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Background Phosphate is absorbed in the small intestine via passive flow and active transport.NaPi-IIb, a type II sodium-dependent phosphate transporter, is considered to mediate active phosphate transport in rodents. To study the regulation of intestinal phosphate transport in chronic kidney disease (CKD), we analyzed the expression levels of NaPi-IIb, pituitary-specific transcription factor 1 (PiT-1) and PiT-2 and the kinetics of intestinal phosphate transport using two CKD models. Methods CKD was induced in rats via adenine orThy1 antibody injection. Phosphate uptake by intestinal brush border membrane vesicles (BBMV) and the messenger RNA (mRNA) expression of NaPi-IIb, PiT-1 and PiT-2 were analyzed. The protein expression level of NaPi-IIb was measured by mass spectrometry (e.g. liquid chromatography tandem mass spectrometry). Results In normal rats, phosphate uptake into BBMV consisted of a single saturable component and its Michaelis constant (Km) was comparable to that of NaPi-IIb. The maximum velocity (Vmax) correlated with mRNA and protein levels of NaPi-IIb. In the CKD models, intestinal phosphate uptake consisted of two saturable components. The Vmax of the higher-affinity transport, which is thought to be responsible for NaPi-IIb, significantly decreased and the decrease correlated with reduced NaPi-IIb expression. The Km of the lower-affinity transport was comparable to that of PiT-1 and -2. PiT-1 mRNA expression was much higher than that of PiT-2, suggesting that PiT-1 was mostly responsible for phosphate transport. Conclusions This study suggests that the contribution of NaPi-IIb to intestinal phosphate absorption dramatically decreases in rats with CKD and that a low-affinity alternative to NaPi-IIb, in particular PiT-1, is upregulated in a compensatory manner in CKD.

Lupus nephritis (LN) is a renal disease presented in systemic lupus erythematosus (SLE) and is divided into 6 classes based on histopathological criteria set by the International Society of Nephrology/Renal Pathology Society. Major mouse models of SLE usually develop class III/IV LN, which are characterized by subendothelial deposits and endocapillary hypercellularity. We examined the pathological features of kidneys in a mouse model of SLE induced by a toll-like receptor 7 agonist, imiquimod (IMQ). In experiment 1, eleven-female FVB/NJcl wild type mice were treated with IMQ on their ear skin 3 times per week. Plasma anti-dsDNA increased from 2 weeks after first IMQ treatment and 2 mice exhibited nephrotic syndrome from 6 weeks. Histopathology revealed eosinophilic mesangial deposits in all mice from 4 weeks. Subsequently, podocytes showed enlargement with vacuolation and their numbers decreased in 6 mice. There was no infiltration of inflammatory cells, subendothelial deposits in glomeruli, or subepithelial deposits in glomeruli. In experiment 2 using 10 mice at 8 weeks after IMQ treatment, the mesangial deposits were observed in all mice and confirmed to be IgG, IgA, IgM, C1q and C3 by immunofluorescence, which corresponds to class II LN. Foot process effacement was detected by transmission electron microscopy and was considered to lead to proteinuria. These mice exhibited pathological characteristics corresponding to class II LN and podocyte injury, which make it distinct from other mouse models of SLE.

Background: Hyperphosphatemia is a major accelerator of complications in chronic kidney disease and dialysis, and phosphate (Pi) binders have been shown to regulate extracellular Pi levels. Research on hyperphosphatemia in mouse models is scarce, and few models display hyperphosphatemia induced by glomerular injury, despite its relevance to human glomerular disease conditions. In this study, we investigated the involvement of hyperphosphatemia in kidney disease progression using a mouse model in which hyperphosphatemia is induced by focal segmental glomerulosclerosis (FSGS). Methods: We established the NEP25 mouse model in which FSGS-hyperphosphatemia is induced by podocyte injury and evaluated the effect of a Pi binder, sevelamer. Results: After disease induction, we confirmed a gradual increase in serum Pi accompanied by reduced renal function and observed increases in serum FGF23 and PTH. Treatment with sevelamer significantly reduced serum Pi and urinary Pi fractional excretion and suppressed increases in serum FGF23 and PTH. A high dose improved serum creatinine and tubular injury markers, and pathological analysis confirmed amelioration of glomerular and tubular damage. Gene expression and marker analysis suggested protective effects on tubular epithelial cells in the diseased kidney. Compared to disease control, NEP25 mice treated with sevelamer retained their mRNA expression of Klotho, a known FGF23 co-receptor and renoprotective factor. Conclusions: Hyperphosphatemia caused by renal function decline was observed in a FSGS-induced NEP25 mouse model. Studies using this model showed that Pi regulation had a positive impact on kidney disease progression, and notably on tubular epithelial cell injury, which indicates the importance of Pi regulation in the treatment of kidney disease progression.

A treatment for hyperphosphatemia would be expected to reduce mortality rates for CKD and dialysis patients. Although rodent studies have suggested sodium-dependent phosphate transporter type IIb (NaPi-IIb) as a potential target for hyperphosphatemia, NaPi-IIb selective inhibitors failed to achieve efficacy in human clinical trials. In this study, we analyzed phosphate metabolism in rats, dogs, and monkeys to confirm the species differences. Factors related to phosphate metabolism were measured and intestinal phosphate absorption rate was calculated from fecal excretion in each species. Phosphate uptake by intestinal brush border membrane vesicles (BBMV) and the mRNA expression of NaPi-IIb, PiT-1, and PiT-2 were analyzed. In addition, alkaline phosphatase (ALP) activity was evaluated. The intestinal phosphate absorption rate, including phosphate uptake by BBMV and NaPi-IIb expression, was the highest in dogs. Notably, urinary phosphate excretion was the lowest in monkeys, and their intestinal phosphate absorption rate was by far the lowest. Dogs and rats showed positive correlations between Vmax/Km of phosphate uptake in BBMV and NaPi-IIb expression. Although phosphate uptake was observed in the BBMV of monkeys, NaPi-IIb expression was not detected and ALP activity was low. This study revealed significant species differences in intestinal phosphate absorption. NaPi-IIb contributes to intestinal phosphate uptake in rats and dogs. However, in monkeys, phosphate is poorly absorbed due to the slight degradation of organic phosphate in the intestine.

Chronic kidney diseases affect more than 800 million people globally and remain a high unmet need. Various therapeutic targets are currently under evaluation in pre-clinical and clinical studies. Because the growth arrest specific gene 6 (Gas6)/AXL pathway has been implicated in the pathogenesis of kidney diseases, we generated a novel selective and potent AXL inhibitor, CH5451098, and we evaluated its efficacy and elucidated its mechanism in an NEP25 mouse model that follows the clinical course of glomerular nephritis. In this model, CH5451098 significantly ameliorated the excretion of urinary albumin and elevation of serum creatinine. Additionally, it also inhibited tubulointerstitial fibrosis and tubular damage. To elucidate the mechanism behind these changes, we analyzed the effect of CH5451098 against transforming growth factor β1 (TGFβ1) and Gas6, which is a ligand of AXL receptor, in NRK-52E renal tubular epithelial cells. CH5451098 inhibited epithelial-to-mesenchymal transition (EMT) caused by the synergistic effects of TGFβ1 and Gas6 in NRK-52E cells. This inhibition was also observed in NEP25 mice. Taken together, these results suggest that CH5451098 could ameliorate kidney dysfunction in glomerular nephritis by inhibiting EMT in tubular cells. These results reveal that AXL strongly contributes to the disease progression of glomerular nephritis.

Hyperphosphatemia is common in chronic kidney disease and is associated with morbidity and mortality. The intestinal Na+-dependent phosphate transporter Npt2b is thought to be an important molecular target for the prevention of hyperphosphatemia. The role of Npt2b in the net absorption of inorganic phosphate (Pi), however, is controversial. In the present study, we made tamoxifen-inducible Npt2b conditional knockout (CKO) mice to analyze systemic Pi metabolism, including intestinal Pi absorption. Although the Na+-dependent Pi transport in brush-border membrane vesicle uptake levels was significantly decreased in the distal intestine of Npt2b CKO mice compared with control mice, plasma Pi and fecal Pi excretion levels were not significantly different. Data obtained using the intestinal loop technique showed that Pi uptake in Npt2b CKO mice was not affected at a Pi concentration of 4 mM, which is considered the typical luminal Pi concentration after meals in mice. Claudin, which may be involved in paracellular pathways, as well as claudin-2, 12, and 15 protein levels were significantly decreased in the Npt2b CKO mice. Thus, Npt2b deficiency did not affect Pi absorption within the range of Pi concentrations that normally occurs after meals. These findings indicate that abnormal Pi metabolism may also be involved in tight junction molecules such as Cldns that are affected by Npt2b deficiency.

Chronic kidney disease is characterized as impaired renal function along with the imbalance and dysregulation of mineral metabolism; recognized as chronic kidney disease-mineral and bone disorder. Hyperphosphatemia, characterized by altered phosphate homeostasis along with elevated fibroblast growth factor-23 and intact parathyroid hormone, is such an alteration of mineral metabolism. We discovered a novel inhibitor, EOS789, that interacts with several sodium-dependent phosphate transporters (NaPi-IIb, PiT-1, and PiT-2) known to contribute to intestinal phosphate absorption. This inhibitor dose-dependently increased the fecal phosphorus excretion rate and inversely decreased the urinary phosphorus excretion rate in normal rats, suggesting inhibition of intestinal phosphorus absorption. In rats with adenine-induced hyperphosphatemia, EOS789 markedly decreased the serum phosphate, fibroblast growth factor-23, and intact parathyroid hormone below values found in normal control rats. Notably, this pan-phosphate transporter inhibitor exhibited a more potent effect on serum phosphate than a NaPi-IIb-selective inhibitor in rats with hyperphosphatemia indicating that PiT-1 and PiT-2 play important roles in intestinal phosphate absorption. Moreover, in a long-term study, EOS789 sustained the suppression of serum phosphorus in parallel with fibroblast growth factor-23 and intact parathyroid hormone and ameliorated ectopic calcification of the thoracic aorta. Additionally, EOS789 treatment also ameliorated kidney deterioration in rats with progressive kidney injury, probably due to the strict phosphate control. Thus, EOS789 has potent efficacy against hyperphosphatemia and its complications and could provide a significant benefit to patients who are ineffectively treated with phosphate binders.

Urate-lowering therapy is indispensable for the treatment of gout, but available drugs do not control serum urate levels tightly enough. Although the uricosurics benzbromarone and probenecid inhibit a urate reabsorption transporter known as renal urate transporter 1 (URAT1) and thus lower serum urate levels, they also inhibit other transporters responsible for secretion of urate into urine, which suggests that inhibiting URAT1 selectively would lower serum urate more effectively. We identified a novel potent and selective URAT1 inhibitor, UR-1102, and compared its efficacy with benzbromarone in vitro and in vivo. In human embryonic kidney (HEK)293 cells overexpressing URAT1, organic anion transporter 1 (OAT1), and OAT3, benzbromarone inhibited all transporters similarly, whereas UR-1102 inhibited URAT1 comparably to benzbromarone but inhibited OAT1 and OAT3 quite modestly. UR-1102 at 3-30 mg/kg or benzbromarone at 3-100 mg/kg was administered orally once a day for 3 consecutive days to tufted capuchin monkeys, whose low uricase activity causes a high plasma urate level. When compared with the same dosage of benzbromarone, UR-1102 showed a better pharmacokinetic profile, increased the fractional excretion of urinary uric acid, and reduced plasma uric acid more effectively. Moreover, the maximum efficacy of UR-1102 was twice that of benzbromarone, suggesting that selective inhibition of URAT1 is effective. Additionally UR-1102 showed lower in vitro potential for mechanisms causing the hepatotoxicity induced by benzbromarone. These results indicate that UR-1102 achieves strong uricosuric effects by selectively inhibiting URAT1 over OAT1 and OAT3 in monkeys, and could be a novel therapeutic option for patients with gout or hyperuricemia.

To identify novel transporters in the kidney, we have constructed an mRNA data base composed of 1000 overall clones by random sequencing of a male rat kidney cDNA library. After a BLAST search, approximately 40% of the clones were unknown and/or unannotated and were screened by measuring the uptake of various compounds using Xenopus oocytes. One clone stimulated the uptake of alpha-methyl-d-glucopyranoside and therefore was termed rat Na(+)-dependent glucose transporter 1 (rNaGLT1). The rNaGLT1 cDNA (2173 bp) has an open reading frame encoding a 484-amino acid protein, showing22% homology to known SGLT and GLUT glucose transporters. alpha-Methyl-d-glucopyranoside uptake by rNaGLT1 cRNA-injected oocytes showed saturability, with an apparent K(m) of 3.7 mm and a coupling ratio of 1:1 with Na(+). rNaGLT1 mRNA was expressed predominantly in the kidney upon Northern blot analysis and reverse transcription-PCR. Reverse transcription-PCR in microdissected nephron segments revealed that rNaGLT1 mRNA was primarily localized in the proximal tubules. A clear signal corresponding to rNaGLT1 protein was recognized in the brush-border (but not basolateral) membrane fraction by immunoblot analysis. The rNaGLT1 mRNA level in the kidney was significantly higher than rat SGLT1 and SGLT2 mRNA levels. These findings suggest that rNaGLT1 is a novel Na(+)-dependent glucose transporter with low substrate affinity that mediates tubular reabsorption of glucose.

An inorganic phosphate (Pi)-restricted diet is important for patients with chronic kidney disease and patients on hemodialysis. Phosphate binders are essential for preventing hyperphosphatemia and ectopic calcification. The sodium-dependent Pi(Na/Pi) transport system is involved in intestinal Piabsorption and is regulated by several factors. The type II sodium-dependent Pitransporter Npt2b is expressed in the brush-border membrane in intestinal epithelial cells and transports Pi. In the present study, we analyzed the phenotype of Npt2b−/−and hetero+/−mice. Npt2b−/−mice died in utero soon after implantation, indicating that Npt2b is essential for early embryonic development. At 4 wk of age, Npt2b+/−mice showed hypophosphatemia and low urinary Piexcretion. Plasma fibroblast growth factor 23 levels were significantly decreased and 1,25(OH)2D3levels were significantly increased in Npt2b+/−mice compared with Npt2b+/+mice. Npt2b mRNA levels were reduced to 50% that in Npt2b+/+mice. In contrast, renal Npt2a and Npt2c transporter protein levels were significantly increased in Npt2b+/−mice. At 20 wk of age, Npt2b+/−mice showed hypophosphaturia and reduced Na/Picotransport activity in the distal intestine. Npt2b+/+mice with adenine-induced renal failure had hyperphosphatemia and high plasma creatinine levels. Npt2b+/−mice treated with adenine had significantly reduced plasma Pilevels compared with Npt2b+/+mice. Intestinal Npt2b protein and Na+/Pitransport activity levels were significantly lower in Npt2b+/−mice than in the Npt2b+/+mice. The findings of the present studies suggest that Npt2b is an important target for the prevention of hyperphosphatemia.

Gene expression variance based on random sequencing in rat remnant kidney. Background. Several examinations have been performed to identify the genes involved in chronic renal failure using 5/6 nephrectomized rats. Recently, many systematic techniques for examining molecular expression have been developed. They might also be effective in elucidating the molecular mechanism of progressive renal failure. In this study, digital expression pro- filing was carried out to construct a subtractive mRNA expres- sion database for the 5/6 nephrectomized kidney. Methods. One thousand clones were randomly sequenced from 5/6 nephrectomized and sham-operated rat kidney cDNA libraries, respectively, and defined by BLAST search. In silico subtractive analysis was performed to search for genes up- or down-regulated in the 5/6 nephrectomized kidney. Results. The growth factor-related mRNAs and the mRNAs encoding cytoskeletal or membrane proteins were up-regulated, but the transporter-related mRNAs were down- regulated in the 5/6 nephrectomized kidney database. In silico subtraction revealed that 63 mRNAs were increased and 59 were decreased in the 5/6 nephrectomized kidney. To confirm whether the in silico subtractive database reflected the actual ex- pression of mRNA or protein, 12 known genes were examined by Northern blotting or immunoblotting, respectively. The ac- tual expression of the 12 genes was comparable with the results of in silico subtraction. In addition, we successfully isolated five unknown genes, two up-regulated and three down-regulated in the 5/6 nephrectomized kidney. Conclusion. We constructed a subtractive mRNA expres- sion database for 5/6 nephrectomized kidney, which reflects the actual alterations in mRNA expression after subtotal nephrec- tomy. This database may be useful for elucidation of the molec- ular mechanism of progressive renal failure.

Background: Recently, two isoforms of cyclooxygenase (COX) have been identified, a constitutive form (COX-1) and a mitogen-inducible form (COX-2). Several studies have suggested that COX is activated in renal insufficiency, but little is known about the relationship between progression of renal insufficiency and the COX isoforms. Methods: Five-sixths-nephrectomized (NX) rats were used. 4, 8, and 12 weeks after nephrectomy, the renal cortical prostaglandin contents and the expression levels of the two isoforms of COX were determined by enzyme immunoassay and Western-blotting, respectively. The localization of COX was examined by immunohistochemistry. Results: Renal cortical prostacyclin (PGI2) and COX-2 were significantly upregulated 8 and 12 weeks after NX, while COX-1 remained at the basal level. There was a high correlation between COX-2 and creatinine clearance (r = –0.845). There was also a high correlation between COX-2 and PGI2 (r = 0.816). Immunohistochemistry revealed the expression of COX-2 to be enhanced in the macula densa in NX rats. Conclusions: Renal cortical COX-2 and prostacyclin were upregulated corresponding to the progression of renal insufficiency in NX rats. These results suggest enhancement of COX-2 expression in the macula densa, perhaps stimulated by a decrease in renal blood flow which upregulates PGI2 synthesis to protect the kidney from ischemia in renal insufficiency.

A monoclonal antibody, hPM-1, was constructed by grafting the complementarity determining regions to human interleukin-6 (IL-6) receptor, raised in mouse, onto a human antibody backbone (humanized antibody). It is expected to be useful as a therapeutic agent for IL-6-related diseases such as multiple myeloma. To investigate the toxicological and kinetic properties of hPM-1 preliminarily, normal cynomolgus monkeys, which showed cross-reactivity with hPM-1, were intravenously administered with hPM-1 at doses of 0 (vehicle), 4 or 40 mg/kg once a week for 13 weeks. Upon toxicological examination, there were no changes in clinical signs, food consumption, body weights, urinalyses, body temperatures, electrocardiograms, hematological and biochemical parameters including blood platelet counts, serum levels of immunoglobulin G and C-reactive protein, and pathological findings. In a kinetic study, serum concentrations of hPM-1 showed a linearity between doses of 4 and 40 mg/kg. The serum concentrations, even at a dose of 4 mg/kg, were maintained at a high enough level to inhibit the IL-6 functions throughout the period of the study. Concentrations of hPM-1 in bone marrow were almost equal to those in serum. The antibodies against hPM-1 were detected only in one of four monkeys receiving hPM-1. This study suggests that blockage of the IL-6 receptor by hPM-1 does not induce any influence on a healthy living body, and hPM-1 is not toxic under the conditions of this investigation.

Background Control of blood uric acid is important for the treatment of gout. The clinical potential of a selective uric acid transporter 1 (URAT1) inhibitor as a drug for hyperuricemia and gout remains unknown because currently available uricosuric drugs block renal uric acid reabsorption by inhibiting not only URAT1 but also other transporters responsible for renal tubular uric acid secretion, such as OAT1 or OAT3. We have identified a highly selective URAT1 inhibitor, UR-1102, which is now under clinical trial for gout. Objectives In this study, we examined the therapeutic potential of selective URAT1 inhibition with UR-1102 by comparing it with benzbromarone, a traditional non-selective URAT1 inhibitor, in vitro and in vivo with cebus monkeys, an animal model that has similar purine metabolism and urinary uric acid excretion to humans. Methods The inhibitory effects of UR-1102 and benzbromarone on URAT1, OAT1, OAT3 and ABCG2 were evaluated in vitro using CHO cells that over-express these transporters. UR-1102 at 3, 10, and 30 mg/kg or benzbromarone at 3, 10, 30, and 100 mg/kg were administered orally once a day to cebus monkeys for 3 consecutive days ( n =6, cross-over study). Plasma and urinary excretion of uric acid and creatinine were measured at regular time intervals. Fractional excretion of uric acid (FEUA) was calculated from those values. Results UR-1102 exhibited significantly more potent and highly selective (Ki values for URAT1 were >100 smaller than other transporters) URAT1 inhibition than benzbromarone in vitro , while benzbromarone inhibited URAT1, OAT1, OAT3 and ABCG2 dose-dependently as reported in the literature. The average plasma uric acid concentration for the control group was 3.6 +/- 0.2 mg/dL and FEUA was 8.8% +/- 0.4% on day 3 (0–8 hours after 3 rd administration) in the cebus monkeys. Benzbromarone showed dose-dependent and significant reduction of plasma uric acid concentration (3.4, 3.0, 2.8, and 2.7 mg/dL at 3, 10, 30, and 100 mg/kg, respectively) and increase of FEUA (10.3%, 14.5%, 18.5%, and 20.6% at 3, 10, 30, and 100 mg/kg, respectively). UR-1102 also showed the dose-dependent and significant effects on plasma uric acid reduction (2.5, 2.4, and 1.8 mg/dL at 3, 10, and 30 mg/kg, respectively) and increase of FEUA (22.6%, 35.4%, and 42.1% at 3, 10, and 30 mg/kg, respectively). The effects were more apparent for UR-1102 at a lower dose. Moreover, comparing the submaximal dose of UR-1102 at 30 mg/kg with benzbromarone at 100 mg/kg, the effects were significantly higher for UR-1102 than for benzbromarone (plasma uric acid concentration: 1.8 +/- 0.2 mg/dL vs 2.7 +/- 0.2 mg/dL, p Conclusions Hypouricemic and uricosuric effects were more potent for UR-1102 than for benzbromarone in both dose and maximum efficacy in cebus monkeys. This may be due to the high selectivity of UR-1102 for URAT1. UR-1102 would have greater efficacy as a therapeutic drug for gout/hyperuricemia than benzbromarone. Disclosure of Interest S. O. Ahn Employee of: C&C Research Laboratories, N. Horiba Employee of: Chugai Pharmaceutical Co., Ltd., S. Ohtomo Employee of: Chugai Pharmaceutical Co., Ltd., K. J. Lee Employee of: C&C Research Laboratories, K. H. Kim Employee of: C&C Research Laboratories, B. H. Kim Employee of: C&C Research Laboratories, J. Kiyokawa Employee of: Chugai Pharmaceutical Co., Ltd., M. Yamane Employee of: Chugai Pharmaceutical Co., Ltd., H. Ikegami Employee of: Chugai Pharmaceutical Co., Ltd., T. Nakagawa Employee of: Chugai Pharmaceutical Co., Ltd., H.-H. Hwang Employee of: JW Pharmaceutical corp., J.-H. PARK Employee of: JW Pharmaceutical corp., J. Y. Cha Employee of: JW Pharmaceutical corp., J. Tanaka Employee of: Shin Nippon Biomedical Laboratories, Ltd., T. Kake Employee of: Chugai Pharmaceutical Co., Ltd.

Hyperphosphatemia is recognized as a contributor to vascular calcification in patients with chronic kidney disease (CKD) and hemodialysis (HD) patients and is independently associated with cardiac mortality. Dietary inorganic phosphorus (Pi) restriction, and the Pi binders are important therapy for dialysis patients with hyperphosphatemia. Recent study reported that salivary secretion of Pi to be an important determinant of hyperphosphatemia in patients with CKD and in those with ESRD under chronic dialysis. In the present study, we investigated the role of type IIb sodium-dependent Pi transporter (Npt2b) on salivary Pi excretion in mice. The expression of Npt2b protein was detected at the apical side of duct cells in the salivary glands, suggesting that ductal cells appears to be able to reabsorb Pi, thereby modifying the Pi concentration in the final saliva. In wild-type mice (Wt mice) fed a high Pi diet, the levels of plasma and salivary Pi are significantly higher than those in mice fed a low Pi diet. In Npt2b+/- mice, the salivary Pi concentrations were significantly increased compared with those in Npt2b+/+ mice. Npt2b+/- mice with adenine-induced renal failure had low plasma and salivary Pi levels, and plasma creatinine and BUN levels compared with Npt2b+/+ mice treated with adenine. In conclusion, Npt2b is involved in Pi secretion by salivary glands.

We found a system of Na+-dependent uptake of fructose by rat renal brush-border membrane vesicles. It consisted of two saturable components, and was thought to involve at least two transporters. rNaGLT1, a novel glucose transporter in rat kidney, showed fructose uptake as well as α-methyl-D-glucopyranoside uptake by transfected HEK293 cells. The features of the lower affinity type of fructose transporter in the brush-border membranes, such as affinity and substrate recognition, were very comparable with those of rNaGLT1-transfected HEK293 cells. These results indicated that rNaGLT1 is a primary fructose transporter in rat renal brush-border membranes.