Establishment of the renal rehabilitation : Elucidation of the mechanism that therapeutic exercise effectively inhibits the aggravation of progressive renal disease.

我们评估了低蛋白饮食（LPD）和长期运动（EX）联合治疗的效果。我们还评估了这些疗法与血管紧张素II受体拮抗剂奥美沙坦（OLS）联合使用的效果。方法：雄性Wistar-Kyoto大鼠5 - 6肾切除术（NX）分为6组；1)正常蛋白质日粮（18.3w%蛋白质）；2) NPD+EX +跑步机（20m/min, 60min/day， 5天/week）；3) LPD （12.6w%蛋白质）；4) lpd + ex；5) LPD+EX加10mg/kg/天，OLS (LPD+EX+OLS)；6)假手术(S)，治疗12周。结果：NX大鼠在20m/min速度下的耗氧量（VO_2）约为80%，与S组相比，NX大鼠的峰值VO_2明显降低。LPD抑制了24小时尿蛋白排泄量（UP）的升高，降低了血清肌酐（Scr）和血尿素氮（BUN），改善了肾小球硬化（IGS）指数和相关肾皮质间质体积（RIV）。EX阻断高血压的发展，降低BUN，改善IGS和RIV。LPD+EX、LPD+EX+OLS、S组的UP明显低于LPD组。LPD、LPD+EX、LPD+EX+OLS、S组的IGS和RIV均显著低于NPD+EX和LPD组。LPD+EX、LPD+EX+OLS、S组肾小球ED-1阳性细胞明显低于NPD组。LPD+EX+OLS组收缩压（SBP）和RIV明显低于LPD+EX组。EX增强了比目鱼肌的毛细血管化和i型纤维的比例。结论：上述结果提示LPD和EX均有肾保护作用，提示LPD和EX联合治疗比LPD单独治疗具有更大的肾保护作用。此外，OLS和LPD+EX同时治疗比LPD+EX治疗具有更大的降压和肾保护作用，并且在该大鼠模型中，EX有一些额外的作用，没有任何并发症。少

We assessed the effects of combination therapy with low-protein diet (LPD) and long-term exercise (EX). We also assessed the effects of a combination of these therapies and the angiotensin II receptor antagonist, olmesartan (OLS).Methods : Male Wistar-Kyoto rats that were five-sixth-nephrectomized (NX) were divided into 6 groups ; 1) normal protein diet (18.3w% protein)(NPD) ; 2) NPD and EX with treadmill running (20m/min, 60min/day, 5days/week)(NPD+EX) ; 3) LPD (12.6w% protein) ; 4) LPD+EX ; 5) LPD+EX with 10mg/kg/day, OLS (LPD+EX+OLS) ; 6) Sham-operated (S), and the rats were then treated for 12weeks.Results : The oxygen consumption (VO_2) when NX rats were running at a speed of 20m/min corresponded to about 80%, and the peak VO_2 in the NX rats was significantly decreased compared with that in the S group. LPD blunted rises in 24h-urinary excretion of protein (UP), reduced serum creatinine (Scr) and blood urea nitrogen (BUN), and improved index of glomerular sclerosis (IGS) and rela … More tive interstitial volume in the renal cortex (RIV). EX blocked the development of hypertension, reduced BUN, and improved IGS and RIV. UP in the LPD+EX, LPD+EX+OLS, S groups was significantly lower than that in the LPD. IGS and RIV in the LPD, LPD+EX, LPD+EX+OLS, S were significantly lower than those in the NPD+EX and LPD. Glomerular ED-1 positive cell in the LPD+EX, LPD+EX+OLS, S was significantly lower than that in the NPD. Systolic blood pressure (SBP) and RIV in the LPD+EX+OLS was significantly lower than those in the LPD+EX. EX enhanced capillarization as well as the proportion of type-I fiber in the soleus muscle.Conclusions : These results indicate that LPD and EX have renoprotective effects, and suggest that the combination therapy with LPD and EX provides greater renoprotective effects than LPD alone. Moreover, simultaneous treatment of OLS and LPD+EX provides greater antihypertensive and renoprotective effects than treatment with LPD+EX, and EX had some additional effects without any complication in this rat model. Less