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Am J Physiol Regul Integr Comp Physiol 294: R277-R278, 2008; doi:10.1152/ajpregu.00790.2007
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LETTERS TO THE EDITOR

DEVELOPMENTAL PHYSIOLOGY AND PREGNANCY

Reply to: Schreuder

Jaap A. Joles,1 Jane L. Tarry-Adkins,2 Sanne Snoeijs,1 Dionne M. van der Giezen,3 Roel Goldschmeding,3 and Susan E. Ozanne2

1Departments of Nephrology and Hypertension and 3Pathology, University Medical Centre, Utrecht, The Netherlands; 2Department of Clinical Biochemistry, University of Cambridge, Addenbrookes Hospital, Cambridge, United Kingdom

REPLY: In aging male Wistar rats, renal injury develops spontaneously (2). It is gratifying that Dr. Schreuder is intrigued by our recent finding of a protective effect of early postnatal protein restriction (i.e., during lactation) on the spontaneous development of renal injury in male Wistar rats followed up to 12 mo of age (10). In his Letter to the Editor, in this issue of AJP-Regulatory, Integrative and Comparative Physiology, Dr. Schreuder (7a) postulates that protein restriction during lactation should result in a lower glomerular number, and presumably increased glomerular volume. This would conform to a finding documented recently by Dr. Schreuder's group in 75-day-old rats that were food restricted by doubling litter size directly after birth. Thus, these pups had a low calorie and protein intake. They found that the glomerular number was 25% lower and the glomerular volume 35% higher in the food-restricted group (8).

Intrauterine protein or food restriction usually reduces glomerular number and increases albuminuria [reviewed by Schreuder et al. (9)]. However, the setup in our experiment was totally different. We cross-fostered male pups born to control dams to dams on low-protein (8%) diets during lactation. Control pups were cross-fostered to dams on normal protein (20%) diets. Note that the diets were isocaloric (10). All offspring were weaned onto normal chow and studied at 3 and 12 mo of age. This approach allowed us to study the isolated effect of postnatal protein restriction on adult renal function and injury. We also measured telomere length and antioxidant enzyme expression.

Our main finding was less susceptibility to the normal process of renal injury that accompanies aging in many laboratory rat strains (5), including the Wistar rats that we used. Reduced albuminuria was accompanied by longer telomeres and increased protein levels of antioxidant enzymes. Of course, these data do not allow us to dissect cause and effect. However, they do extend the well-known protective effect of protein restriction on the progression of renal disease (4) into an earlier phase of development than that studied previously.

Dr. Schreuder, by extrapolation from observations in studies utilizing prenatal dietary or protein restriction or postnatal calorie restriction suggests that our intervention should have reduced nephron number (7a). This would be unexpected in the presence of less renal injury according to the hyperfiltration hypothesis of Zandi-Nejad et al. (12). This is indeed an interesting question to which we have now attempted to provide an answer.

Although our samples were not collected under ideal conditions for glomerular morphometry and counting (3), we measured glomerular dimensions and assessed glomerular density in a single section. Paraffin sections were stained with periodic acid-Schiff. Glomeruli were counted at magnification x40 by applying a grid on randomly chosen fields and expressed as number of glomeruli/mm3 (n), calculated by the formula n = G/(F x A x (D + T)), where G is the number glomeruli counted in 400 fields, F is the number of fields counted, A is the grid area, D is the average glomerular tuft diameter, and T is the section thickness (0.003 mm) (6). Tuft diameter was assessed by tracing tuft edge and assuming a spherical shape.

The results, listed in Table 1 are quite clear. Glomeruli in the protein-restricted group were smaller, and glomerular density was about 30% higher. However, because kidneys in the protein-restricted group weighed about 23% less, the estimated glomerular number will not be significantly different. On the other hand, by 12 mo, body weight of the postnatal low-protein rats was also ~21% less. Thus, the estimated relative nephron number was indeed increased. Of course, we acknowledge that this extrapolation is uncertain. First, the absolute product of glomerular density and kidney weight will grossly overestimate nephron number because kidney weight included the medulla. Second, absolute glomerular numbers can only be assessed using the dissection-fractionater technique. Finally, in the absence of standardized perfusion conditions, absolute morphometry is not reliable (7). However, these limitations apply to both groups to the same extent, because all kidneys were collected in an identical fashion.


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Table 1. Glomerular diameter, glomerular density, and kidney weight of male control and PLP rats at 12 mo of age

 
Thus, contrary to the expectation of Dr. Schreuder, the estimated nephron number of the protein-restricted group was not lower than in the control group. Furthermore, the lower glomerular diameter does not suggest glomerular hypertension. In fact, the differences were in the opposite direction. The latter may well be secondary to more injury-related nephron loss in the control group. Thus, ideally nephron number should be assessed prior to the development of renal injury. N-acetyl-glucosaminidase excretion was already higher in the control rats at 1 mo of age, suggesting that development of injury starts at a very young age. Thus, for nephron counting in our model, kidneys should ideally be sampled at 21 days of age, i.e., at weaning, directly after exposure to low-protein intake, be perfusion-fixed, and be analyzed with state of the art technology. These samples are currently not available but will be collected in a future study.

We wish to point out that a recent study directed at lactational environment challenges the low nephron number hypothesis (11). A dissociation of blood pressure and nephron number was also documented by using cross-breeding studies in spontaneously hypertensive rats and normotensive Wistar-Kyoto rats (3). Both studies utilized state of the art counting technology. Dr. Bagby recently discussed the issue of causality in relation to the low nephron number hypothesis (1).

FOOTNOTES


Address for reprint requests and other correspondence: J. A. Joles, Dept. of Nephrology and Hypertension, Univ. Medical Center Utrecht (F03.223) POB 85500, 3508 GA UTRECHT, The Netherlands (e-mail: j.a.joles{at}umcutrecht.nl)

REFERENCES

  1. Bagby SP. Developmental hypertension, nephrogenesis, and mother's milk: programming the neonate. J Am Soc Nephrol 18: 1626–1629, 2007.[Free Full Text]
  2. Baylis C. Age-dependent glomerular damage in the rat. Dissociation between glomerular injury and both glomerular hypertension and hypetrophy. Male gender as a risk factor. J Clin Invest 94: 1823–1829, 1994.[Web of Science][Medline]
  3. Black MJ, Briscoe TA, Constantinou M, Kett MM, Bertram JF. Is there an association between level of adult blood pressure and nephron number or renal filtration surface area? Kidney Int 65: 582–588, 2004.[CrossRef][Web of Science][Medline]
  4. Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation and intrinsic renal disease. N Engl J Med 307: 652–659, 1982.[Web of Science][Medline]
  5. Goldstein RS, Tarloff JB, Hook JB. Age-related nephropathy in laboratory rats. FASEB J 2: 2241–2251, 1988.[Abstract]
  6. Lucas SR, Costa Silva VL, Miraglia SM, Zaladek Gil F. Functional and morphometric evaluation of offspring kidney after intrauterine undernutrition. Pediatr Nephrol 11: 719–723, 1997.[CrossRef][Web of Science][Medline]
  7. Nyengaard JR. Stereologic methods and their application in kidney research. J Am Soc Nephrol 10: 1100–1123, 1999.[Abstract/Free Full Text]
  8. Schreuder MF. Combined nephroprotective effect and low nephron endowment as a consequence of postnatal growth restriction in the rat? Am J Physiol Regul Integr Comp Physiol doi:10.1152/ajpregu.00684.2007.
  9. Schreuder MF, Nyengaard JR, Remmers F, van Wijk JA, Delemarre-van de Waal HA. Postnatal food restriction in the rat as a model for a low nephron endowment. Am J Physiol Renal Physiol 291: F1104–F1107, 2006.[Abstract/Free Full Text]
  10. Schreuder M, Delemarre-van de Waal H, van Wijk A. Consequences of intrauterine growth restriction for the kidney. Kidney Blood Press Res 29: 108–125, 2006.[CrossRef][Web of Science][Medline]
  11. Tarry-Adkins JL, Joles JA, Chen JH, Martin-Gronert MS, van der Giezen DM, Goldschmeding R, Hales CN, Ozanne SE. Protein restriction in lactation confers nephroprotective effects in the male rat and is associated with increased antioxidant expression. Am J Physiol Regul Integr Comp Physiol 293: R1259–R1266, 2007.[Abstract/Free Full Text]
  12. Wlodek ME, Mibus A, Tan A, Siebel AL, Owens JA, Moritz KM. Normal lactational environment restores nephron endowment and prevents hypertension after placental restriction in the rat. J Am Soc Nephrol 18: 1688–1696, 2007.[Abstract/Free Full Text]
  13. Zandi-Nejad K, Luyckx VA, Brenner BM. Adult hypertension and kidney disease: the role of fetal programming. Hypertension 47: 502–508, 2006.[Abstract/Free Full Text]




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