Total nitric oxide production is low in patients with chronic renal disease
Total nitric oxide production is low in patients with chronic renal disease
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DOI：
10.1046/j.1523-1755.2000.00281.x
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发表时间：
2000-09-01
影响因子：
19.6
通讯作者：
Baylis, C
中科院分区：
文献类型：
--
作者：
Schmidt, RJ;Baylis, C
内源性血管扩张剂一氧化氮（NO）的缺乏是慢性肾脏病（CRD）患者高血压的潜在原因。本研究旨在确定CRD患者的24小时NOx（NO2和NO3）排泄（总NO产生的定性指标）是否减少。在控制低NOx饮食48小时后，对13名CRD患者和9名血压正常的健康对照进行了测量。在第二个24小时期间收集尿液，用于分析24小时NOx和cGMP，并在完成时抽血。还测定了精氨酸（内源性肾脏NO合成的底物）、瓜氨酸（肾脏精氨酸合成的底物）和内源性NO合成抑制剂不对称二甲基精氨酸（ADMA）及其惰性异构体和对称二甲基精氨酸（SDMA）的血浆水平。CRD组（其中12例已接受降压治疗）的收缩压高于对照组（P < 0.05）。24小时尿氮氧化物排泄量低CRD患者与对照组相比，尽管类似的饮食NO摄入量，表明净内源性NO生产减少肾脏疾病。相反，24小时尿cGMP与UNOXV无关。CRD患者的血浆瓜氨酸水平升高，可能反映了瓜氨酸转化为精氨酸的减少。与对照组相比，CRD患者的血浆精氨酸没有差异，血浆ADMA水平升高，这些变化往往会降低NO合酶。结论。这些结果表明，CRD患者的NO产生较低，可能有助于CRD患者的高血压和疾病进展。
Background A deficiency of the endogenous vasodilator nitric oxide (NO) has been implicated as a potential cause of hypertension in chronic renal disease (CRD) patients. This study was conducted to determine whether 24-hour NOx (NO2 and NO3) excretion (a qualitative index of total NO production) is reduced in patients with CRD.Methods. Measurements were made in 13 CRD patients and 9 normotensive healthy controls after 48 hours on a controlled low-NOx diet. Urine was collected over the second 24-hour period for analysis of 24-hour NOx, and cGMP and blood drawn at the completion. Plasma levels of arginine (the substrate for endogenous renal NO synthesis), citrulline (substrate for renal arginine synthesis), and the endogenous NO synthesis inhibitor asymmetrical dimethylarginine (ADMA) and its inert isomer and symmetrical dimethylarginine (SDMA) were also determined.Results. Systolic blood pressure was higher in CRD patients (12 of whom were already on antihypertensive therapy) than in controls (P < 0.05). Twenty-four-hour urinary NOx excretion was low in CRD patients compared with controls despite similar dietary NO intake, suggesting that net endogenous NO production is decreased in renal disease. In contrast, the 24-hour urinary cGMP did not correlate with UNOXV. Plasma citrulline was increased in CRD patients, possibly reflecting reduced conversion of citrulline to arginine. Plasma arginine was not different, and plasma ADMA levels were elevated in CRD versus controls, changes that would tend to lower NO synthase.Conclusion. These results suggest that NO production is low in CRD patients and may contribute to hypertension and disease progression in CRD.