gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

Rapid, nongenomic effects on renal perfusion

Schnelle, nicht-genomische Aldosteroneffekte auf die renale Perfusion

Meeting Abstract (Hypertonie 2003)

  • presenting/speaker B.M.W. Schmidt - Universität Erlangen-Nürnberg (Nürnberg, D)
  • U. Sammer - Universität Erlangen-Nürnberg (Nürnberg, D)
  • S. Oehmer - Universität Erlangen-Nürnberg (Nürnberg, D)
  • C. Delles - Universität Erlangen-Nürnberg (Nürnberg, D)
  • M.P. Schneider - Universität Erlangen-Nürnberg (Nürnberg, D)
  • R.E. Schmieder - Universität Erlangen-Nürnberg (Nürnberg, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochP7

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hoch2003/03hoch107.shtml

Veröffentlicht: 11. November 2004

© 2004 Schmidt et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Rapid nongenomic aldosterone effects have been proposed to be important in hypertension in addition to genomic aldosterone effects. From in vitro data there is evidence of rapid nongenomic vasoconstrictive aldosterone effects to afferent and efferent renal arterioles. We conducted this study to evaluate the importance of this observation in vivo in humans.

13 healthy male volunteers were examined in a randomized, placebo controlled, double blinded 4-fold cross-over trial. Renal perfusion and glomerular filtration rate were measured by constant-infusion clearance technique using inulin and para-aminohippuric acid. Aldosterone (500mg) or placebo was injected intravenously with or without coinfusion of N(G) monomethyl-L-arginine (L-NMMA) according to the 4-fold cross-over design.

Infusion of aldosterone without concomitant infusion of L-NMMA did not change RPF and GFR statistically significant (28.6 ± 80.5 vs. -33.14 ± 137.9, p= 0.116 and 4.6 ± 8.2 vs. 2.9 ± 6.5, p= 0.233, respectively).

During infusion of L-NMMA alone RPF decreased by 58.2 ± 97.5 ml/min, but during coinfusion of aldosterone with L-NMMA RPF decreased more marked by 190.0 ± 213.7 ml/min (p = 0.074, t-test). Aldosterone coinfused with L-NMMA decreased GFR slightly, whereas infusion of L-NMMA alone increased GFR (8.3 ± 9.8 ml/min vs. -1.4 ± 6.2 ml/min)(p=0.004, t test). Filtration fraction was stronger increased by aldosterone and L-NMMA than with L-NMMA alone (4.9 ± 2.3 vs. 2.8 ± 2.4, p=0.024, t-test).

These data suggest that indeed aldosterone acts via rapid nongenomic effects at the renal vasculature in humans. Antagonizing the endothelial NO synthase liberates these effects, which seem to be more pronounced at the efferent arterioles. These rapid non-genomic effects of aldosterone may be of importance in disease states characterized by impaired endothelial function as hypertension, diabetes mellitus and heart failure.