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• W3021218977 abstract "We thank Drs Chou and Lin for their observation1.Chou Y.H. Lin S.L. How to confirm the specific effect of spironolactone in chronic kidney disease caused by ischemic acute kidney.Kidney Int. 2013; 84: 415Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar that allowed us to further expand the results of our findings. Previously, we showed that mineralocorticoid receptor blockade (MRB) or adrenalectomy prevented renal damage induced by a mild ischemic period (20min).2.Mejia-Vilet J.M. Ramirez V. Cruz C. et al.Renal ischemia-reperfusion injury is prevented by the mineralocorticoid receptor blocker spironolactone.Am J Physiol Renal Physiol. 2007; 293: F78-F86Crossref PubMed Scopus (111) Google Scholar,3.Ramirez V. Trujillo J. Valdes R. et al.Adrenalectomy prevents renal ischemia-reperfusion injury.Am J Physiol Renal Physiol. 2009; 297: F932-F942Crossref PubMed Scopus (43) Google Scholar In our recently published study,4.Barrera-Chimal J. Perez-Villalva R. Rodriguez-Romo R. et al.Spironolactone prevents chronic kidney disease caused by ischemic acute kidney injury.Kidney Int. 2013; 83: 93-103Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar rats were exposed to a more severe ischemic injury (45min), and we observed that MRB before or even after the ischemic insult prevented chronic kidney disease (CKD) development, which was associated with a reduction in acute kidney injury (AKI) severity, as was evidenced by a lower proteinuria 24 h after reperfusion (Figure 1a)4.Barrera-Chimal J. Perez-Villalva R. Rodriguez-Romo R. et al.Spironolactone prevents chronic kidney disease caused by ischemic acute kidney injury.Kidney Int. 2013; 83: 93-103Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar. Here, we added a new set of rats that underwent 45min of bilateral ischemia and were studied after 24 h, as is shown in Figure 1. The prophylactic MRB only partially protected these animals as is exhibited by the reduction of levels of urinary heat shock protein 72 (Figure 1d).5.Barrera-Chimal J. Perez-Villalva R. Cortes-Gonzalez C. et al.Hsp72 is an early and sensitive biomarker to detect acute kidney injury.EMBO Mol Med. 2011; 3: 5-20Crossref PubMed Scopus (54) Google Scholar These results emphasize that the degree of AKI was lower than that in untreated rats although serum creatinine was not corrected. In spite of the complete restoration of renal function observed after 10 days of ischemia, MRB was effective enough to prevent the increased signaling of inflammation and fibrosis pathways (Figure 1e and f)4.Barrera-Chimal J. Perez-Villalva R. Rodriguez-Romo R. et al.Spironolactone prevents chronic kidney disease caused by ischemic acute kidney injury.Kidney Int. 2013; 83: 93-103Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar that is not seen in ischemic untreated rats. Therefore, we believe that MRB not only reduced the severity of AKI but it also avoided other aldosterone detrimental effects. We agree with Drs Chou and Lin that it will be necessary to see the time course of these pathways to know with more precision the effects of aldosterone leading to long-term development of CKD. Indeed, this is a part of another ongoing project in our laboratory." @default.
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• W3021218977 date "2013-08-01" @default.
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• W3021218977 title "The Authors Reply:" @default.
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• W3021218977 doi "https://doi.org/10.1038/ki.2013.166" @default.
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