"Renal autoregulation stabilizes renal blood flow to protect the glomerular capillaries and maintain glomerular filtration rates through two mechanisms: tubuloglomerular feedback (TGF) and the myogenic response (MR). It is considered that the feedback mechanisms operate independently in each nephron (the functional unit of the kidney) within a kidney, but renal autoregulation dynamics can be coupled between vascular connected nephrons. It has also been shown that the mechanisms are time-varying and interact with each other. Understanding of the significance of such complex behavior has been limited by absence of techniques capable of monitoring renal flow signals among more than 2 or 3 nephrons simultaneously. The purpose of this thesis was to develop approaches to allow the identification and characterization of spatial and temporal properties of renal autoregulation dynamics. We present evidence that laser speckle perfusion imaging (LSPI) effectively captures renal autoregulation dynamics in perfusion signals across the renal cortex of anaesthetized rats and that spatial heterogeneity of the dynamics is present and can be investigated using LSPI. Next, we present a novel approach to segment LSPI of the renal surface into phase synchronized clusters representing areas with coupled renal autoregulation dynamics. Results are shown for the MR and demonstrate that when a signal is present phase synchronized regions can be identified. We then describe an approach to identify quadratic phase coupling between the TGF and MR mechanisms in time and space. Using this approach we can identify locations across the renal surface where both mechanisms are operating cooperatively. Finally, we show how synchronization between nephrons can be investigated in relation to renal autoregulation effectiveness by comparing phase synchronization estimates from LSPI with renal autoregulation system properties estimated from renal blood flow and blood pressure measurements. Overall, we have developed approaches to 1) capture renal autoregulation dynamics across the renal surface, 2) identify regions with phase synchronized renal autoregulation dynamics, 3) quantify the presence of the TGF-MR interaction across the renal surface, and 4) determine how the above vary over time. The described tools allow for investigations of the significance and mechanisms behind the complex spatial interactions and time-varying properties of renal autoregulation dynamics. "

Under normotensive conditions, the progressive loss of renal function in diabetes mellitus is very slow. Since hypertension accelerates many forms of renal disease, we assessed the progression of nephropathy in Streptozotocin-induced type 1 diabetes mellitus under renin-mediated hypertension condition. We investigated the diabetic “salt paradox” as a modifiable susceptibility factor for renal damage. Since hyperfiltration occurs in early diabetes, the reduction of glomerular filtration rate due to an increased salt intake could be mediated by increased tubuloglomerular feedback sensitivity. We compared intact-hypertensive versus diabetic-hypertensive Long-Evans rats under normal and increased salt intake, 1 and 2.5% by weight of food eaten, respectively. Weekly 24-h blood pressure records were acquired by telemetry during the six months of the experiment. Target mean blood glucose of ~ 25 mmol/L was maintained by suboptimal insulin implants. Systolic blood pressure increased after induction of hypertension but was not affected by diabetes or increased salt intake, either alone or together. Autoregulation was highly efficient in both intact and diabetic rats. Nephropathy was scored by histology in the clipped and non-clipped kidneys at the end of the protocol. The non-clipped kidney, which was exposed to hypertension, showed a linear pressure-dependent glomerular injury in both intact and diabetic rats. The best fit line describing the linear relationship between pressure load and injury was shifted toward lower blood pressure in diabetic rats. Over the time course of our experiments, injury was entirely pressure dependent in intact and diabetic rats. Diabetes mellitus increased the susceptibility of the kidney to injury, but independent of blood pressure. Increased salt intake affected neither blood pressure nor renal susceptibility to hypertensive injury. / Graduate

Chronic kidney disease (CKD) is defined as glomerular filtration rate (GFR) less than 60 mL/min/1.73 m2 for 3 months and is characterized by progressive loss of renal function. The second leading cause of CKD is hypertension. More than half of CKD patients also suffer from hypertension. Arteries and arterioles adjust to the fluctuations in the systematic blood pressure through a mechanism called autoregulation. In the kidneys, autoregulation protects the delicate glomeruli capillaries from high blood pressure and occurs through myogenic constriction (MC). MC refers to contraction of arterioles in response to an increase in the blood pressure. Chronically hypertensive individuals and animal models have an enhanced MC, leading to minimal renal injury despite their elevated blood pressure. Experimental and clinical evidence point to a role for the MC in the pathogenesis of the CKD, however, the mechanism through which preglomerular arterial MC contributes to CKD has not been fully elucidated. This thesis showed that augmented MC in chronically hypertensive animal models was due to increased thromboxane A2 prostaglandin that was not released from the endothelium (Chapter 2). Nevertheless, inhibiting MC while also reducing the blood pressure prevented salt-induced renal injury even though the blood pressure was still not normalized compared to the normotensive controls (Chapter 3). The resulting improvement in renal structure and function could be attributed to the reduction in the blood pressure, albumin, and uromodulin (UMOD) excretion (Chapter 3). UMOD is a kidney-specific glycoprotein that, based on a genome-wide association study have the strongest association to CKD (Chapter 3). Comparing two CKD hypertensive animal models further revealed that CKD progression was independent of the blood pressure and strongly associated with UMOD excretion levels (Chapter 4). Collectively, the data discussed in this thesis demonstrates potential therapeutic targets in CKD hypertensive animal models. / Dissertation / Doctor of Philosophy (PhD)