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Department of Internal Medicine, School of Medicine, Keio University, Tokyo 160-8582, Japan
The role of nitric oxide (NO) and
prostaglandins (PG) in modifying renal hemodynamics was examined in
clipped and nonclipped kidneys of unilateral renal artery stenosis.
Chronic unilateral renal ischemia was established by
4-wk-clipping the left renal artery of canine kidneys, and renal
interstitial nitrate+nitrite and PGE2 contents were
evaluated by the microdialysis technique. Unilateral renal artery
stenosis caused 45 ± 1 and 73 ± 1% decrements in renal
plasma flow (RPF) in moderately and severely clipped kidneys and
21 ± 3% decrements in nonclipped kidneys with severe stenosis.
Renal nitrate+nitrite decreased in moderately (
31 ± 1%) and
severely clipped kidneys (
63 ± 4%).
N
-nitro-L-arginine methyl
ester reduced RPF (
56 ± 3%) and glomerular filtration rate
(GFR;
54 ± 3%) in moderately clipped kidneys, whereas this
inhibitory effect was abolished in severely clipped kidneys. In
contrast, renal PGE2 contents increased modestly in moderate clipping and were markedly elevated in severely clipped kidneys (from 111 ± 7 to 377 ± 22 pg/ml); sulpyrine
impaired renal hemodynamics only in severely clipped kidneys. In
contralateral nonclipped kidneys, although renal PGE2 was
not increased, sulpyrine reduced RPF (
32 ± 1%) and GFR
(
33 ± 3%) in severe stenosis. Collectively, NO plays a
substantial role in maintaining renal hemodynamics both under basal
condition and in moderate renal artery stenosis, whereas the
contributory role shifts from NO to PG as renal artery stenosis
progresses. Furthermore, because intrarenal angiotensin II is reported
to increase in nonclipped kidneys, unilateral severe ischemia
may render the nonclipped kidney susceptible to PG inhibition.
ischemic nephropathy; renal artery stenosis; renal hemodynamics
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