Abstract P127: Pericyte Detachment is Involved in Renal Congestion in a Novel Rat Model

Abstract

Increased central venous pressure in congestive heart failure is responsible for renal dysfunction; however, the underlying mechanisms are unclear. We hypothesized that renal interstitial hydrostatic pressure (RIHP) and expansion pressures of the vasa recta are responsible for pericyte detachment resulting renal congestion-mediated fibrosis. We created a novel rat renal congestion model and investigated the effect of renal congestion on hemodynamics and its molecular mechanisms. The inferior vena cava (IVC) between the renal veins was ligated by suture in male Sprague-Dawley rats to increase upstream IVC pressure and induce congestion in the left kidney only. Left kidney congestion reduced renal blood flow in cortex (33.6%, 28.3 to 16.0 mL/min) and in medulla (41.8%, 11.9 to 6.9 mL/min) and glomerular filtration rate (1.16 to 0.20 mL/min/kg BW), and increased RIHP (12.6 to 17.6 mm Hg). Hypoxia was observed in the medullary thick ascending limb of Henle, only in the congestive kidneys. Tubulointerstitial injury, podocyte injury, albuminuria, and reduced creatinine clearance were observed in the congestive kidneys. Molecules related to extracellular matrix expansion, tubular injury, and focal adhesion were upregulated in microarray analysis. Renal decapsulation ameliorated the tubulointerstitial injury (mRNA expression of Kim1 15.3 to 4.3 A.U., αSma 5.3 to 2.8 A.U.). Electron microscopy captured pericyte detachment in the congestive kidneys. Transgelin and platelet-derived growth factor receptors (PDGFRs), as indicators of pericyte-myofibroblast transition, were upregulated in the pericytes and the adjacent interstitium. Imatinib, a PDGFR inhibitor, ameliorated the interstitial injury. Our results reveal a novel mechanism of worsening renal function associated with congestive heart failure, and provide a new therapeutic strategy based on a better understanding of the pericyte-myofibroblast transition.