The Combination Of RAS Blocker Plus Sympathetic Blocking Agent Or Renal Denervation Is Superior To RAS Blocker Or Sympathetic Blocking Agent Monotherapy In The Rat Renal Ablation Model

The renoprotective actions of the blockade of the renin-angiotensin and the sympathetic nervous system are well documented, but monotherapies fail to completely abrogate progression. We investigated whether combined inhibition of the two systems provides additive renoprotection.Methods60 rats were randomly devided into 6 groups.The first group served as control by sham operating; the second to fifth groups were subjected 5/6 subtotal nephrectomy (SNX) and were respectively administrated tap water, benazepril, arotinololhydrochloride or benazepril+arotinololhydrochloride for 8 weeks.After SNX, the sixth group underwent resection of dorsal roots, i.e. rhizotomy and were administrated benazepril for 8 weeks. Albuminuria, blood pressure and kidneys were assessed (morphometry, immunohistochemistry).ResultsAt the end of the study, the blood pressure was 118.67±13.34 mmHg in sham operation group, was 173.49±16.48 mmHg inSNX group, was 113.78±15.14 mmHg in SNX+benazepril group, was 115.67±15.53 mmHg in SNX+arotinololhydrochloride group, was 102.98±13.95mmHg in SNX+benazepril+arotinololhydrochloride group and was 100.99±12.35mm Hg in SNX+benazepril+rhizotomy group. Albuminuria was 6.19±2.70,35.35±4.58,18.21±3.73,19.49±3.77,15.36±1.68 and 14.23±0.69mg/ 24h respectively. The glomerulosclerosis was better in combined interventions than the others.The lowest indices for collagenⅢ, collagen IV and AT1-R were seen with combined interventions (p<0.05).ConclusionThe combination of RAS blockers plus sympathetic blocking agents or renal denervation is superior to the monotherapies.