Loss of size-selectivity of the glomerular filtration barrier in rats following laparotomy and muscle trauma.

Post-traumatic microalbuminuria may be caused by either charge- or size-selective alterations in the glomerular filtration barrier, or both, and/or to a reduction in proximal tubular protein reabsorption (PTR). This study was performed to elucidate the pathophysiology of the increases in glomerular permeability occurring in rats exposed to laparotomy or to laparotomy and muscle trauma. In anaesthetized Wistar rats (250-280 g), the left ureter was catheterized for urine collection, while simultaneously blood access was achieved. Rats were exposed to trauma by laparotomy (L) (n=8), or by a combination of L and muscle trauma (MT), induced by topical blunt injury of the abdominal muscles bilaterally. After L muscles were crushed using a hemostatic forceps at either 2x2 sites ("small" MT; n=9), or at 2x5 sites ("large" MT; n=9). Sham groups (n=16), not exposed to laparotomy, were used as controls. The glomerular sieving coefficients () to polydisperse, fluorescein isothiocyanate (FITC)-Ficoll-70/400 (mol.radius 13-80A) were determined at 5 or 60 min after L and (L + MT), respectively, from plasma and urine samples, and analyzed by high performance size-exclusion chromatography (HPSEC). A tissue uptake technique was used to assess for (125)I-serum albumin. L, with or without MT, increased for Ficoll55-80A and albumin rapidly and markedly. -Ficoll70A thus increased approximately threefold, and for albumin significantly, for all trauma groups. According to the "two-pore model" of glomerular permeability these changes reflect an increase in the number of large pores in the glomerular filter without any primary changes in the charge-selective properties of the filter. Key words: microalbuminuria, glomerular sieving coefficients, albumin, Ficoll.