Effect of hypertension on the progress and prognosis of experimental focal glomerular sclerosis

Effect of hypertension on progressive renal disease was examined in spontaneously hypertensive rats (SHR) with experimental focal glomerular sclerosis, produced by the intravenous administration of adriamycin (ADR). Serial changes of urinary protein, blood pressure and blood chemistry for 22 weeks after ADR-treatment, and renal histology at week 22, were compared between ADR-treated SHR (group ADR-HT) and ADR-treated SHR given antihypertensive drugs (group ADR-AH). Hypertension persisted in group ADR-HT, while blood pressure markedly decreased in group ADR-AH, after oral administration of antihypertensive drugs (guanethidine and hydralazine). Massive proteinuria, hypoalbuminaemia and hypercholesterolaemia were observed throughout the experiment both in group ADR-HT and in group ADR-AH. Urinary protein levels were significantly larger in the former at weeks 12 and 16. Blood urea nitrogen and serum creatinine levels increased progressively from week 16 in the ADR-treated rats. The increase was more rapid in group ADR-HT than in group ADR-AH. In group ADR-HT, 10 of 25 rats died between weeks 20 and 22, whereas all in group ADR-AH survived. Histologically, ADR-treated rats showed focal glomerular sclerosis with tubulointerstitial changes. The lesions were more extensive in group ADR-HT than in group ADR-AH. We conclude that hypertension influences the progress and prognosis of chronic progressive renal disease, as induced by adriamycin.