Background: The compensatory changes following renal mass reduction are harmful to the remaining kidney tissue in the long run. Therefore, they have to be controlled early. The current study aimed to detect the histological changes in podocytes following unilateral nephrectomy in young male albino rats, and to evaluate the possible ameliorative effect of sodium glucose cotransporter 2 inhibitor (SGLT2I) versus angiotensin converting enzyme inhibitor (ACEI) by histological and morphometric studies.
In this study, 48 young male albino rats were used; 6 control rats (group I), 6 sham operated (group II), and the remaining 36 were subjected to uninephrectomy, then randomly equally divided into 3 groups: (group III) was left untreated, (group IV) received an ACEI [enalapril], and (group V) received an SGLT2I [dapagliflozin]. The drugs were given daily for 2 weeks. Before sacrifice, the rats were subjected to serum creatinine and 24-hour urinary albumin measurements. After sacrifice, histological and immunohistochemical analysis for nestin were done. Transmission electron microscopy (TEM) was used to examine the ultrastructural changes in podocytes and to measure the glomerular basement membrane (GBM) thickness.
Morphometric studies were done to measure Bowman's space and glomerular areas, and area percent of nestin immune reactivity. All measurements were statistically analyzed.
Results: The histological outcome that followed uninephrectomy in the untreated group showed all the criteria of focal segmental glomerulosclerosis (FSGS). This outcome was ameliorated by the early administration of the ACEI and SGLT2I. Both treated groups showed significant reduction in Bowman's space area, area percent of nestin, and GBM thickness when compared to the untreated group. However, no significant difference could be detected between the two treated groups denoting the drugs' almost similar efficacy.
Conclusion: SGLT2I is almost equally effective as the ACEI. Therefore, it could be given following renal mass reduction whenever the ACEI is contraindicated, untolerated, or inadequa