title: Does L-arginine alter proteinuria and renal hemodynamics in patients with chronic glomerulonephritis and hypertension?
abstract: 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.
authors.affiliation: Section of Nephrology and Hypertension, University of Tübingen, Germany.
authors.forename: S C
authors.initials: SC
authors.lastname: Wolf
authors.forename: C M
authors.initials: CM
authors.lastname: Erley
authors.forename: S
authors.initials: S
authors.lastname: Kenner
authors.forename: E D
authors.initials: ED
authors.lastname: Berger
authors.forename: T
authors.initials: T
authors.lastname: Risler
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000503:physiopathology; D001120:Arginine / Q000494:pharmacology*; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D005921:Glomerulonephritis / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007074:Immunoglobulin G / Q000652:urine; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000502:physiology; D011446:Prospective Studies; D011507:Proteinuria / Q000503:physiopathology*; D012079:Renal Circulation / Q000187:drug effects*; D051437:Renal Insufficiency / Q000503:physiopathology*
chemical_list: D007074:Immunoglobulin G; D009569:Nitric Oxide; D001120:Arginine