EFFECTS OF SOME CALCIUM CHANNEL BLOCKERS AGAINSTS CCL4-INDUCED NEPHROTOXICITY IN ALBINO RATS

Abstract

Acute kidney injury remains associated with high morbidity and mortality despite progress in medical care. Carbon tetrachloride (CCl4)-toxicity causes free radical generation and increases calcium influx, leading to pathogenesis in target tissues which includes the kidney. The present study reports the protective effects of some calcium channel blockers (nifedipine and amlodipine) against CCl4-induced acute kidney injury. Twenty four (24) albino rats were randomly grouped into four groups: A, B, C and D; with six animals per group. Groups A-C received CCl4 (0.4ml/kg b.wt, i.p) for 3 days. Group A served as toxic (negative) control. Group B received nifedipine (1mg/100g of rat, i.p), while Group C received amlodipine (1mg/100g of rat, i.p) for 3 days. No treatment was administered to group D (Normal control). Renal injury was assessed through biochemical and
histopathological analyses. The CCl4 administration alone caused a marked alteration in the levels of: Na+
(120.83±2.14 mmol/l), K+ (7.02±0.61 mmol/l), Creatinine (1.52±0.19 mg/dl) and Urea (34.02±4.46 mg/dl) (p<0.01). Treatment with the calcium channel blockers (nifedipine and amlodipine) separately, significantly attenuated the renal dysfunction with: Na+(129.54±1.68; 130.13±1.75 mmol/l), K+ (5.10±0.72; 5.08±0.60 mmol/l), Creatinine (0.72±0.16; 0.71±0.12 mg/dl) and Urea (21.37±2.09; 20.08±1.83 mg/dl) respectively (p<0.05). Histopathological results showed a concomitant association with the biochemical findings. Calcium channel blockers are nephroprotective, and may be used to prevent drug/chemical-induced acute renal injury.

Full text

April 30, 2019
Archives • 2019 • vol.1 • 87-95
http://pharmacologyonline.silae.it
ISSN: 1827-8620
EFFECTS OF SOME CALCIUM CHANNEL BLOCKERS AGAINSTS CCL4-INDUCED NEPHROTOXICITY IN
ALBINO RATS
Ikegwuonu Ifeoma Chinwe; Uchendu Ikenna Kingsley*; Ekeigwe Ifeoma Blessing
Department of Medical Laboratory Science, Faculty of Health Sciences and Technology, College of Medicine,
University of Nigeria Enugu Campus
Email address: ikenna.uchendu@unn.edu.ng*
Abstract
Acute kidney injury remains associated with high morbidity and mortality despite progress in medical care.
Carbon tetrachloride (CCl4)-toxicity causes free radical generation and increases calcium influx, leading to
pathogenesis in target tissues which includes the kidney. The present study reports the protective effects of
some calcium channel blockers (nifedipine and amlodipine) against CCl4-induced acute kidney injury. Twenty four
(24) albino rats were randomly grouped into four groups: A, B, C and D; with six animals per group. Groups A-C
received CCl4 (0.4ml/kg b.wt, i.p) for 3 days. Group A served as toxic (negative) control. Group B received
nifedipine (1mg/100g of rat, i.p), while Group C received amlodipine (1mg/100g of rat, i.p) for 3 days. No treatment
was administered to group D (Normal control). Renal injury was assessed through biochemical and
histopathological analyses. The CCl4 administration alone caused a marked alteration in the levels of: Na+
(120.83±2.14 mmol/l), K+ (7.02±0.61 mmol/l), Creatinine (1.52±0.19 mg/dl) and Urea (34.02±4.46 mg/dl) (p<0.01).
Treatment with the calcium channel blockers (nifedipine and amlodipine) separately, significantly attenuated the
renal dysfunction with: Na+ (129.54±1.68; 130.13±1.75 mmol/l), K+ (5.10±0.72; 5.08±0.60 mmol/l), Creatinine
(0.72±0.16; 0.71±0.12 mg/dl) and Urea (21.37±2.09; 20.08±1.83 mg/dl) respectively (p<0.05). Histopathological
results showed a concomitant association with the biochemical findings. Calcium channel blockers are
nephroprotective, and may be used to prevent drug/chemical-induced acute renal injury.
Keywords: Calcium channel blockers, nephroprotection, CCl4, nephrotoxicity

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Introduction
Drugs such as aminoglycoside antibiotics, NSAIDS
(non-steroidal anti-inflammatory drugs),
amphotericin B, and ACE (angiotensin-converting
enzyme) inhibitors, have been implicated as causes
of nephrotoxicity (1). Factors such as age, presence
of comorbidities, and exposure to multiple drugs
and other therapeutic agents could trigger and
culminate into drug-induced nephrotoxicity (2). The
primary function of the renal system is the
elimination of metabolic waste products (3, 4). The
kidney is a common site of chemical toxicity as a
result of its constant exposure to chemicals and
toxicant xenobiotics, which it needs to eliminate
from the host’s body.
The production of toxic or active phase 1
metabolites during the biotransformation of
drugs/chemicals is a key feature of nephrotoxicity
and one known toxicant xenobiotic, among others,
which can be activated during biotransformation, is
carbon tetrachloride (CCl4). CCl4 is a well-established
xenobiotic and both the liver and the kidneys are its
target organs (5). It is known for its lytic injury on
target organs. Studies have also shown that
exposure to CCl4 is metabolized by cytochrome
P450 isoenzyme, CYP2E1 to the highly reactive
trichloromethyl (CCl3 and CCl3OO) free radical
which causes target tissue cell alteration through
lipid peroxidation (6).
Drug-induced nephrotoxicity is fast becoming a
common complication, with the ever-increasing
plethora of drugs and the ease of availability of OTC
(over-the-counter) drugs with detrimental effect on
the renal function (7). Drugs cause approximately
one-fifth of community- and hospital-acquired
episodes of acute renal failure (7-9), Although renal
impairment is often reversible if the offending drug
is discontinued, the condition can be costly and may
require multiple interventions including
hospitalization (10). Inhospital drug use may
contribute to 35% of all cases of acute tubular
necrosis, most cases of allergic interstitial nephritis,
as well as nephrotoxicity due to alterations in renal
hemodynamics and postrenal obstruction (7, 11).
Several biochemical mechanisms have been
reported to be involved in the occurrence of renal
cell injury. These mechanisms include cell death
through apoptosis, disruption of cell volume/ion
homeostasis, changes in cell membrane integrity,
mitochondrial ATP (adenosine triphosphate)
dysfunction, and disruption in cellular calcium (Ca2+)
homeostasis (8).
Ca2+ is a second messenger that plays a critical
role in a variety of cellular functions. Its distribution
within renal cells is known to be complex and
involves binding to anionic sites on macromolecules
and compartmentalization within subcellular
organelles (8). However, because the proximal renal
tubular cells reabsorb approximately over 50% of the
filtered load of Ca2+, they must maintain low
cytosolic Ca2+ concentrations during a large Ca2+ flux
(7, 8). Sustained elevations or abnormally large
increase in free cytosolic Ca2+ can exert a number of
harmful effects on the renal cells. While the precise
role of Ca2+ in toxicant-induced injury remains
unclear, release of endoplasmic reticulum (ER) Ca2+
stores may be a key step in initiating the injury
process and increasing cytosolic-free Ca2+
concentrations (8, 12, 13). However, prior depletion
of ER Ca2+ stores protect renal proximal tubules
from extracellular Ca2+ influx and cell death
produced by mitochondrial inhibition and hypoxia
(14). Ca2+ channel blockers (CCBs) are known
pharmacologically to inhibit the influx of Ca2+ into
cells thereby depleting the Ca2+ stores in the renal
cells, thus potentially exerting nephroprotective
effect.
This study was designed to investigate the
ameliorative effect of CCBs (nifedipine and
amlodipine) against CCl4-induced acute renal injury
in rats. This study is important because, CCBs are
commonly used for the treatment of hypertention
in many parts of the world, but have not been
clinically known to be used for treatment of acute
kidney injuries. Recently, Uchendu et al (15)
reported that combination of aqueous extracts of
curcuma longa (turmeric) and some calcium channel
blockers synergistically improves CCl4-induced
hepatotoxicity in albino rats. This suggests the
protective potentials of CCBs against target-tissue
injury by CCl4. Furthermore, there is scarcity of
literatures on the antinephotoxic effect of CCBs
against drug/chemical-induced kidney injury. Again
only one study, by Akindele et al. (7), has been
carried out on the protective effects of CCBs against
CCl4-induced nephrotoxicity. Thus, further studies
and more literatures are therefore needed to

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validate their finding, either in support or in
contradiction for justification of results and/or to
affirm CCBs as potential nephroprotective drugs.
Materials and Methods
Chemical and drugs
The chemical used in the study was of analytical
grade and only includes CCl4 solution (Alpha
Pharmaceuticals, Enugu, Nigeria). Drugs used
include Nifedipine and Amlodipine (Salutas Pharma
GmBH for Lek Pharmaceutical and Chemical
Company, Veroskova, Slovenia).
Preparation of calcium channel blocker solutions.
Thirty-two (32) tablets of 10 mg (i.e. 320 mg)
amlodipine and 20 tablets of 20 mg nifedipine (400
mg) were grinded to powder, dissolved in 100ml
distilled water to give a stock solution of 3.2mg/ml
and 4mg/ml respectively.
Induction of acute kidney injury.
Renal injury was induced in each animal by
intraperitoneal injection with CCl4 (0.4ml/kg), daily
for 3 days.
Animals and maintenance
A total of twenty-four (24) adult albino rats,
weighing (120±20g), were obtained from the animal
house of the College of Veterinary Medicine,
University of Nigeria. The animals were housed in
metallic cages in the animal house under ambient
temperature (25±3°C) and 12-hour light and dark
periodicity. They were adequately fed with
commercial rat pellets (Neimeth Livestock Feeds
Ltd., Ikeja) and water ad libitum. The animals were
kept under observation for about 14 days before the
onset of the experiment for acclimatization. Ethical
approval for the use of animals for experimental
research was obtained from the Institutional Ethics
Committee at Department of Animal Science,
University of Nigeria, Nsukka, Enugu State, Nigeria.
Experimental Design
The 24 albino rats were grouped into (A-D) and
received the following treatments on a daily basis
for three days:
Group A: (Negative Control): received
intraperitoneal administration of carbon
tetrachloride CCl4 (0.4ml/kg body weight) only for 3
days.
Group B: received CCl4 and nifedipine (1mg/100g of
rat, i.p) for 3 days.
Group C: received CCl4 and amlodipine (1mg/100g of
rat, i.p) for 3 days.
Group D: (normal Control): No treatment was
administered to this group.
Sacrificing of animals and sample collection
Blood samples for the determination of kidney
biochemical markers were taken by cardiac
puncture of the left ventricle of the heart under
chloroform anaesthesia and the kidney harvested
for histopathological analyses.
Biochemical analysis
The levels of Serum Electrolyte, Urea and
Creatinine were estimated using the following
methods: K+ and Na+ was determined using Perlong
Medical PL1000A Electrolyte Analyser; Serum urea
concentration was determined using the diacetyl
monoxime method with protein precipitation
according to Natelson et al. (16) Serum creatinine
concentration was determined using the Jaffe
Reaction according to Fabing and Ertingshausen
(17).
Histopathological analysis
The excised kidneys were processed using the
paraffin wax embedding technique, sectioned at 5
microns and stained using the Haematoxylin and
Eosin [H and E] staining procedure (18). The
histological sections were examined using an
Olympus TM light microscope.
Statistical analysis
Data analysis was done using GraphPad prism
version 6.0 (GraphPad, San Diego, CA, USA). The
results of the biochemical assays were reported as
mean±SEM (standard error of mean). The level of
significance was tested using one way analysis of
variance (ANOVA), followed by the Tukey post hoc
analysis. Probability levels less than 0.05 (p<0.05)
were considered significant.

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Results
Biochemical results
Table 1 shows the results of kidney biochemical
parameters: urea, creatinine, K+, Na+ levels in four
(4) groups of six (6) animals, which received
intraperitoneal administration of carbon
tetrachloride CCl4 (0.4ml/kg body weight) and/or
some calcium channel blockers (nifedipine and
amlodipine; separately) for 3 days. From the results,
The CCl4 administration caused a marked alteration
in the levels of: Na+ (120.83±2.14 mmol/l), K+
(7.02±0.61 mmol/l), Creatinine (1.52±0.19 mg/dl) and
Urea (34.02±4.46 mg/dl) (p<0.01) in the negative
control animals when compared to normal control
animals. Treatment with the calcium channel
blockers (Nifedipine and Amlodipine) separately,
significantly attenuated the renal dysfunction with:
Na+ (129.54±1.68; 130.13±1.75 mmol/l), K+ (5.10±0.72;
5.08±0.60 mmol/l), Creatinine (0.72 ± 0.16; 0.71 ± 0.12
mg/dl) and Urea (21.37±2.09; 20.08±1.83 mg/dl)
respectively (p<0.05), when compared to the
negative control animals.
Histopathological results
The results are represented in figures 1 (A-D).
Microscopic examination of the kidney, revealed no
histopathological alteration, in the normal control
rats (Figure 1D). Presence of significant distortion
the glomeruli was observed in the kidney of rats
treated with CCl4 only (Figure 1A); however non-
significant degenerations were observed in rats
administered with nifedipine or amlodipine
separately, in the presence of CCl4 challenge (Figure
1B and 1C respectively). The kidneys of rats in group
B and C showed no significant histological
alterations when compared with the normal control
group.
Discussion
In the present study, the aim was to evaluate the
protective effects of two selected calcium channel
blockers (nifedipine and amlodipine) against CCl4-
induced acute renal injury. Findings from our study
showed that CCB effectively protected rat kidneys
against nephrotoxic injury by CCl4. This agrees with
or strengthens similar findings by Akindele et al (7).
It further scientifically supports the potential use of
calcium channel blockers for the prevention or
treatment of drug/chemical-induced renal injury in
hospital patients.
Drugs are chemical substance, and their
therapeutic use, usually alters the physiological
homeostasis and affects organs during treatment
process. Effective use of most drugs is limited
because of their toxicity to various organs including
the kidney (19, 20). Acute renal failure has remained
associated with high mortality and morbidity in
societies, considering major advances made in the
field of medicine and medical care (21-26). There is
increasing evidence that free radicals and reactive
steps initiate and regulate the progression of kidney
disease (7, 22).
CCl4-induced-target tissue injury is one of the
most characterized models of xenobiotic-induced
tissue toxicity, and is employed for evaluating
antihepatotoxicant or nephroprotective activities of
drugs or bioactive substances (27). The metabolism
of CCl4, primarily through the activity of CYP2E1,
generates highly reactive trichloromethyl free
radicals CCl3 and CCl3OO which result in target-
tissue damage. These free radicals initiate lipid
peroxidation by abstracting a hydrogen atom from
the polyunsaturated fatty acid of a phospholipid
(28). The CCl4-induced lipid peroxidation in turn
increases the permeability of plasma membrane to
calcium ion, resulting in severe disruption of calcium
homeostasis and necrotic cell death (28, 29). The
extent of kidney damage was assessed by the
alterations in serum levels of Urea, Creatinine,
potassium, sodium, and by histopathological
examination. The aim of the study was to evaluate,
the effects of selected calcium channel blockers
(nifedipine and amlodipine) against carbon
tetrachloride (CCl4)-induced acute renal injury in
rats.
Except for serum Na+, other renal biochemical
parameters, which include serum creatinine, urea,
and K+, were elevated in the group (negative
control) administered with CCl4 alone when
compared to the normal group. Factors like gender,
age, and the amount of the muscle mass can
influence serum creatinine level (11). These factors
were kept constant, as the rats were of the same
weight range and were restricted from movement.
The elevated urea and creatinine levels could be
attributed to renal damage, since kidney function,
with increased blood urea and creatinine (22).

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Urea, creatinine and K+ were seen to be
significantly decreased, whereas Na+ was increased
in the group co-treated with a calcium channel
blocker, which indicates that calcium channel
blockers may afford protection against kidney
injury. Hiroki et al. (29) report that hypocalcaemia
has an ameliorating effect on CCl4-induced
hepatotoxicity. This again suggests that calcium
influx is involved in CCl4-induced tissue-toxicity. In
this study, the effects of calcium channel blockers
(nifedipine and amlodipine) on CCl4-induced kidney
damage were determined and the kidney showed a
significant reestablishment of several of the renal
biochemical parameters: a considerable decrease in
Urea, Creatinine and K+ levels was observed.
Conclusion
The present study shows that carbon
tetrachloride induced kidney injury; however the
treatment with calcium channel blockers (nifedipine
and amlodipine) ameliorated the effects in test
groups. Thus this data suggests that calcium
channel blockers may be of health benefit to patient
suffering from acute kidney injury induced by
nephrotoxic agents. Furthermore, this study
supports discovery of the potential use of calcium
channel blockers as complementary and alternative
drugs for the prevention or treatment of
drug/chemical-induced renal injury in hospital
patients. Therefore, this study would serve as
insight into further researches to harness more
pharmacologic potentials of calcium channel
blockers, aside their common use as
antihypertensive agents.
Acknowledgments
The authors express deep sense of gratitude to
Mr. Chris Ireoba, The head of department of the
Laboratory Division at Eastern Nigeria Medical
Centre, Enugu, and all the technical staff for their
kind cooperation.
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Table 1: Statistical comparison of kidney biochemical concentrations in different experimental animal groups.
Groups
Urea
(mg/dl)
Creatinine
(mg/dl)
K+
(mmol/l)
Na+
(mmol/l)
CCl4 Alone
34.02 ± 4.46
1.52 ± 0.19
7.02 ± 0.61
120.83 ± 2.14
CCl4 + Nifedipine
21.37 ± 2.09*
0.72 ± 0.16*
5.10 ± 0.72
129.54 ± 1.68*
CCl4 + Amlodipine
20.08 ± 1.83*
0.71 ± 0.12*
5.08 ±0.60
130.13 ± 1.75*
Normal Control
17.85 ± 5.38**
0.54 ± 0.06**
4.02 ± 0.51*
132.21 ± 1.61*
Values given as Mean ± SEM. **P˂0.01 or *P˂0.05 is significant when CCl4 alone (negative control) is compared with all other groups.
Figure 1A: Photomicrograph of kidney from (A) CCl4 alone-treated rats. Presence of constricted glomerulus (CG), eroded
glomerulus (EG), stromal hyperaemia (arrow head) and eroded tubules (arrows). [Stain: H and E; ×400].
CG
EG

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Figure 1B: Photomicrograph of kidney from (B) CCl4 +nifedipine-treated rats. Presence of some normal glomeruli (G), the
tubules (T) appear normal. A hyperaemic portion of the stroma is seen (arrow head). [Stain: H and E; ×400].
Figure 1C: Photomicrograph of kidney from (C) CCl4+amlodipine-treated rats. Presence of some normal glomeruli (G), and the
tubules (T) appear normal. [Stain: H and E; ×400].
G
G
T
T
G
G
T

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Figure 1D: Histopathology and photomicrograph of kidney from (D) normal control rats. Presence of normal Glomeruli (G)
and renal tubules (T).[Stain: H and E; ×400].
G
G
T
T
T
T