Recovery from acute renal failure predisposes hypertension and secondary renal disease in response to elevated sodium

Am J Physiol Renal Physiol. 2007 Jul;293(1):F269-78. doi: 10.1152/ajprenal.00279.2006. Epub 2007 May 16.


Recovery of renal function is a well-characterized feature of models of acute renal failure; however, more recent studies have reported a predisposition to chronic renal disease. This study sought to determine the susceptibility to sodium-dependent hypertension following recovery from ischemic acute renal failure. Following ischemia-reperfusion (I/R) injury, rats were allowed to recover for 35 days on a 0.4% salt diet, then were switched to 4.0% salt diet for an additional 28 days. Blood pressure was significantly increased in postischemic rats switched to high-sodium diet at day 35 (19 +/- 9 mmHg) compared with postischemic rats maintained on low-sodium diet. Plasma renin activity and creatinine clearance were not affected by I/R injury. The ischemic injury combined with transfer to 4.0% salt diet resulted in marked renal hypertrophy characterized by interstitial cellular deposition, tubular dilation, and enhanced rates of albumin excretion. Glomerular structure was altered in post-I/R rats switched to high-sodium diet but not in those maintained on low-sodium diets. When rats were acclimated to high-sodium diet before I/R injury, the early injury was similar to that observed in animals acclimated to low-sodium diet, and these animals progressed rapidly toward chronic kidney disease, as evidenced by advancement of albuminuria. These data suggest that the recovery from acute I/R injury is not complete, compromises Na homeostasis, and predisposes hypertension and secondary renal disease.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Kidney Injury / complications*
  • Acute Kidney Injury / physiopathology*
  • Aging / physiology
  • Animals
  • Blood Pressure / drug effects
  • Capillaries / physiology
  • Catecholamines / pharmacology
  • Creatinine / blood
  • Cyclosporine / toxicity
  • Diet
  • Disease Progression
  • Hypertension, Renal / etiology*
  • Hypertension, Renal / physiopathology*
  • Immunohistochemistry
  • Immunosuppressive Agents / toxicity
  • Kidney Failure, Chronic / etiology
  • Kidney Failure, Chronic / physiopathology
  • Kidney Glomerulus / pathology
  • Kidney Tubules / blood supply
  • Male
  • Organ Size / drug effects
  • Rats
  • Rats, Sprague-Dawley
  • Renal Circulation / physiology
  • Renin / blood
  • Sodium / physiology*
  • Sodium, Dietary / adverse effects


  • Catecholamines
  • Immunosuppressive Agents
  • Sodium, Dietary
  • Cyclosporine
  • Sodium
  • Creatinine
  • Renin