Effect of L-arginine infusion on systemic and renal hemodynamics in hypertensive patients

Citation
Y. Higashi et al., Effect of L-arginine infusion on systemic and renal hemodynamics in hypertensive patients, AM J HYPERT, 12(1), 1999, pp. 8-15
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiovascular & Respiratory Systems
Journal title
AMERICAN JOURNAL OF HYPERTENSION
ISSN journal
0895-7061 → ACNP
Volume
12
Issue
1
Year of publication
1999
Part
1
Pages
8 - 15
Database
ISI
SICI code
0895-7061(199901)12:1<8:EOLIOS>2.0.ZU;2-Y
Abstract
This study was designed to compare the renal endothelial function in patien ts with essential hypertension and normal renal function with that in hyper tensive patients with renal insufficiency. We studied the effects of L-argi nine (500 mg/kg intravenously over 30 min) on renal hemodynamics in 30 norm otensive control subjects, 32 patients with mild to moderate essential hype rtension who had normal renal function, and seven hypertensive patients wit h renal insufficiency who had a serum creatinine concentration >2.0 mg/mL a nd a glomerular filtration rate <50 mL/min/1.48 m(2). L-Arginine infusion s imilarly reduced the mean blood pressure between the three groups (normoten sive: -9.7% +/- 0.7%, hypertensives with normal renal function: -10.2% +/- 0.8%, and hypertensives with renal insufficiency: -8.2% +/- 1.3%). The L-ar ginine-induced decrease in renal vascular resistance was smaller in essenti al hypertensive patients than in normotensive subjects (-11.0% +/- 2.2 v -1 9.8% +/- 2.1%, P < .05). However, L-arginine had no effect on the renal vas cular resistance in hypertensive patients with renal insufficiency (1.6% +/ - 4.8%). Urine nitrite/nitrate levels in response to L-arginine significant ly increased in the three groups in the following order: patients with rena l insufficiency (47% +/- 15%), essential hypertensive patients (87% +/- 10% ), and normotensive subjects (129% +/- 12%). The glomerular filtration rate was unaffected by L-arginine in normotensive and essential hypertensive pa tients (3.1% +/- 2.4% and 4.2% +/- 2.5%), but significantly decreased in hy pertensive patients with renal insufficiency (-13.7% +/- 6.1%). These findi ngs suggest that the ability of the L-arginine-nitric oxide-cGMP pathway to relax the renal vascular tone may be impaired in essential hypertensive pa tients and more markedly blunted in hypertensive patients with renal insuff iciency, in parallel with increasing serum creatinine concentrations. (C) 1 999 American Journal of Hypertension, Ltd.