NDT Advance Access originally published online on March 5, 2004
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Nephrol Dial Transplant (2004) 19: 1385-1391
Nephrol Dial Transplant Vol. 19 No. 6 © ERA-EDTA 2004; all rights reserved
Original Article
C-peptide and captopril are equally effective in lowering glomerular hyperfiltration in diabetic rats
1Department of Nephrology, Danderyd Hospital, Stockholm, 2Department of Nephrology and 3Department of Surgical Sciences, Division of Clinical Physiology, Karolinska Hospital, Stockholm and 4Department of Cell Biology, Biomedicum, Uppsala University, Sweden
Correspondence and offprint requests to: Björn Samnegård, MD, Department of Nephrology, Danderyd Hospital, SE-182 88 Stockholm, Sweden. Email: bjorn.samnegard{at}medks.ki.se
Background. C-peptide has been shown to reduce glomerular hyperfiltration, glomerular hypertrophy and urinary albumin excretion in type 1 diabetes, but its effect has not been compared with that of an angiotensin-converting enzyme inhibitor (ACEI) in the early stage of renal involvement in diabetes.
Methods. Glomerular filtration rate (GFR) was measured in terms of inulin clearance and renal blood flow, using ultrasound technique, in four groups of streptozotocin-induced diabetic rats before and after a 60 min infusion of C-peptide (D-Cp), captopril (D-ACEI), C-peptide and captopril (D-Cp–ACEI) or placebo (D-placebo). In addition, a non-diabetic control group was studied before and after captopril infusion (C-ACEI).
Results. GFR was 37–51% higher in the diabetic groups than in the control animals. GFR decreased after treatment in the D-Cp, D-ACEI and D-Cp–ACEI groups, but did not change in the D-placebo group. Blood flow increased by 26–32% in the three groups receiving captopril and by 5% in the diabetic groups treated with C-peptide alone or placebo. The increase in blood flow in the three ACEI-treated groups was significantly greater than in the D-placebo group. Filtration fraction fell significantly in all groups, but only in the combined D-Cp–ACEI group did it fall significantly more than in the D-placebo group.
Conclusions. C-peptide and captopril lower diabetes-induced glomerular hyperfiltration to a similar extent, but the influence of captopril on blood flow is greater than that of C-peptide, suggesting different mechanisms of action. No statistically significant additive effects of C-peptide and captopril were shown in this acute infusion study.
Keywords: captopril; C-peptide; diabetic nephropathy; glomerular hyperfiltration; renal blood flow
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