Poor Glycemic Control Is Related to Increased Nitric Oxide Activity Within the Renal Circulation of Patients With Type 2 Diabetes

• DOI: 10.2337/dc13-0806
• Publication Date: 2013-10-16T04:45:59Z
• Authors: Markus P. Schneider; Christian Ott; Stephanie Schmidt; Iris Kistner; Stefanie Friedrich; Roland E. Schmieder
• Keywords: Renal circulation

Experimental studies have shown that glucose releases endothelial nitric oxide (NO) and NO contributes to renal hyperperfusion in models of diabetes. To examine whether this translates into the human condition, we studied relationship between glycemic control activity patients with type 2 diabetes.A total 113 diabetes a wide range HbA1c concentrations were included. Renal plasma flow (RPF) glomerular filtration rate (GFR) determined by constant infusion input clearance. Functional circulation was as change RPF synthase (NOS) inhibitor N(G)-monomethyl-L-arginine (L-NMMA) (4.25 mg/kg). As additional markers, measured urinary excretion (UNOx) L-arginine-to-asymmetrical dimethylarginine (ADMA) ratio plasma.Subjects within highest tertile concentration had increased (low, medium, high tertiles 576 ± 17 vs. 585 22 627 33 mL/min/m(2), P = 0.05 one-way ANOVA), while GFR similar across tertiles. The response NOS blockade augmented subjects higher levels (-55 7 -64 8 -86 mL/min, 0.04 ANOVA). Further, L-arginine-to-ADMA UNOx levels.In line experimental evidence, could demonstrate humans poor is related kidney. system may thus be novel therapeutic target for improving hemodynamics