title: Nitric oxide modulation of renal and cardiac hemodynamics in type 2 diabetes.
abstract: OBJECTIVE
  To evaluate endothelial function in type 2 diabetic patients with and without diabetic nephropathy.
  
  
  METHODS
  We studied the effects of systemic infusion of the nitric oxide (NO) synthase inhibitor NG-monomethyl-l-arginine (L-NMMA) on cardiovascular and renal hemodynamics in six type 2 diabetic patients with microalbuminuria (D2-MA), six type 2 diabetic patients with normoalbuminuria (D2-NA) and five control subjects. Both type 2 diabetic patients and control subjects had mild arterial hypertension.
  
  
  RESULTS
  L-NMMA infusion decreased the cardiac index in all groups. A reduction in glomerular filtration rate (GFR) and an increase in filtration fraction were observed only in controls. Renal plasma flow decreased in controls and D2-NA patients and renal vascular resistance increased in all groups.
  
  
  CONCLUSIONS
  The effect of L-NMMA on cardiac output was similar in controls and type 2 diabetic patients with and without diabetic nephropathy. In contrast, the effect on GFR was impaired in both diabetic groups, suggesting that glomerular NO homeostasis is altered in type 2 diabetes. Moreover the discrepancy, in diabetic patients, between cardiac and renal effects during L-NMMA infusion suggests that the modulation of glomerular hemodynamics is independent from NO-regulated cardiac output.
authors: Department of Medical and Surgical Sciences, Clinica Medica I, University of Padova, Via Giustiniani 2, 35128, Italy. michele.dallavestra@unipd.it
authors: Michele
authors: M
authors: Dalla Vestra
authors: David
authors: D
authors: Sacerdoti
authors: Giancarlo
authors: G
authors: Bombonato
authors: Paola
authors: P
authors: Fioretto
authors: Gianfranco
authors: G
authors: Finucci
authors: Alois
authors: A
authors: Saller
authors: Andrea
authors: A
authors: Sfriso
authors: Marino
authors: M
authors: Bruseghin
authors: Maria
authors: M
authors: Sambataro
authors: Mario
authors: M
authors: Velussi
authors: Bruno
authors: B
authors: Baggio
authors: Romano
authors: R
authors: Nosadini
authors: Gaetano
authors: G
authors: Crepaldi
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000209:etiology; D002302:Cardiac Output / Q000187:drug effects; D003326:Coronary Circulation / Q000502:physiology*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000652:urine; D003928:Diabetic Nephropathies / Q000503:physiopathology; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006439:Hemodynamics; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000502:physiology*; D012016:Reference Values; D012079:Renal Circulation / Q000502:physiology*; D019323:omega-N-Methylarginine / Q000494:pharmacology
chemical_list: D004791:Enzyme Inhibitors; D019323:omega-N-Methylarginine; D009569:Nitric Oxide