Importance of Early and Continuous Use of Protein Restriction on the Progression of Adriamycin Nephropathy

Abstract

Three experimental protocols were carried out with the aim of evaluating the role of protein restriction on the progression of the established adriamycin-induced nephropathy, and whether the protective effect of the diet persists after the diet is discontinued. The effect of a low protein diet (LPD) was studied for 6 weeks in protocol 1, 16 weeks in protocol 2 and for 28 weeks in protocol 3. In protocol 3, one group (LL) received LPD and another (NN) was given a normal protein diet (NPD). A third group (LN) received LPD for 16 weeks and then NPD for 12 weeks and a fourth group (NL) was fed NPD for 16 weeks and then LPD for 12 weeks. In protocol 1 the tubulo-interstitial index (TILI) of rots on LPD (Md = 2, P25 = 0.0; P75 = 3.5) after six weeks, was smaller than that of the animals on NPD (Md = 60; P25 = 3.0; P75 = 8.0; p 0.0,5;. In protocol 2, the group taking LPD presented an area of interstitial fihrosis (IF) (Md 0.5%, P25 0.2%; P75 = 1.9%) smaller than that of the NPD group (Md = 6.8%; P25 = 5.2%; P75 = 7.1%; p < 0.05). No significant difference in the area of glomerulosclerosis (GSA) was observed between the animals on LPD (Md = 0.0%; P25 = 0.0%, P75 = 0.0%) and NPD (Md = 0.37%; P25 = 02%, P75 = 1.25%; p > 0.05). In protocol 3, the group LL showed GSA (Md = 1.3%; P25 0.6%, P75 = 2.5%; and IF (Md = 3.6%; P25 = 1.6%; P75 = 5.9%; smaller that those of LN (GSA Md = 10.1%; P25 = 6.6%; P75 = 14.8%; IF:Md = 17.3%; P25 = 14.1%; P75 = 24.5%), NL (GSA:Md = 9.1%; P25 = 5.8%; P75 = 11.7%; IF:Md = 25.0%; P25 = 20.4%; P75 = 50%), and NN (GSA:Md = 6.75%; P25 = 4.9%; P75 = 11.7%; IF:Md = 20.9%; P25 = 16.2%; P75 = 32.4%). In conclusion, in order to be effective, LPD must be introduced early and maintained for a long period of tune.

Key Words:

• Proteinuria
• Protein restriction
• Adriamycin nephropathy
• Tubulointterstitial nephritis