Effect of Proximal Tubular Glucose Transport Blockade on Urinary Enzyme Excretions in Hyperglycemic Rats

To investigate proximal tubular dysfunction under hyperglycemic status, we infused 10% glucose solution into male Wistar rats with and without 0.16% phloridzin (a specific inhibitor of proximal tubular glucose transportation) and measured the urinary excretion rates of enzymes that are derived predominantly from proximal tubules. We used 10% mannitol solution and 0.9% saline as controls. Urinary excretion levels of N-acetyl β- D-glucosaminidase, alanine aminopeplidase, y-glutamyl transpeptidase and dipeptidyl aminopeptidase IV were significantly increased in the 10% glucose-loaded group. In contrast, these increased enzyme excretions were not observed in the 10% mannitol or 0.9% saline-loaded group. Moreover, addition of 0.16% phloridzin to 10% glucose solution completely prevented these increases in N-acetyl-β-D-glucosaminidase. alanine aminopeptidase and y-glutamyl transpeptidase excretion, and slightly decreased dipeptidyl aminopeptidase IV excretion. At the end of the infusion study, a rise in renal cortical sorbitol concentration of the 10% glucose-loaded group was about 2 times higher than the 0.9% saline or 10% mannitol-loaded group. However, in the group that received both glucose and phloridzin, elevation of renal cortical sorbitol concentration was not observed. This study showed that glucose-load results in both abnormal enzymuria and renal cortical sorbitol accumulation; they were completeley prevented by phloridzin.