changes were associated with an increase in renal immunoreactive UII staining but little change in UT expression. As CKD progressed to end‐stage disease in the SNx‐L group, markers of renal function deteriorated further, in association with a marked increase in immunoreactive UII and UT staining. Subchronic administration of a UT antagonist, SB‐611812, at 30 mg kg−1 day−1 for 13 weeks, in a separate group of SNx rats resulted in a 2 week delay in the increase in both systolic blood pressure and urinary albumin:creatinine ratio observed in vehicle‐treated SNx but did not prevent the progression of renal dysfunction. The urotensin system is upregulated as renal function deteriorates in the rat; UT antagonism can slow but not prevent disease progression, suggesting that UII plays a role in CKD.
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Eyre et al. (2018) studied Chronic kidney disease. SB-611812 (UT antagonist) vs. Vehicle was evaluated on Progression of renal dysfunction (systolic blood pressure and urinary albumin:creatinine ratio). Subchronic administration of the UT antagonist SB-611812 delayed the increase in systolic blood pressure and urinary albumin:creatinine ratio by 2 weeks but did not prevent renal disease progression.
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