Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1996 May;51(5):516–519. doi: 10.1136/thx.51.5.516

Effect of L-arginine on renal blood flow in normal subjects and patients with hypoxic chronic obstructive pulmonary disease.

T Q Howes 1, S E Keilty 1, V L Maskrey 1, C R Deane 1, S V Baudouin 1, J Moxham 1
PMCID: PMC473598  PMID: 8711680

Abstract

BACKGROUND: L-arginine is the precursor of endothelium derived nitric oxide (NO) and increasing the available substrate may increase the production of NO. This has been shown by local infusion in peripheral vascular beds but there are few studies of the effects during systemic infusion. Renal vasoconstriction is known to be important in the pathogenesis of cor pulmonale in patients with hypoxic chronic obstructive pulmonary disease (COPD). The effects of a systemic infusion of L-arginine on renal and aortic haemodynamics were therefore investigated in normal subjects and in patients with hypoxic COPD. METHODS: Ten normal volunteers were recruited from the research staff of King's College Hospital Six patients with COPD and hypoxia (arterial oxygen tension (PaO2) < 8.5 kPa) were recruited from the thoracic medicine outpatient clinic at King's College Hospital and five age and sex matched normal subjects were recruited from a group of normal subjects recruited from the database of the Department of Health Care for the Elderly as volunteers for medical research. There was no history of renal, cardiac, or hepatic disease. Baseline values of time averaged mean of the maximum instantaneous velocity (Tamx) and maximum velocity (Vmax) of blood flow in intrarenal arteries were obtained using colour flow Doppler ultrasound. Using the same technique, Vmax was obtained from the abdominal aorta just distal to the xiphisternum before and after infusion of L-arginine via a large peripheral vein (20 g in 100 ml sterile water over 30 minutes). RESULTS: In normal subjects L-arginine increased blood velocity in the intrarenal vessels from a mean of 0.22 m/s to 0.26 m/s, an increase of 19.8%. There was no effect on arterial blood pressure, heart rate, or aortic blood velocity. L-arginine had no effect on intrarenal or aortic blood velocity in patients with hypoxic COPD. In age matched controls L-arginine increased blood velocity in the intrarenal vessels from a mean of 0.20 m/s to 0.26 m/s, an increase of 36.8%. There was no effect on arterial blood pressure, heart rate, or aortic blood velocity. CONCLUSIONS: L-arginine, at the doses administered, increased renal blood flow, as assessed by renal arterial velocity. This effect was not seen in patients with hypoxic COPD but was present in age matched controls. This suggests that the abnormal renal vascular control seen in hypoxic patients with COPD may reflect a disturbance of the L-arginine/nitric oxide pathway.

Full text

PDF
516

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Baudouin S. V., Bath P., Martin J. F., Du Bois R., Evans T. W. L-arginine infusion has no effect on systemic haemodynamics in normal volunteers, or systemic and pulmonary haemodynamics in patients with elevated pulmonary vascular resistance. Br J Clin Pharmacol. 1993 Jul;36(1):45–49. doi: 10.1111/j.1365-2125.1993.tb05890.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Baudouin S. V., Bott J., Ward A., Deane C., Moxham J. Short term effect of oxygen on renal haemodynamics in patients with hypoxaemic chronic obstructive airways disease. Thorax. 1992 Jul;47(7):550–554. doi: 10.1136/thx.47.7.550. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Cannon P. J. The kidney in heart failure. N Engl J Med. 1977 Jan 6;296(1):26–32. doi: 10.1056/NEJM197701062960108. [DOI] [PubMed] [Google Scholar]
  4. Coburn R. F., Eppinger R., Scott D. P. Oxygen-dependent tension in vascular smooth muscle. Does the endothelium play a role? Circ Res. 1986 Mar;58(3):341–347. doi: 10.1161/01.res.58.3.341. [DOI] [PubMed] [Google Scholar]
  5. Farber M. O., Roberts L. R., Weinberger M. H., Robertson G. L., Fineberg N. S., Manfredi F. Abnormalities of sodium and H2O handling in chronic obstructive lung disease. Arch Intern Med. 1982 Jul;142(7):1326–1330. [PubMed] [Google Scholar]
  6. Hirooka Y., Imaizumi T., Tagawa T., Shiramoto M., Endo T., Ando S., Takeshita A. Effects of L-arginine on impaired acetylcholine-induced and ischemic vasodilation of the forearm in patients with heart failure. Circulation. 1994 Aug;90(2):658–668. doi: 10.1161/01.cir.90.2.658. [DOI] [PubMed] [Google Scholar]
  7. Howes T. Q., Deane C. R., Levin G. E., Baudouin S. V., Moxham J. The effects of oxygen and dopamine on renal and aortic blood flow in chronic obstructive pulmonary disease with hypoxemia and hypercapnia. Am J Respir Crit Care Med. 1995 Feb;151(2 Pt 1):378–383. doi: 10.1164/ajrccm.151.2.7842195. [DOI] [PubMed] [Google Scholar]
  8. Huntsman L. L., Stewart D. K., Barnes S. R., Franklin S. B., Colocousis J. S., Hessel E. A. Noninvasive Doppler determination of cardiac output in man. Clinical validation. Circulation. 1983 Mar;67(3):593–602. doi: 10.1161/01.cir.67.3.593. [DOI] [PubMed] [Google Scholar]
  9. Ignarro L. J. Biosynthesis and metabolism of endothelium-derived nitric oxide. Annu Rev Pharmacol Toxicol. 1990;30:535–560. doi: 10.1146/annurev.pa.30.040190.002535. [DOI] [PubMed] [Google Scholar]
  10. Kanno K., Hirata Y., Emori T., Ohta K., Eguchi S., Imai T., Marumo F. L-arginine infusion induces hypotension and diuresis/natriuresis with concomitant increased urinary excretion of nitrite/nitrate and cyclic GMP in humans. Clin Exp Pharmacol Physiol. 1992 Sep;19(9):619–625. doi: 10.1111/j.1440-1681.1992.tb00514.x. [DOI] [PubMed] [Google Scholar]
  11. Kourembanas S., McQuillan L. P., Leung G. K., Faller D. V. Nitric oxide regulates the expression of vasoconstrictors and growth factors by vascular endothelium under both normoxia and hypoxia. J Clin Invest. 1993 Jul;92(1):99–104. doi: 10.1172/JCI116604. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Leier C. V. Regional blood flow in human congestive heart failure. Am Heart J. 1992 Sep;124(3):726–738. doi: 10.1016/0002-8703(92)90284-3. [DOI] [PubMed] [Google Scholar]
  13. MacNee W., Wathen C. G., Flenley D. C., Muir A. D. The effects of controlled oxygen therapy on ventricular function in patients with stable and decompensated cor pulmonale. Am Rev Respir Dis. 1988 Jun;137(6):1289–1295. doi: 10.1164/ajrccm/137.6.1289. [DOI] [PubMed] [Google Scholar]
  14. McQueston J. A., Cornfield D. N., McMurtry I. F., Abman S. H. Effects of oxygen and exogenous L-arginine on EDRF activity in fetal pulmonary circulation. Am J Physiol. 1993 Mar;264(3 Pt 2):H865–H871. doi: 10.1152/ajpheart.1993.264.3.H865. [DOI] [PubMed] [Google Scholar]
  15. Moncada S., Higgs E. A. Endogenous nitric oxide: physiology, pathology and clinical relevance. Eur J Clin Invest. 1991 Aug;21(4):361–374. doi: 10.1111/j.1365-2362.1991.tb01383.x. [DOI] [PubMed] [Google Scholar]
  16. Murakami M., Suzuki H., Ichihara A., Naitoh M., Nakamoto H., Saruta T. Effects of L-arginine on systemic and renal haemodynamics in conscious dogs. Clin Sci (Lond) 1991 Dec;81(6):727–732. doi: 10.1042/cs0810727. [DOI] [PubMed] [Google Scholar]
  17. Pearson P. J., Lin P. J., Evora P. R., Schaff H. V. Endothelium-dependent response of human internal mammary artery to hypoxia. Am J Physiol. 1993 Feb;264(2 Pt 2):H376–H380. doi: 10.1152/ajpheart.1993.264.2.H376. [DOI] [PubMed] [Google Scholar]
  18. Richens J. M., Howard P. Oedema in cor pulmonale. Clin Sci (Lond) 1982 Mar;62(3):255–259. doi: 10.1042/cs0620255. [DOI] [PubMed] [Google Scholar]
  19. Schrier R. W. Pathogenesis of sodium and water retention in high-output and low-output cardiac failure, nephrotic syndrome, cirrhosis, and pregnancy (1) N Engl J Med. 1988 Oct 20;319(16):1065–1072. doi: 10.1056/NEJM198810203191606. [DOI] [PubMed] [Google Scholar]
  20. Stuehr D. J., Ikeda-Saito M. Spectral characterization of brain and macrophage nitric oxide synthases. Cytochrome P-450-like hemeproteins that contain a flavin semiquinone radical. J Biol Chem. 1992 Oct 15;267(29):20547–20550. [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES