Higashi Y, Oshima T, Ozono R, Ono N, Hiraga H, et al
Counter-regulation of renal responses to L-arginine in
hypertensive patients with renal insufficiency
16th Scientific Meeting of the International Society of Hypertension
ISH Abstract Book
(Jun) 16: 1996
Endothelium-dependent renal vasodilatation has been reported to be
impaired in patients with mild essential hypertension (EHT) with
normal renal function. This study was designed to evaluate the renal
endothelial function in patients with hypertension and renal
insufficiency. The effects of intravenous administration of L-arginine
(L-arg; 500 mg/kg over 30 min.) on renal hemodynamics were studied in
25 normotensive controls (NT), 23 EHT, and 7 patients who had GFR
below 50 mL/min/1.48 m2.
The renal vasodilatation (i.e the decrease in
renal vascular resistances) induced by L-Arginine was smaller in EHT
than in NT and completely abolished in patients with renal
insufficiency. The increase in plasma cyclic GMP levels was RHT <
EHT < NT. GFR was unaffected in NT and
EHT by L-arg, but decreased in RHT.
These findings indicate that the
ability of L-arg-nitric oxide-cGMP to reduce renal vascular tone is
attenuated in EHT and abolished in hypertensives with renal diseases.
Comment: A weak point of this study is the small number of
patients with renal
insufficiency and the poor definition of the renal diseases
(Carmine Zoccali, M.D, Reggio Calabria, Italy).
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16th Scientific Meeting of the International Society of Hypertension
H: Pathophysiology :
Kidney in hypertension
H: Pathophysiology :
Endothelium, Nitric Oxide