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Abstract
Chronic renal disease accompanied by high incidence mortality. Death occurred in this case due to cardiovascular disease rather than to the developed kidney failure. So, this work aimed to throw more light on the changes caused by chronic renal failure on rat’s myocardium and the role of vitamin E as antioxidant. For this purpose, thirty adult healthy male albino rats were utilized in the present study. They were subdivided into 3 equal groups. In group I (control group) was further subdivided into 2 equal subgroups. One of them was sham operated and the other was given vitamin E. Animals in group II were subjected to partial nephrectomy at which the right kidney is removed while the left kidney is exposed to ischemia by ligation of its renal artery and these animals were left for 12 weeks. Group III included animals that were supplemented with vitamin E (3000 mg/kg BW/week) for 12 weeks started from the third day after operation. At the end of experiment blood samples were collected for determination of serum creatinine level. Then animals were sacrified and kidney samples were taken and stained with H&E to detect the histological changes. Also, left ventricular wall of the hearts were dissected out and processed for histological, immunohistochemical and ultrastructure study. Examination of histological stained kidney sections in group II showed alterations in most of the renal corpuscles and tubules. The corpuscles appeared with condensed glomeruli and wide Bowman’s spaces. Some of tubules contained intraluminal hyaline casts. Moreover, examination of histological stained heart sections revealed alternations in the general architecture of cardiac muscle fibers, loss of striated pattern, wide intercellular spaces and destructive areas that replaced with massive cellular infiltrations. Moreover, darkly stained nuclei, sarcoplasmic vacuolations and thick interstitial myocardial arteriole were observed. Aggregation of collagen fibers was also detected. However, with vitamin E supplementation in group III, cardiac muscle fibers showed moderate observable structural alternations in comparison to group II. Numerous cardiac muscle fibers were preserved cha racteristic pattern while some other showed changes. These changes are darkly stained nuclei, loss of normal striation, wide intercellular spaces and few destructive areas that replaced with minimal cellular infiltration. Less aggregation of collagen fibers were demonstrated. Immunohistochemical stained sections clarified that PICNA positive interstitial cells were numerous in group II while less in numbers in III and few in control. Examination of ultra thin sections (group II) revealed, cardiac muscle fibers contained bizarre shaped nuclei, the myofibrils showed attenuations, disorganizations and areas of focal destructions. Sarcosomes were giant and pleomorphic that randomly arranged. Z line showed focal fragmentation and thickening. Disorganized intercalated discs were seen with separations in certain areas. Myocardial interstitial cells with RER and cell membrane protrusions were observed surrounded by abundant collagen fibrils. However, with vitamin E supplementation in group III, most cardiac muscle fibers appeared normally while others revealed variable degrees of alternations. These alternations like small nuclei with peripheral heterochromatin, focal destruction and disruptions of A and I bands . Myocardial interstitial cell were surrounded by few collagen fibrils. In conclusion, chronic renal disease cause premature death due to cardiovascular cause rather than the developed renal failure while vitamin E supplementation as antioxidant give good protection against uremic microstructural changes in the heart. So, it is recommended to give vitamin E to minimize occurrence of uremic cardiomyopathy.