Role of L-arginine in the pathogenesis and treatment of renal disease.
L-arginine is a semi essential amino acid and also a substrate for the synthesis of nitric oxide (NO), polyamines, and agmatine. These L-arginine metabolites may participate in the pathogenesis of renal disease and constitute the rationale for manipulating L-arginine metabolism as a strategy to ameliorate kidney disease. Modification of dietary L-arginine intake in experimental models of kidney diseases has been shown to have both beneficial as well as deleterious effects depending on the specific model studied. L-arginine supplementation in animal models of glomerulonephritis has been shown to be detrimental, probably by increasing the production of NO from increased local expression of inducible NO synthase (iNOS). L-arginine supplementation does not modify the course of renal disease in humans with chronic glomerular diseases. However, beneficial effects of L-arginine supplementation have been reported in several models of chronic kidney disease including renal ablation, ureteral obstruction, nephropathy secondary to diabetes, and salt-sensitive hypertension. L-arginine is reduced in preeclampsia and recent experimental studies indicate that L-arginine supplementation may be beneficial in attenuating the symptoms of preeclampsia. Administration of exogenous L-arginine has been shown to be protective in ischemic acute renal failure. In summary, the role of L-arginine in the pathogenesis and treatment of renal disease is not completely understood and remains to be established.
Cherla
Gautam
G
Nephrology Section VA Medical Center, Renal Division, Miami, FL 33136, USA.
Jaimes
Edgar A
EA
D058186:Acute Kidney Injury / Q000188:drug therapy; D000818:Animals; D001120:Arginine / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use*; D002908:Chronic Disease; D004032:Diet; D005260:Female; D005921:Glomerulonephritis / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000188:drug therapy*; D007678:Kidney Glomerulus / Q000187:drug effects; D011225:Pre-Eclampsia / Q000188:drug therapy; D011247:Pregnancy
D001120:Arginine