Increased plasma nitric oxide, L-arginine, and arginase-1 in cirrhotic patients with progressive renal dysfunction.
Increased plasma nitric oxide, L-arginine, and arginase-1 in cirrhotic patients with progressive renal dysfunction.
复制标题
伴有进行性肾功能障碍的肝硬化患者血浆一氧化氮、L-精氨酸和精氨酸酶-1 升高。
DOI：
10.1111/j.1440-1746.2008.05757.x
复制
发表时间：
2009
影响因子：
4.1
通讯作者：
Schmidt,WarrenN
中科院分区：
文献类型：
--
作者：
Kayali,Zeid;Herring,Jason;Baron,Pedro;Franco,Edson;Ojogho,Okechukwu;Smith,Jason;Watkins,Gregory;Smith,Douglas;Lamin,Victor;Hoang,Thanh;Sharma,Rajiv;Mathahs,Meleah;Sowers,Lawrance;Brown,KyleE;Schmidt,WarrenN
Background and Aims:Increased levels of nitric oxide (NO) are hypothesized to contribute to renal dysfunction in patients with decompensated cirrhosis. In this study, we examined whether splanchnic and/or peripheral NO levels and L‐arginine (L‐Arg) correlate with progressive renal dysfunction in cirrhotics.Methods:Serum NO metabolites (NOx) and L‐Arg were measured in: controls (n= 10); organ donors (n= 12); compensated cirrhotics (n= 17), cirrhotics with ascites (n= 25), refractory ascites (n= 11) or hepatorenal syndrome type II (HRS) (n= 11) and chronic renal failure patients (n= 18).Results:Plasma NOx and L‐Arg levels rose progressively with worsening renal function in decompensated cirrhotics. Both NOx and L‐Arg levels were highest in patients with HRS (P< 0.001 andP< 0.025, respectively). While there were no differences in NOx levels related to the site of sampling, L‐Arg levels were lowest in hepatic venous blood. There were significant relationships of NOx and L‐Arg with Model for End‐Stage Liver Disease score and Child–Pugh scores (P< 0.04 andP< 0.01, respectively). Multivariate analysis showed a significant relationship between NOx, L‐Arg and HRS.Conclusion:Worsening renal function in decompensated cirrhosis is accompanied by progressive elevation in plasma NOx and L‐Arg. These findings support the hypothesis that NO‐mediated vasodilation is probably linked with the mechanism of progressive renal failure in decompensated cirrhotics.
