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2008, Number 4

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Rev Med Inst Mex Seguro Soc 2008; 46 (4)

Increase Glomerular Filtration Rate and Urinary Excretion of Nitric Oxide Metabolites in Diabetes. Modification with Low Captopril Doses Treatment

Osorio-Bretón MP

Language: Spanish
References: 25
Page: 397-403
PDF size: 346.44 Kb.


ABSTRACT

Objective: to measure the baseline urinary excretion of nitric oxide metabolites and their changes after an oral acute protein load (APL) and after a short-course with a low-dose captopril treatment in children with I-II stages of diabetic nephropathy.
Methods: eleven children with early diagnosis of insulin dependent diabetes mellitus and with poor metabolic control were studied. Urinary excretion of nitric oxide metabolites (UENOm) and renal functional reserve with iothalamate clearance were measured, before and after an APL both in baseline form and after 15 days with captopril treatment.
Results: In pre-treatment period the UENOm was 1113 ± 797 and after APL was 1800.10 ± 1329.07 nmolmLminute (ns). Glomerular filtration rate (GFR) was 159.5 ± 42.1 and post-APL was 149.3 ± 41.2 mL/minute 1.73 m2 (ns). Post-captopril treatment, UENOm 2316.30 ± 1392 and after APL was 1514.49 ± 685 nmolmLminute (ns). GFR pre-APL was 119.6 ± 28.8 mL/minute 1.73 m2, p ‹ 0.03 versus GFR baseline precaptopril) and post-APL was 135.0 ± 15.0 mL/minute 1.73 m2, p ‹ 0.05 versus GFR baseline postcaptopril). The renal plasmatic flow and the filtration fraction did not have significative changes.
Conclusions: the renal functional reserve was restored with captopril despite the poor metabolic control. It is difficult to identify if the basal UENOm were elevated because, the normal values were unknown in association with the poor metabolic control. And it’s interesting that the captopril decreases the GRF and the UENOm rises without correlation with or without renal functional reserve and changes in UENOm.


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