Does L-arginine alter proteinuria and renal hemodynamics in patients with chronic glomerulonephritis and hypertension?

Clin Nephrol. 1995 Jan;43 Suppl 1:S42-6.

Abstract

Endogenous nitric oxide (EDRF) plays an important role in the regulation of systemic and renal blood pressure by an alteration of vascular tone. To assess the effect of L-arginine (160 mumol/min i.v. for 3 hours), the precursor of EDRF, on blood pressure, protein-excretion and renal function (GFR = glomerular filtration rate, RPF = renal plasma flow) we performed a prospective, double blind, placebo controlled study. 18 patients with chronic glomerulonephritis (51.3 +/- 11.5 years), renal insufficiency (GFR < 65 ml/min) and hypertension were investigated for changes in GFR and RPF by continuous inulin- and PAH-clearances and for changes in permselectivity by determination of protein-excretion. L-arginine infusion results in a reduction of proteinuria (p < 0.05, t-test). There is no significant effect on renal hemodynamics and mean arterial pressure (MAP). Comparing the excretion of the endogenous proteins, only albuminuria is decreased significantly (p < 0.01), whereas IgG-excretion is reduced slightly (p < 0.05). This can be considered as an indicator of a special influence on the mesangial cells or the basement membrane of the glomerulum itself by EDRF. In conclusion L-arginine reduces protein-excretion without significant alterations in renal hemodynamics and so might prevent a decline in renal failure.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Albuminuria / physiopathology
  • Arginine / pharmacology*
  • Blood Pressure / drug effects
  • Double-Blind Method
  • Female
  • Glomerular Filtration Rate / drug effects
  • Glomerulonephritis / physiopathology*
  • Humans
  • Hypertension / physiopathology*
  • Immunoglobulin G / urine
  • Male
  • Middle Aged
  • Nitric Oxide / physiology
  • Prospective Studies
  • Proteinuria / physiopathology*
  • Renal Circulation / drug effects*
  • Renal Insufficiency / physiopathology*

Substances

  • Immunoglobulin G
  • Nitric Oxide
  • Arginine