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Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) resulting in the need for renal replacement therapy. While, the physical inactivity is associated with the development of noncommunicable chronic diseases, the practice of physical exercise (PE) has been considered a promising intervention for the control of endothelial function and to prevent the progression of DKD. The aim of this study was to evaluate the effect of the exercise training, when performed routinely or only after the DKD on the function, hemodynamics and oxidative renal profile.
Male Wistar rats, weighing between 250 and 300g and g, were randomized into four groups: Citrate, "control" : animals that received citrate buffer, the vehicle of the streptozotocin-STZ (pH 4.2, i.v., single dose, on the 1st day of the experimental protocol); DM: animals that received STZ (60 mg/kg, i.v., single dose, on the 1st day of the experimental protocol); DM+PE: DM animals that were submitted to swimming training (PE, daily,1 hour, 4 weeks) after DM induction and PE+DM+PE: animals that were submitted to physical exercise before and after receiving STZ (PE for 4 weeks before and 4 weeks after DM). All groups were followed for 60 days. Renal function was evaluated by inulin clearance, plasma creatinine and microalbuminuria; oxidative profile by urinary peroxides, urinary nitric oxide (NO) and thiobarbituric acid reactive substances (TBARS).
The PE+DM+PE group showed a reduction in serum creatinine and microalbuminuria and an increase in inulin clearance, even better than those parameters presented by the DM+PE group. Considering the oxidative profile, it was observed that the DM exercised groups presented a decrease in urinary peroxides, NO and TBARS compared with the citrate group, highlighting better results in the animals that were exercised before and after the DM (Tables 1 and 2).
Table 1. Renal function of the Citrate, DM, DM+PE and PE+DM+PE groups.
Groups
n
Albuminuria (mg/24h)
Serum Creatinine (mg/dl)
Inulin Clearance (ml/min/100mg)
Citrato
7
3,76±0,91
0,30±0,06
0,91±0,26
DM
39,42±8,89 a
1,21±0,06 a
0,49±0,10 a
DM+PE
34,57±8,12 a
0,74±0,14 ab
0,65±0,11 ab
PE+DM+PE
5
27,00±5,30 ab
0,49±0,09 bc
0,95 ±0,66 bc
Table 2. Oxidative profile of the Citrate, DM, DM+PE e PE+DM+PE groups.
Urine peroxides (nmol/g urine creatinine)
Lipid peroxidation (mnol/g urinary creatinine)
Urinary nitrate (nmol/g urinary creatinine)
Citrate
1,33±0,82
0,29±0,05
23,71±4,96
11,64±4,00a
12,91±3,02 a
56,82±12,73 a
6,34±0,94 ab
8,82±1,39 ab
43,23±4,76 ab
3,33±2,06 abc
6,83±1,54 ab
43,55 ±14,41 a
DM: Diabetes. PE Physical exercise. ap<0,05 vs Citrate; bp<0,05 vs DM; c p<0,05 vs DM+PE.
This study showed that the routine of physical exercise is a renoprotective intervention in animals with DKD by attenuating the renal dysfunction with reversal of microalbuminuria, with improvement in the oxidative profile, thus, confirming it as a promising far-reaching benefit on the progression of DKD.