Effect of endovascular treatment on nitric oxide and renal function in Takayasu's arteritis with renovascular hypertension.
BACKGROUND
Renal involvement in Takayasu's arteritis (TA) effects the disease outcome and endovascular treatment is an effective treatment of choice. We investigated nitric oxide (NO) levels and the effect of endovascular treatment in renovascular hypertensive TA patients.


METHODS
In five hypertensive patients with renal artery stenosis due to TA, serum creatinine, nitrite, nitrate; urinary microalbumin, nitrite, nitrate measurements and blood pressures were recorded at entry and after 24 h and 6 weeks of endovascular treatment.


RESULTS
Serum NO levels were higher in patients than controls (p = 0.008). Serum and urine NO levels increased 24 h after the treatment and decreased after 6 weeks (p = 0.015; p = 0.01, respectively). After the treatment blood pressures decreased. Urinary microalbumin excretions increased after the intervention (p = 0.02) and returned to normal in patients 1 and 4, and decreased in the others. There were no significant differences in estimated glomerular filtration rate (EGFR), serum creatinine, urinary sodium and potassium levels.


CONCLUSIONS
Increased NO secretion in these patients may contribute to improve the prognosis of renal function through its vasodilator and antiproliferative activities possibly by counterbalancing the excessive vasoconstrictor actions. Endovascular treatment causes a dilatation-induced shear stress that may be responsible for the increased NO release, which in turn leads to the rapid hypotensive response.
Parildar
Zuhal
Z
Department of Clinical Biochemistry, Ege University Faculty of Medicine, Bornova, Izmir, Turkey. zparildar@yahoo.com
Gulter
Ceyda
C
Parildar
Mustafa
M
Oran
Ismail
I
Erdener
Dilek
D
Memis
Ahmet
A
D000293:Adolescent; D000328:Adult; D000800:Angioplasty, Balloon; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000201:enzymology* / Q000209:etiology; D007668:Kidney / Q000503:physiopathology*; D007677:Kidney Function Tests; D008297:Male; D009566:Nitrates / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism*; D011188:Potassium / Q000652:urine; D012964:Sodium / Q000652:urine; D015607:Stents; D013625:Takayasu Arteritis / Q000201:enzymology* / Q000473:pathology / Q000601:surgery*
D009566:Nitrates; D009569:Nitric Oxide; D012964:Sodium; D011188:Potassium