L-arginine-induced vasodilation of the renal vasculature is preserved in uremic type 1 diabetic patients after kidney and pancreas but not after kidney-alone transplantation.

Autor:	De Cobelli, Francesco, Fiorina, Paolo, Perseghin, Gianluca, Magnone, Marta, Venturini, Massimo, Zerbini, Gianpaolo, Zanello, Alessandro, Mazzolari, Gabriella, Monti, Lucilla, Di Carlo, Valerio, Secchi, Antonio, Del Maschio, Alessandro
Předmět:	DIABETES PEOPLE with diabetes KIDNEY transplantation ARGININE BLOOD vessels PANCREAS transplantation BLOOD flow measurement VASODILATION COMPARATIVE studies HEMODYNAMICS TYPE 1 diabetes KIDNEYS VASCULAR resistance RESEARCH methodology MEDICAL cooperation RESEARCH UREMIA RENAL circulation EVALUATION research MAGNETIC resonance angiography DISEASE complications
Zdroj:	Diabetes Care; Apr2004, Vol. 27 Issue 4, p947-954, 8p, 2 Charts, 2 Graphs
Abstrakt:	OBJECTIVE — In uremic type 1 diabetic patients, kidney and pancreas transplantation (KP) and kidney-alone transplantation (KD) provide full restoration of normal renal function; however, only KP, i.e., curing diabetes, is expected to prevent endothelial damages. Our aim was to study L-arginine-induced vasodilation of the renal vasculature in uremic type 1 diabetic patients after KP or KD using magnetic resonance (MR). RESEARCH DESIGN AND METHODS — MR quantitative flow measurements were performed in 15 KP patients (mean age 39.0 ± 1.7 years, 10 men and 5 women), in 11 KD patients (mean age 47.3 ± 1.9 years, 7 men and 4 women), and in 8 nondiabetic kidney transplant patients (mean age 44.0 ± 4.8 years, 7 men and 1 woman), who were used as control subjects, to measure renal blood flow and velocity and renal vascular resistance before and immediately after infusion of L-arginine. RBSULTS — Renal blood flow and velocity were not different at baseline in KP, KD, and control subjects. In contrast, during L-arginine administration renal blood flow increased significantly in KP subjects (basal 8.4 ± 0.6 vs. post 9.6 ± 0.8 ml/s, Δ 14.3 ± 4.4%, P < 0.05) and in control subjects (basal 9.3 ± 0.8 vs. post 9.1 ± 0.8 ml/s, Δ 17.3 ± 6.2%, P < 0.01), while it remained unchanged in KD subjects (basal 10.0 ± 0.8 vs. post 11.6 ± 0.9 ml/s,Δ -1.36 ± 6.9%, NS). Parallel results have been achieved for renal blood velocity (KP subjects: 20.1 ± 4.9%, P < 0.01; control subjects: 23.0 ± 7.99%, P < 0.01; and KD subjects: -0.3 ± 6.5%; NS). A reduction in renal vascular resistance in response to L-arginine was evident in KP and control subjects but not in KD patients. CONCLUSIONS — L-Arginine vasodilatory response was successfully assessed with MR quantitative flow measurements. KP patients and control subjects, but not those with KD, showed a preserved L-arginine-induced vasodilation of the renal vasculature. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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