Effect of captopril on the renal veno-arterial gradient of erythropoietin and oxygen in unilateral renal artery disease.
Twenty-nine patients with unilateral renal artery stenosis or occlusion were investigated. The veno-arterial gradient (VA-gradient) of erythropoietin (EPO), haemoglobin oxygen saturation and plasma renin activity (PRA) was determined separately in each kidney before and 1 h after angiotensin converting enzyme inhibition (ACE-inhibition). The VA-gradient of EPO and of hemoglobin oxygen saturation were the same in the affected and unaffected kidney during basal conditions. During ACE-inhibition the VA-gradient of EPO disappeared on the affected side but not on the unaffected side. A fall in s-EPO after ACE inhibition was demonstrated in the renal vein on the affected side (-1.4 U l-1, p < 0.01), in the contralateral vein (-0.8 U l-1, p < 0.01) and in the aorta (-0.6 U l-1, p < 0.01). The O2-gradients were reduced on both sides after captopril, from 10.8-7.5% (p < 0.04) on the affected side and from 10.8-9.0% (p < 0.04) on the contralateral. It is suggested that the stimulated renin-angiotensin system may be important for EPO production in the affected kidney in unilateral renal disease.
Jensen
J D
JD
Department of Medicine and Nephrology C, Skejby Hospital, Denmark.
Eiskjaer
H
H
Madsen
B
B
Egeblad
M
M
Nielsen
C B
CB
Pedersen
E B
EB
D000328:Adult; D000368:Aged; D002216:Captopril / Q000494:pharmacology*; D004921:Erythropoietin / Q000096:biosynthesis / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood*; D012077:Renal Artery; D012078:Renal Artery Obstruction / Q000097:blood*; D012082:Renal Veins
D004921:Erythropoietin; D002216:Captopril; D010100:Oxygen