Artikel
Impaired Basal NO Activity in Patients with Chronic Glomerulonephritis
Störung der basalen NO-Produktion bei Patienten mit chronischer Glomerulonephritis
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Veröffentlicht: | 10. August 2005 |
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Background: While evidence has been given that reactive oxygen plays a major role in the development of endothelial dysfunction, it is yet unspecified whether increased oxidative stress contributes to endothelial dysfunction in patients with chronic glomerulonephritis(GN).
Methods: In the current trial we investigated endothelial function of the renal vasculature as assessed by basal NO activity in 26 patients with chronic GN (age 51 plusminus 12 years, blood pressure 131 plusminus 22/78 plusminus 10 mmHg) and 50 age and blood pressure matched control subjects (age 48 plusminus 8 years, blood pressure 136/plusminus 15/82 plusminus 9 mmHg). We measured renal plasma flow (by PAH-clearance) and glomerular filtration rate (by inulin-clearance) at baseline and following infusions of the nitric synthase inhibitor N-monomethyl-L-arginine (L-NMMA 4,25 mg/kg), L-arginine (100mg/kg, the substrate of nitric oxide synthase) and of the antioxidant vitamin C (3g/kg co-infused with L-arginine 100mg/kg).
Results: At baseline renal plasma flow (RPF) and glomerular filtration rate (GFR) were similar in the two groups. The response of RPF to L-NMMA (-9,84 plusminus 9% and -4,6 plusminus 12%; p=0,04) was higher in the control group than in the GN group indicating lower basal NO activity in GN patients. The response to L-arginine showed no statistically significant differences between the two groups. Administration of vitamin C induced a more pronounced increase in RPF in patients with GN when co-infused with L-arginine (10,9 plusminus 22% and 21,7 plusminus 16,8%; p=0.02) suggesting increased oxidative stress in patients with GN.
Conclusion: Thus, we conclude that patients with chronic glomerulonephritis have a reduced basal NO activity compared to an age and blood pressure matched control group that might be in part related to increased oxidative stress.