Nitric oxide bioavailability and its potential relevance to the variation in susceptibility to the renal and vascular complications in patients with type 2 diabetes

Abstract

Objective: We compared the renal and systemic vascular (renovascular) response to reducing bioavailable nitric oxide in patients with type 2 diabetes without nephropathy of African and Caucasian heritage.

Method: Under euglycaemic conditions, renal blood flow was measured by a constant infusion of paraminohippurate and changes in blood pressure and renal vascular resistance estimated before and after an infusion of L-N^g-monomethyl-l-arginine (L-NMMA).

Results: In the African heritage group there was a significant fall in renal blood flow (Δ − 46.0 mls/min/1.73 m²;p<0.05) and rise in systolic blood pressure (Δ10.0 [2.3 – 17.9] mmHg; p=0.017) which correlated with an increase in renal vascular resistance (r²=0.77; p=0.004).

Conclusions: The renal vasconstrictive response associated with nitric oxide synthase inhibition in this study may be of relevance to the observed vulnerability to renal injury in patients of African heritage.