Renin-Angiotensin system inhibitors reduce serum asymmetric dimethylarginine levels and oxidative stress in normotensive patients with chronic kidney disease.
Renin-Angiotensin system inhibitors reduce serum asymmetric dimethylarginine levels and oxidative stress in normotensive patients with chronic kidney disease.
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作者：
Fujii H;Kono K;Nakai K;Goto S;Kitazawa R;Fukagawa M;Nishi S
本研究的目的是阐明不对称二甲基精氨酸（ADMA）与肾内病变之间的关系，并确定肾素-血管紧张素系统抑制剂（RAS-Is）对血压正常的慢性肾脏病（CKD）患者血清ADMA水平、一氧化氮（NO）合成和氧化应激的影响。这项研究包括23名血压正常的慢性肾小球肾炎患者，肾功能正常或轻度受损，接受肾活检。我们评估了血清ADMA水平与肾内病变之间的关系，并在开始RAS-Is治疗前和治疗后3个月检查了肾功能、尿蛋白排泄、ADMA水平、NO合成、氧化应激和血压（BP）。血清ADMA水平仅与动脉内膜纤维增生厚度相关。尽管肾功能和血压相当，血清ADMA水平和尿蛋白排泄量显着降低，尿NO代谢产物排泄量显着增加后开始与RAS-Is治疗。氧化应激标志物也倾向于通过治疗而减少。这些发现表明，RAS-Is改善了血压正常的CKD患者的NO系统，降低了氧化应激。此外，ADMA可能与肾内病变相关，可以作为CKD早期治疗效果的有用标志物。
The purpose of our study was to elucidate the relationship between asymmetric dimethylarginine (ADMA) and intrarenal lesions and to determine the effect of renin-angiotensin system inhibitors (RAS-Is) on serum ADMA levels, nitric oxide (NO) synthesis and oxidative stress in normotensive patients with chronic kidney disease (CKD). This study included 23 normotensive patients with chronic glomerulonephritis and normal or mildly impaired renal function who underwent renal biopsy. We evaluated the relationship between serum ADMA levels and intrarenal lesions, and examined renal function, urinary protein excretion, ADMA levels, NO synthesis, oxidative stress and blood pressure (BP) before and 3 months after starting the treatment with RAS-Is. Serum ADMA levels were correlated only with arterial intimal fibroplastic thickness. Despite comparable renal function and BP, serum ADMA levels and excretion of urinary protein excretion significantly decreased, and urinary NO metabolite excretion significantly increased after starting the treatment with RAS-Is. Oxidative stress markers also tended to be reduced by the treatment. These findings suggest that RAS-Is improve the NO system and decrease oxidative stress in normotensive patients with CKD. In addition, ADMA may be associated with intrarenal lesions and can be a useful marker for the effects of treatment in the early stages of CKD.