Abstract

Although disturbed phosphate metabolism frequently accompanies chronic kidney disease (CKD), its causal role in CKD progression remains unclear. It is also not fully understood how excess salt induces organ damage. We here show that urinary phosphate-containing nanoparticles promote kidney injury in salt-sensitive hypertension. In Dahl salt-sensitive rats, salt loading resulted in a significant increase in urinary phosphate excretion without altering serum phosphate levels. An intestinal phosphate binder sucroferric oxyhydroxide attenuated renal inflammation and proteinuria in this model, along with the suppression of phosphaturia. Using cultured proximal tubule cells, we confirmed direct pathogenic roles of phosphate-containing nanoparticles in renal tubules. Finally, transcriptome analysis revealed a potential role of complement C1q in renal inflammation associated with altered phosphate metabolism. These data demonstrate that increased phosphate excretion promotes renal inflammation in salt-sensitive hypertension and suggest a role of disturbed phosphate metabolism in the pathophysiology of hypertensive kidney disease and high salt-induced kidney injury.

Highlights

  • Disturbed phosphate metabolism frequently accompanies chronic kidney disease (CKD), its causal role in CKD progression remains unclear

  • DSH rats had a progressive increase in urinary albumin levels (Fig. 1d–f) and showed marked albuminuria compared with the DSN group at 4 weeks (DSH, 11.15 ± 1.40 mg/day versus DSN, 0.61 ± 0.08 mg/day; P < 0.001; Fig. 1f)

  • In quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) analysis, we found that the upregulation of Ccl[2] (encoding C-C chemokine motif ligand 2 (Ccl2)) and Opn in DSH rats was significantly ameliorated in DSH+2.5%sucroferric oxyhydroxide (SF) rats (29% decrease for Ccl[2]; P = 0.0037, and 62% decrease for Opn, P = 0.041; Fig. 2g)

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Summary

Introduction

Disturbed phosphate metabolism frequently accompanies chronic kidney disease (CKD), its causal role in CKD progression remains unclear. Reduced expression of Ccl[2] and Opn in the kidney of DSH+2.5% SF rats can result from either decreased production in renal tubules or attenuation of macrophage infiltration.

Results
Conclusion
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