Captopril augments the renal response to an amino acid infusion in diabetic adults

Slomowitz, Larry A.; Hirschberg, Raimund; Kopple, Joel D.

doi:10.1152/ajprenal.1988.255.4.f755

Cited by 21 publications

(21 citation statements)

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“…Renal hemodynamic responses to amino acid infusion or a protein meal vary across the spectrum from absent to augmented (4,6,9,26,38,47,57,58). However, in diabetic humans or animals with impaired responses, treatment with either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker restores responsiveness (9,49,50). These observations indicate that the response is not fixed and implicate intrarenal angiotensin II in blunting the response to amino acids.…”

Section: Discussionmentioning

confidence: 99%

Effects of amino acids and glucagon on renal hemodynamics in type 1 diabetes

Puhlman

Cooney

Short

2002

American Journal of Physiology-Renal Physiology

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Increased dietary protein and circulating amino acids raise glomerular filtration rate (GFR) and pressure. In diabetes, this glomerular hyperfiltration response is augmented. The purpose of this study was to determine whether glucagon mediates the augmented GFR response to amino acids in diabetes and whether the responses to amino acids and glucagon depend on prostaglandins. Patients with type 1 diabetes mellitus ( n = 12) and normal control subjects ( n= 12) were studied in a series of six experiments, each on different occasions. Baseline GFR was not significantly increased, but filtration fraction was higher in diabetes. In response to amino acid infusion, GFR increased more and filtration fraction was greater among those with diabetes. Their augmented GFR response to amino acids was not inhibited by octreotide or indomethacin. Participants with diabetes also had enhanced GFR and renal plasma flow responses to glucagon infusion, both of which were inhibited by indomethacin. Glomerular hyperfiltration responses induced by amino acids or glucagon occur by divergent pathways in diabetes; only the response to glucagon is prostaglandin dependent.

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Section: Discussionmentioning

confidence: 99%

Effects of amino acids and glucagon on renal hemodynamics in type 1 diabetes

Puhlman

Cooney

Short

2002

American Journal of Physiology-Renal Physiology

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“…Among hypertensive patients on a low-salt diet, the consequent activation of the renin-angiotensin system blunted the hemodynamic response to amino acids and the response was restored to normal with angiotensin-converting enzyme inhibitors (41). In other pathophysiologic conditions among human subjects, angiotensin-converting enzyme inhibitors restored the hemodynamic response to amino acids (42,43). Therefore, in different conditions with a prevalence of AngII over NO as a common feature, the renal functional reserve is blunted or absent.…”

Section: Effects Of Glycine On Gfrmentioning

confidence: 99%

Decreases in Renal Functional Reserve and Proximal Tubular Fluid Output in Conscious Oophorectomized Rats

Nielsen¹,

Flyvbjerg²,

Bruun³

et al. 2003

Journal of the American Society of Nephrology

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Abstract. Age-dependent glomerulosclerosis with reduced GFR develops earlier among men than among women. Therefore, whether female sex hormones could prevent the agedependent decrease in GFR was investigated. The kidney function in oophorectomized rats treated with placebo (OOX group), estrogen (OOXϩE 2 group), or estrogen plus progesterone (OOXϩE 2 ϩP group) for 5 mo and in sham-operated rats (sham group) was examined. The rats were 13 mo of age at the time of the investigation. They were conscious and chronically instrumented. The results demonstrated that estrogen, alone or in combination with progesterone, was without effect on the baseline GFR and effective renal plasma flow but prevented severe decreases in the renal functional reserve and fractional proximal tubular fluid output (lithium clearance technique, fractional lithium excretion), which were observed in the OOX group. The renal functional reserve (estimated by stimulation with glycine) was Ϫ223 Ϯ 151, 483 Ϯ 129, 675 Ϯ 76, and 208 Ϯ 140 l/min in the OOX, OOXϩE 2 , OOXϩE 2 ϩP, and sham groups, respectively. Fractional lithium excretion was 12.4 Ϯ 3.1, 26.8 Ϯ 2.0, 31.8 Ϯ 2.5, and 23.6 Ϯ 3.3% in the OOX, OOXϩE 2 , OOXϩE 2 ϩP, and sham groups, respectively. In conclusion, oophorectomy at the age of 8 mo did not produce a decrease in baseline GFR in female rats within a period of 5 mo. However, oophorectomy led to severe decreases in the renal functional reserve and fractional proximal tubular fluid output. Both effects were prevented with administration of estrogen. Sham-operated rats demonstrated values for renal functional reserve and fractional lithium excretion that were between those observed for the OOX group and the groups treated with sex hormones.

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“…5). The renal response to glycine is also impaired in humans and rats with diabetes mellitus (3,15,16). In each of these models, failure of the GFR to increase during glycine infusion correlates with a decrease in proximal reabsorption, and it has been suggested, although not proven, that reduced proximal reabsorption could be responsible for the failure of GFR to increase during glycine infusion, because reduced reabsorption will increase flow past the macula densa, which subsequently activates tubuloglomerular feedback (TGF) (5).…”

mentioning

confidence: 99%