Article date: October 2014
By: Frank Holden Mose, Thomas Larsen, Janni Majgaard Jensen, Annebirthe Bo Hansen, Jesper Nørgaard Bech, Erling Bjerregaard Pedersen, in Volume 78, Issue 4, pages 789-799
Aims
Clinical trials suggest that statins have beneficial effects on the cardiovascular system independent from their cholesterol lowering properties. In patients with chronic kidney disease stage II–III, we tested the hypothesis that atorvastatin increased systemic and renal nitric oxide (NO) availability using L‐NG‐monomethyl arginine (L‐NMMA) as an inhibitor of NO production.
Methods
In a randomized, placebo‐controlled, crossover study patients were treated with atorvastatin for 5 days with standardized diet and fluid intake. Glomerular filtration reate (GFR), fractional excretions of sodium (FENa), urinary excretion of aquaporin‐2 (u‐AQP2) and epithelial sodium channels (u‐ENaCγ), vasoactive hormones (renin, angiotensin II, aldosterone, arginine vasopressin, endothelin‐1 and brain natriuretic peptide) and central blood pressure (BP) estimated by applanation tonometry were measured before and after systemic administration of the NO inhibitor L‐NMMA.
Results
Atorvastatin caused a significant reduction in U‐ENaCγ, but sodium excretion, , FENa and u‐AQP2 were not changed by atorvastatin. L‐NMMA reduced renal effect variables, including GFR, FENa and u‐ENaCγ and increased brachial BP and central BP to a similar extent during both treatments. Vasoactive hormones were changed in the same way by L‐NMMA during atorvastatin and placebo treatment.
Conclusion
During, atorvastatin and placebo treatment, inhibition of nitric oxide synthesis induced the same response in brachial and central blood pressure, GFR, renal tubular function and vasoactive hormones. Thus, the data do not support that atorvastatin changes nitric oxide availability in patients with mild nephropathy. The reduced u‐ENaC may reflect changes in sodium absorption in the nephron induced by atorvastatin.
DOI: 10.1111/bcp.12390
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