Diabetic Nephropathy in Spontaneously Diabetic Torii (SDT) Rats

Similar documents
Spontaneously Diabetic Torii Lepr fa (SDT Fatty) Rat: A Novel Model of Obese Type 2 Diabetes

Obese Type 2 Diabetic Model. Rat Model with Early Onset of Diabetic Complications. SDT fatty rats. SDT fatty rats

Diabetic Nephropathy

Ordering Physician. Collected REVISED REPORT. Performed. IgG IF, Renal MCR. Lambda IF, Renal MCR. C1q IF, Renal. MCR Albumin IF, Renal MCR

Diabetic Nephropathy

Histopathology: Hypertension and diabetes in the kidney These presentations are to help you identify basic histopathological features.

Title a novel obese diabetic model( Disse. /doctor.r12

Diabetic Nephropathy. Introduction/Clinical Setting. Pathologic Findings Light Microscopy. J. Charles Jennette

RENAL HISTOPATHOLOGY

Surgical Pathology Report

Diabetes-Associated Complications in Spontaneously Diabetic Torii Fatty Rats

Diabetic Nephropathy 2009

Glomerular pathology in systemic disease

Reversal of Microalbuminuria A Causative Factor of Diabetic Nephropathy is Achieved with ACE Inhibitors than Strict Glycemic Control

Chapter 2. Standardization of rat model for diabetic nephropathy

REVIEW ARTICLE NEWER BIOMARKERS IN EARLY DIABETIC NEPHROPATHY

Familial DDD associated with a gain-of-function mutation in complement C3.

THE URINARY SYSTEM. The cases we will cover are:

THE URINARY SYSTEM. The cases we will cover are:

Hyperglycemia: Type I Diabetes Mellitus

RENOPROTECTIVE EFFECTS OF COMBINED ALISKIREN AND VALSARTAN IN PROGRESSIVE DIABETIC NEPHROPATHY IN RATS

Risk Factors for Diabetic Nephropathy

No significant differences in short-term renal prognosis between living kidney donors with and without diabetes

Year 2004 Paper one: Questions supplied by Megan

For more information about how to cite these materials visit

Nephritic vs. Nephrotic Syndrome

Diabetes in Renal Patients. Contents. Understanding Diabetic Nephropathy

Effects of beraprost sodium on renal function and inflammatory factors of rats with diabetic nephropathy

Case # 2 3/27/2017. Disclosure of Relevant Financial Relationships. Clinical history. Clinical history. Laboratory findings

Diabetes and Hypertension

Glomerular Pathology- 1 Nephrotic Syndrome. Dr. Nisreen Abu Shahin

Mouse Models of Diabetic Nephropathy. Mount Sinai / Jefferson / Einstein / Minnesota Erwin Böttinger, PI Kumar Sharma, Co-PI

Renal Pathology 1: Glomerulus. With many thanks to Elizabeth Angus PhD for EM photographs

Case Presentation Turki Al-Hussain, MD

A clinical syndrome, composed mainly of:

CASE 3 AN UNUSUAL CASE OF NEPHROTIC SYNDROME

The CARI Guidelines Caring for Australasians with Renal Impairment. ACE Inhibitor and Angiotensin II Antagonist Combination Treatment GUIDELINES

CHAPTER 2. Primary Glomerulonephritis

ORIGINAL ARTICLE Urinary type IV collagen levels in diabetes mellitus

The principal functions of the kidneys

renoprotection therapy goals 208, 209

Oxidative Stress Unify the Pathophysiological Mechanism of Experimental Hypertension and Diabetes of Spontaneously Hypertensive Stroke-Prone Rats

Functions of the kidney:

The Morphologic Patterns of Diabetic Nephropathy in Koreans

Interesting case seminar: Native kidneys Case Report:

Dr Ian Roberts Oxford. Oxford Pathology Course 2010 for FRCPath Illustration-Cellular Pathology. Oxford Radcliffe NHS Trust

Lab 3, case 1. Is this an example of nephrotic or nephritic syndrome? Why? Which portion of the nephron would you expect to be abnormal?

Monoclonal Gammopathies and the Kidney. Tibor Nádasdy, MD The Ohio State University, Columbus, OH

Hemizygous Fabry disease associated with IgA nephropathy: A case report

Kengo Furuichi, Miho Shimizu, Akinori Hara, Tadashi Toyama and Takashi Wada

Diabetes and kidney disease.

Introduction to Clinical Diagnosis Nephrology

Histopathology: Glomerulonephritis and other renal pathology

Glomerular diseases mostly presenting with Nephritic syndrome

CHAPTER 2 PRIMARY GLOMERULONEPHRITIS

Low-Dose Candesartan Cilexetil Prevents Early Kidney Damage in Type 2 Diabetic Patients with Mildly Elevated Blood Pressure

Basic Urinary Tract Anatomy and Histology

The hypertensive kidney and its Management

Citation Acta Medica Nagasakiensia. 1987, 32

The Diabetes Kidney Disease Connection Missouri Foundation for Health February 26, 2009

Renal System Physiology

Non-protein nitrogenous substances (NPN)

NIH Public Access Author Manuscript Drug Discov Today Dis Models. Author manuscript; available in PMC 2015 August 22.

Dense deposit disease with steroid pulse therapy

Proteinuria. Louisiana State University

Diabetic Kidney Disease Tripti Singh MD Department of Nephrology University of Wisconsin

Dr. Hayam Gad Associate Professor of Physiology College of Medicine King Saud University

RENAL EVENING SPECIALTY CONFERENCE

Functional morphology of kidneys Clearance

HRZZ project: Genotype-Phenotype correlation in Alport's syndrome and Thin Glomerular Basement Membrane Nephropathy. Patohistological Aspects

Objectives. Pre-dialysis CKD: The Problem. Pre-dialysis CKD: The Problem. Objectives

Prevention And Treatment of Diabetic Nephropathy. MOH Clinical Practice Guidelines 3/2006 Dr Stephen Chew Tec Huan

Renal histologic changes and the outcome in patients with diabetic nephropathy

Dr Ian Roberts Oxford. Oxford Pathology Course 2010 for FRCPath Illustration-Cellular Pathology. Oxford Radcliffe NHS Trust

Introduction to the kidney: regulation of sodium & glucose. Dr Nick Ashton Senior Lecturer in Renal Physiology Faculty of Biology, Medicine & Health

Chapter 23. Composition and Properties of Urine

C1q nephropathy the Diverse Disease

Familial Nephropathy (FN) in [English] Cocker Spaniel Dogs Introduction Clinical signs Laboratory features

SGLT2 inhibition in diabetes: extending from glycaemic control to renal and cardiovascular protection

Prof. Andrzej Wiecek Department of Nephrology, Endocrinology and Metabolic Diseases Medical University of Silesia Katowice, Poland.

Kidney disease in people with diabetes. Ian Gallen

Glomerular filtration rate (GFR)

The topic of normal vascular and glomerular anatomy is introduced

Cellular Injury. Intracellular degeneration. By Dr. Hemn Hassan Othman PhD, Pathology Fall /20/2018 1

Light and electron microscopical studies of focal glomerular sclerosis

Case Report A Case of Proliferative Glomerulonephritis with Monoclonal IgG Deposits That Showed Predominantly Membranous Features

Invited Revie W. Diabetic nephropathy: the modulating influence of glucose on transforming factor D production

Proceedings of the 34th World Small Animal Veterinary Congress WSAVA 2009

Summary of Recommendation Statements Kidney International Supplements (2013) 3, 5 14; doi: /kisup

Objectives. Kidney Complications With Diabetes. Case 10/21/2015

Recurrent Idiopathic Membranous Glomerulonephritis After Kidney Transplantation and Successful Treatment With Rituximab

The interest in microalbuminuria originated. Cardiovascular Implications of Albuminuria. R e v i e w P a p e r.

The organs of the human body were created to perform ten functions among which is the function of the kidney to furnish the human being with thought.

Disorders of the kidney. Urine analysis. Nephrotic and nephritic syndrome.

Accepted Manuscript. Glomerulopathy Associated with Moderate Obesity

Elevated Serum Creatinine, a simplified approach

Clinico-pathological features of kidney disease in diabetic cases

Diabetic nephropathy affects 25 30% of type 1

Ch 19: The Kidneys. Functional unit of kidneys:?? Developed by John Gallagher, MS, DVM

THE KIDNEY AND SLE LUPUS NEPHRITIS

Transcription:

The Open Diabetes Journal, 2011, 4, 45-49 45 Diabetic Nephropathy in Spontaneously Diabetic Torii (SDT) Rats Takeshi Ohta * and Tomohiko Sasase Open Access Biological/Pharmacological Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc., 1-1 Murasaki-cho, Takatsuki, Osaka 569-1125, Japan Abstract: Diabetic nephropathy is a serious complication of diabetes mellitus, making it essential to develop animal models of diabetic complications to simulate the pathogenesis in humans. We monitored pathobiochemical parameters and histopathological findings of kidneys in male Spontaneously Diabetic Torii (SDT) rats. Renal-related parameters in SDT rats have deteriorated with the progress of diabetes mellitus, and histopathological changes in the renal tubules and the glomeruli were observed with aging. Glycemic control in SDT rats prevented the development of renal lesions. The features of SDT rat indicate its usefulness as an animal model for investigating diabetic nephropathy. Keywords: Diabetic nephropathy, insulin, SDT rat. INTRODUCTION Diabetic nephropathy is the most common cause of endstage renal failure [1, 2]. From a clinical perspective, it is characterized by the onset of proteinuria, a subsequent decline in glomerular filtration rate, and ultimate progression to renal failure, which is fatal if left untreated [3, 4]. The identification of an experimental animal model with diabetic nephropathy that closely mirrors human disease will significantly enhance our understanding of the nephropathy and accelerate our progress toward more effective treatments. ANIMAL MODEL The functional and morphological features of the diabetic renal lesions have been evaluated in male Spontaneously Diabetic Torii (SDT) rats from 8 to 68 weeks of age [5]. Sprague-Dawley (SD) rats of similar age were used as control animals. KIDNEY FUNCTION In SDT rats, urinalysis showed increase in urine volume and in urinary protein at 24 weeks of age, and further increase thereafter, until 54 weeks of age. Also, an increase of urinary albumin excretion was observed during the same period. The levels of creatinine clearance were higher from 28 to 52 weeks of age, as compared with SD rats. KIDNEY SIZE Renal hypertrophy and glomerular hypertrophy are seen at the early stage of diabetes mellitus. In streptozotocininduced diabetic models, the glomerular hypertrophy was prominent during the first few days of diabetes [6, 7]. Also, in SDT rats, the increase of kidney weight and glomerular size was observed from the early stage of diabetes mellitus. Kidney weights in SDT rats were observed from 12 to 20 *Address correspondence to this author at the Japan Tobacco, Inc. Central Pharmaceutical Research Institute 1-1, Murasaki-cho, Takatsuki, Osaka, 569-1125, Japan; Tel: +81-72-681-9700; Fax: +81-72-681-9722; E-mail: takeshi.ota@jt.com weeks of age. The relative kidney weights significantly increased after 14 weeks of age, as compared with those in age-matched SD rats (Table 1). Moreover, a strong positive correlation was observed between serum glucose level and absolute or relative kidney weight in SDT rats (glucose vs absolute kidney weight: R 2 =0.8233, glucose vs relative kidney weight: R 2 =0.8121). Glomerular size in SDT rats and SD rats was determined at 16 weeks of age. The glomerular size in SDT rats was significantly enlarged, as compared with that in SD rats (SDT rats: 9033.7 ± 666.4 m 2 vs SD rats: 7020.9 ± 463.6 m 2, Data represent means ± SD (n=4 or 5)). In streptozotocin-induced diabetic models, kidney weights increased by 15-20% during the first 4 to 5 days of diabetes and by 70 to 90% after 6 weeks [6]. HISTOPATHOLOGY Histopathological examination of the kidneys revealed changes in the renal tubules from 24 weeks of age, and in the glomeruli, from 32 weeks of age. In the glomeruli, basement membrane thickening was observed from 32 weeks of age, and the change progressed with aging. Mesangial matrix proliferation was observed from 50 weeks of age. These findings included an increase in periodic acid Schiff (PAS) positive areas, fibrous proliferation on Masson's trichrome (MT) staining, and increased type IV collagen positive areas on immunohistochemical (IHC) staining (Fig. 1). The glomerular changes gradually progressed with aging, with diffuse glomerular lesions at 50 and 68 weeks of age. At 68 weeks of age, nodular lesions were observed in a few glomerular capillary loops on PAS staining (Fig. 2). In the renal tubules, glycogen deposition in the tubular epithelium (Armanni-Ebstein lesions) and tubular dilation were noted starting at 24 weeks of age in SDT rats. There were increased hyaline casts at 50 weeks of age. These renal tubular changes markedly progressed with aging, and severe changes throughout the kidneys were present by 68 weeks of age (Fig. 3). At 50 and 68 weeks of age, tubules with glycogen deposition were seen throughout the renal cortex. 1876-5246/11 2011 Bentham Open

46 The Open Diabetes Journal, 2011, Volume 4 Ohta and Sasase Table 1. Bodyweights, Serum Parameters, and Organ Weights in Male SD Rats and SDT Rats 12 14 16 18 20 Body weight (g) SD rat 567.0 ± 31.4 565.4 ± 32.8 634.4 ± 62.7 635.6 ± 43.3 691.0 ± 35.1 SDT rat 515.2 ± 14.2* 533.6 ± 14.1 532.9 ± 12.2* 542.1 ± 28.9* 508.1 ± 39.7** Glucose (mg/dl) SD rat 115.4 ± 4.5 144.2 ± 8.8 147.2 ± 5.0 130.5 ± 4.7 136.5 ± 7.9 SDT rat 297.8 ± 204.3 347.4 ± 196.4 450.8 ± 252.4 473.3 ± 252.1 604.0 ± 261.3* Trigryceride (mg/dl) SD rat 371.5 ± 67.1 275.9 ± 61.3 341.7 ± 112.0 345.6 ± 175.8 419.9 ± 208.1 SDT rat 287.2 ± 125.5 329.7 ± 93.4 243.3 ± 52.0 317.1 ± 122.5 427.9 ± 127.7 Absolute kidney weight (mg) SD rat 3124.6 ± 318.8 2981.0 ± 221.3 3214.5 ± 347.1 2923.0 ± 154.5 3187.8 ± 317.5 SDT rat 3376.2 ± 424.2 3373.8 ± 317.2 3708.7 ± 630.9 3737.5 ± 555.2 4088.0 ± 603.1* Relative kidney weight (mg/g) SD rat 5.52 ± 0.66 5.27 ± 0.20 5.07 ± 0.31 4.60 ± 0.15 4.61 ± 0.34 SDT rat 6.55 ± 0.77 6.33 ± 0.68* 6.94 ± 1.06* 6.92 ± 1.19* 8.13 ± 1.64** Data represent means ± SD (n = 4 or 5). *P<0.05, **P<0.01 vs age-matched SD rats. Fig. (1). Histological and immunohistological analysis of glomeruli in SD, SDT, and SDT+insulin rats [5]. A, E, and I: HE stained sections; B, F, and J: PAS stain; C, G, and K: MT stain; D, H, and L: Collagen type IV immunohistostained sections. Kidney sections are from SD (A-D) and SDT rats (E-H) at 50 weeks of age. SDT rats treated with insulin pellets (I-L) at 68 weeks of age. Bar = 20 μm. Human clinical stage of diabetic nephropathy is classified from Stage I into Stage V (Stage I: initial stage, II: early renal involvement, III: incipient nephropathy, IV: overt nephropathy, V: end-stage renal disease) [1]. In Stage I, glomerular filtration rate (GFR) is increased, and glomerular hypertrophy and increased kidney volume are observed. In Stage II, the glomerular basement membrane (GBM) thickening and mesangial expansion are observed. Further GBM thickening and mesangial expansion are shown in Stage III, and albumin excretion rate is increased. Persistent dipstick albuminuria defines overt nephropathy (Stage IV). It is characterized by a decline in GFR and increased mortality.

Diabetic Nephropathy in Spontaneously Diabetic Torii (SDT) Rats The Open Diabetes Journal, 2011, Volume 4 47 The histologic features are diffuse and/or nodular glomerulosclerosis and hypertension is observed. In Stage V, GFR is reduced and glomerular closure and obsolescence are observed. In SDT rat from 24 to 68 weeks of age, an increase of urinary albumin excretion, GBM thickening and mesangial expansion were observed. Those changes are similar to the features as stage I to III in human clinical diabetic nephropathy. SDT rat is considered to be a new model of early phase of diabetic nephropathy. Fig. (2). Light microscopic feature of glomerulus in SDT rat at 68 weeks of age [5]. PAS stain. Bar = 20 μm. Nodular lesions were observed in a few glomeruli (arrow). Renal lesions with diabetes mellitus have been reported in other genetic diabetes models. Goto-Kakizaki (GK) rats, a nonobese type2 diabetes model, exhibited proteinuria by 6 months of age, accompanied by renal histologic abnormalities such as focal glomerulosclerosis, mesangial matrix expansion, and thickening of basement membranes. Furthermore, diffuse global glomerulosclerosis with nodule formation and arteriolar hyalinosis were exhibited by 18 months of age [8, 9]. In Zucker Diabetic Fatty (ZDF) rats, an obese type 2 diabetes model, proteinuria started to rise until 3 months of age. The glomerulosclerosis commenced as early as 5 months of age, and was associated with glomerular hypertrophy and mild mesangial expansion [10]. Moreover, an adjacent tubulus showed enlarged cells with clear cytoplasm (Armanni-Ebstein cells), indicating a history of diabetes and glucosuria [11]. EFFECT OF BLOOD GLUCOSE CONTROL The main clinical associations that frequently precede overt diabetic nephropathy are poor glycemic control and hypertension [12]. To control blood glucose levels in SDT rats, an insulin pellet was implanted subcutaneously. The rats were then examined to determine whether the renal dysfunction was caused by hyperglycemia [5]. In the insulin treated group, the values for urinary parameters such as urine volume, urine protein, and urinary albumin excretion were clearly decreased (Table 3). Furthermore, the insulin-treated group of SDT rats at 50 and 68 weeks of age showed no glomerular or tubular lesions (Figs. 1 and 3). Renal damage in the SDT rats was obviously prevented by glycemic control. BLOOD PRESSURE There has been no report of examination of the blood pressure in SDT rats. We previously examined the systolic blood pressure (SBP) by the indirect tail cuff method, and observed that the levels at 24 weeks of age tended to increase (SDT rats: 145 ± 13 mmhg vs SD rats: 125 ± 21 mmhg (n=5)). Table 2 shows the physiological parameters, including blood chemical parameters, renal-related parameters, and blood pressure, in SD rats and SDT rats at that time. Renal-related parameters, such as blood urea nitrogen, urine volume, urine protein and creatinine clearance, were deteriorated with an elevation of blood glucose levels. Moreover, urine angiotensinogen levels in SDT rats at 24 weeks of age tended to elevate (SDT rats: 30.68 ± 21.93 ng/ml vs SD rats: 6.84 ± 2.46 ng/ml (n=5)). Thus, the increase of blood pressure might be caused by the activation of Renin-Angiotensin System (RAS) [13]. In further study, it is necessary to examine the participation of the blood pressure in diabetic nephropathy of SDT rats. CONCLUSION Renal-related parameters in SDT rats were deteriorated with the progress of diabetes mellitus, and histopathological changes, such as the diffuse glomerular lesions and the nodular lesions, were observed with aging. The histological changes in the kidney of SDT rat mimics the changes seen in the kidney of patients with diabetes. SDT rat is a useful model for investigating diabetic nephropathy. Use of SDT rats will assist in the further elucidation of the pathogenesis of human diabetic nephropathy and in discovering new drugs. Fig. (3). HE stained section of the kidneys. SD rat (A), SDT rat (B), and SDT rat treated with insulin pellets (C) at 68 weeks of age [5]. Bar = 50 μm. In the renal tubules of SDT rats, glycogen deposition in the tubular epithelium (single arrow) and tubular dilation (double arrow) were observed.

48 The Open Diabetes Journal, 2011, Volume 4 Ohta and Sasase Table 2. Physiological Parameters in SD Rats and SDT Rats 8 16 24 Body weight (g) SD rat 354.7 ± 15.1 648.6 ± 36.3 789.5 ± 63.7 SDT rat 335.4 ± 23.3 544.7 ± 29.9** 488.2 ± 27.0** Glucose (mg/dl) SD rat 127.2 ± 7.2 115.0 ± 9.9 123.4 ± 7.9 SDT rat 138.6 ± 16.3 486.8 ± 238.4** 862.0 ± 95.2** Insulin (ng/ml) SD rat 1.58 ± 0.61 2.25 ± 0.72 2.67 ± 0.49 SDT rat 1.84 ± 0.56 1.48 ± 1.18 0.14 ± 0.09** Leptin (ng/ml) SD rat 2.63 ± 1.05 10.00 ± 2.86 13.04 ± 4.11 SDT rat 5.14 ± 1.05** 6.24 ± 4.29 1.47 ± 0.54** Blood urea nitrogen (mg/dl) SD rat 23.6 ± 2.6 21.8 ± 4.2 19.2 ± 2.6 SDT rat 21.2 ± 2.1 22.3 ± 1.7 28.7 ± 2.1** Urine volume (ml/8h) SD rat 14.0 ± 6.3 10.3 ± 5.4 12.7 ± 7.7 SDT rat 7.0 ± 1.5 10.6 ± 5.6 41.1 ± 9.2** Urine protein (creatinine -1 ) SD rat 0.17 ± 0.08 0.11 ± 0.04 0.04 ± 0.01 SDT rat 0.21 ± 0.01 0.17 ± 0.06 0.21 ± 0.14 Creatinine clearance (ml/h g) SD rat 0.43 ± 0.14 0.25 ± 0.08 0.23 ± 0.06 SDT rat 0.50 ± 0.17 0.31 ± 0.04 0.31 ± 0.04* Urine angiotensinogen (ng/ml) SD rat 3.73 ± 2.42 5.45 ± 5.16 6.84 ± 2.46 SDT rat 8.42 ± 2.72* 13.82 ± 6.02** 30.68 ± 21.93 Systolic blood pressure (mmhg) SD rat 116 ± 23 132 ± 12 125 ± 21 SDT rat 127 ± 9 141 ± 18 145 ± 13 Heart rate (beat/min) SD rat 362 ± 43 311 ± 24 313 ± 24 SDT rat 344 ± 6 305 ± 13 287 ± 21 Data represent means ± SD (n=5). *P<0.05, **P<0.01 vs age-matched SD rats.

Diabetic Nephropathy in Spontaneously Diabetic Torii (SDT) Rats The Open Diabetes Journal, 2011, Volume 4 49 Table 3. Blood Glucose Levels and Urinary Parameters in SD rats, SDT Rats and SDT Rats with Insulin Therapy Glucose (mg/dl) 36 44 56 SD rat 134.7 ± 9.2 142.7 ± 29.0 135.3 ± 18.7 SDT rat 822.1 ± 134.1** 784.3 ± 118.1** 972.3 ± 149.5** SDT rat + Insulin 199.8 ± 130.3 ## 189.1 ± 88.7 ## 153.0 ± 18.5 ## Urine volume (ml/24h) SD rat 13.7 ± 2.7 24.2 ± 9.2 24.0 ± 8.4 SDT rat 253.5 ± 40.5** 307.8 ± 46.4** 355.0 ± 34.2** SDT rat + Insulin 28.9 ± 13.3 ## 28.3 ± 10.5 ## 20.8 ± 6.5 ## Urine protein (mg/24h) SD rat 29.9 ± 8.3 46.7 ± 22.8 56.3 ± 26.5 SDT rat 162.7 ± 72.2** 218.0 ± 81.1** 232.9 ± 85.8* SDT rat + Insulin 40.0 ± 14.2 ## 55.8 ± 29.0 ## 54.7 ± 37.6 ## Urine albumin excretion (mg/24h) SD rat 4.1 ± 3.6 4.8 ± 4.5 4.6 ± 2.3 SDT rat 18.2 ± 12.2** 14.1 ± 4.1** 16.5 ± 1.8* SDT rat + Insulin 6.9 ± 5.1 # 6.9 ± 4.7 ## 5.0 ± 3.6 ## Creatinine clearance (ml/min/kg) SD rat 1.4 ± 0.4 4.5 ± 1.1 4.7 ± 0.8 SDT rat 7.1 ± 2.5** 8.1 ± 1.3** 5.9 ± 2.7 SDT rat + Insulin 3.2 ± 1.9 ## 3.9 ± 1.1 ## 5.2 ± 1.8 Insulin therapy was started from 24 weeks of age. Data represent means ± SD (n=4-10). *P<0.05,**P<0.01vs age-matched SD rats. # P<0.05, ## P<0.01 vs SDT rats. REFERENCES [1] Ismail N, Becker B, Strzelczyk P, Ritz E. Renal disease and hypertension in non-insulin-dependent diabetes mellitus. Kidney Int 1999; 55: 1-28. [2] Suzuki Y, Arakawa M. The treatment of the uraemic diabetic. Are we doing enough? A view from Japan. Fumitake Gejyo Collaborate Study Group. Nephrol Dial Transplant 1995; 10(Suppl 7): 47-55. [3] Calcutt NA, Cooper ME, Kern TS, Schmidt AM. Therapies for hyperglycaemia-induced diabetic complications: from animal models to clinical trials. Nat Rev Drug Discov 2009; 8: 417-29. [4] Hostetter TH. Diabetic nephropathy. Metabolic versus hemodynamic considerations. Diabetes Care 1992; 15: 1205-15. [5] Ohta T, Matsui K, Miyajima K, et al. Effect of insulin therapy on renal changes in spontaneously diabetic Torii rats. Exp Anim 2007; 56: 355-62. [6] Seyer-Hansen K. Renal hypertrophy in experimental diabetes mellitus. Kidney Int 1983; 23: 643-6. [7] Seyer-Hansen K. Renal hypertrophy in experimental diabetes: some functional aspects. J Diabet Complications 1987; 1: 7-10. [8] Nobrega MA, Fleming S, Roman RJ, et al. Initial characterization of a rat model of diabetic nephropathy. Diabetes 2004; 53: 735-42. [9] Sato N, Komatsu K, Kurumatani H. Late onset of diabetic nephropathy in spontaneously diabetic GK rats. Am J Nephrol 2003; 23: 334-42. [10] Hoshi S, Shu Y, Yoshida F, et al. Podocyte injury promotes progressive nephropathy in zucker diabetic fatty rats. Lab Invest 2002; 82: 25-35. [11] Schafer S, Schmidts HL, Bleich M, Busch AE, Linz W. Nephroprotection in Zucker diabetic fatty rats by vasopeptidase inhibition is partly bradykinin B2 receptor dependent. Br J Pharmacol 2004; 143: 27-32. [12] Breyer MD, Bottinger E, Brosius FC, 3rd, et al. Mouse models of diabetic nephropathy. J Am Soc Nephrol 2005; 16: 27-45. [13] Rahmouni K, Correia ML, Haynes WG, Mark AL. Obesityassociated hypertension: new insights into mechanisms. Hypertension 2005; 45: 9-14. Received: April 27, 2010 Revised: December 11, 2010 Accepted: January 15, 2011 Ohta and Sasase; Licensee Bentham Open. This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited.