RENIN-ANGIOTENSIN SYSTEM IN NEONATAL RATS - INDUCTION OF A RENAL ABNORMALITY IN RESPONSE TO ACE-INHIBITION OR ANGIOTENSIN-II ANTAGONISM

In experiments designed to analyze cardiovascular structure in response to antihypertensive therapy with an ACE inhibitor, we decided to start very early in life with the aim to prevent blood pressure increases and the development of vascular structural changes. In these treated groups of rats we unexpectedly observed that after they were weaned, their water consumption and urine volume, respectively, increased substantially. The present study was designed to determine if inhibition of the renin-angiotensin system produced similar effects in different strains of rats, and focused on characterizing the abnormal fluid balance occurring as a consequence to neonatal treatment with ACE inhibitors or angiotensin II blockers. Three-day-old Wistar Kyoto (WKY), Wistar (WR) and spontaneously hypertensive rats (SHR) were given either saline, enalapril, captopril, losartan and the AT, blocker, PD123319, in the same amount of volume for 20 days. Treatment was stopped and rats were examined with regard to renal morphology at 4, 14 and 30 weeks of age. In addition, water consumption, urine volume, urine electrolytes and osmolality were analyzed at 14 weeks of age, that is, 10 weeks off treatment. Early treatment with the ACE inhibitors, enalapril and captopril, and the AT1 blocker, losartan, but not the AT2 blocker, PD 123319, in the SHR and in the normotensive strains WKY and WR produced persistent, irreversible histopathological renal abnormalities in adult life, long after the rats had been taken off treatment. These abnormalities consisted of mainly cortical tubulointerstitial inflammation, various degrees of papillary atrophy and pelvic dilation. These structural renal abnormalities impaired the urine concentrating ability in the treated animals, as evidenced by a reduced urine osmolality, and caused increases in water consumption and diuresis. These results suggest an important role for angiotensin II in the developing kidney during the first postnatal weeks or even days in the development of normal renal function, a situation that should be seriously considered in clinical situations when any extended ACE inhibitor therapy in newborns is discussed.