Does L-arginine alter proteinuria and renal hemodynamics in patients with chronic glomerulonephritis and hypertension?

Endogenous nitric oxide (EDRF) plays an important role in the regulation of systemic and renal blood pressure by an alteration of vascular tone. To assess the effect of L-arginine (160 mumol/min i.v. for 3 hours), the precursor of EDRF, on blood pressure, protein-excretion and renal function (GFR =...

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Bibliographic Details
Published inClinical nephrology Vol. 43 Suppl 1; p. S42
Main Authors Wolf, S C, Erley, C M, Kenner, S, Berger, E D, Risler, T
Format Journal Article
LanguageEnglish
Published Germany 01.01.1995
Subjects
Adult
Albuminuria - physiopathology
Arginine - pharmacology
Blood Pressure - drug effects
Double-Blind Method
Female
Glomerular Filtration Rate - drug effects
Glomerulonephritis - physiopathology
Humans
Hypertension - physiopathology
Immunoglobulin G - urine
Male
Middle Aged
Nitric Oxide - physiology
Prospective Studies
Proteinuria - physiopathology
Renal Circulation - drug effects
Renal Insufficiency - physiopathology
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Summary:Endogenous nitric oxide (EDRF) plays an important role in the regulation of systemic and renal blood pressure by an alteration of vascular tone. To assess the effect of L-arginine (160 mumol/min i.v. for 3 hours), the precursor of EDRF, on blood pressure, protein-excretion and renal function (GFR = glomerular filtration rate, RPF = renal plasma flow) we performed a prospective, double blind, placebo controlled study. 18 patients with chronic glomerulonephritis (51.3 +/- 11.5 years), renal insufficiency (GFR < 65 ml/min) and hypertension were investigated for changes in GFR and RPF by continuous inulin- and PAH-clearances and for changes in permselectivity by determination of protein-excretion. L-arginine infusion results in a reduction of proteinuria (p < 0.05, t-test). There is no significant effect on renal hemodynamics and mean arterial pressure (MAP). Comparing the excretion of the endogenous proteins, only albuminuria is decreased significantly (p < 0.01), whereas IgG-excretion is reduced slightly (p < 0.05). This can be considered as an indicator of a special influence on the mesangial cells or the basement membrane of the glomerulum itself by EDRF. In conclusion L-arginine reduces protein-excretion without significant alterations in renal hemodynamics and so might prevent a decline in renal failure.
ISSN:0301-0430