title: Oxidative stress and hemodynamic maladjustment in chronic renal disease: a therapeutic implication.
abstract: Hemodynamic maladjustment with predominant constriction at the efferent arteriole has been encountered in a variety of clinical settings of glomerulonephropathy. In essence, it induces not only intraglomerular hypertension but also exaggeratedly reduces the peritubular capillary flow, which supplies the tubulointerstitial compartment. The hemodynamic maladjustment is believed to reflect a glomerular endothelial cell dysfunction. In this regard, oxidative stress and antioxidant defect are likely responsible for the glomerular endothelial dysfunction. Improvement in renal function was accomplished following the correction of oxidant and antioxidant imbalance with antioxidant therapy and vasodilators. Following such therapy, there was a correction in hemodynamic maladjustment with a decline in intraglomerular hydrostatic pressure and an increase in renal perfusion with a subsequent increase in renal functions namely creatinine clearance, glomerular filtration rate and a decline in FEMg.
authors.affiliation: Department of Physiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
authors.forename: Narisa
authors.initials: N
authors.lastname: Futrakul
authors.forename: Piyaratana
authors.initials: P
authors.lastname: Tosukhowong
authors.forename: Yuvadee
authors.initials: Y
authors.lastname: Valyapongpichit
authors.forename: Numdee
authors.initials: N
authors.lastname: Tipprukmas
authors.forename: Prasit
authors.initials: P
authors.lastname: Futrakul
authors.forename: Suthiluk
authors.initials: S
authors.lastname: Patumraj
mesh_terms: D001205:Ascorbic Acid / Q000097:blood; D005978:Glutathione / Q000097:blood; D005979:Glutathione Peroxidase; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000503:physiopathology*; D015227:Lipid Peroxidation / Q000502:physiology; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000503:physiopathology*; D018384:Oxidative Stress; D014810:Vitamin E / Q000097:blood
chemical_list: D014810:Vitamin E; D005979:Glutathione Peroxidase; D005978:Glutathione; D001205:Ascorbic Acid