Renal and Vascular Nitric Oxide System in Reduced Renal Mass Saline Hypertension

Loss of a kidney during fetal life: long-term consequences and lessons learned

Epidemiological studies reveal that children born with a solitary functioning kidney (SFK) have a greater predisposition to develop renal insufficiency and hypertension in early adulthood. A congenital SFK is present in patients with unilateral renal agenesis or unilateral multicystic kidney dysplasia, leading to both structural and functional adaptations in the remaining kidney, which act to mitigate the reductions in glomerular filtration rate and sodium excretion that would otherwise ensue. To understand the mechanisms underlying the early development of renal insufficiency in children born with a SFK, we established a model of fetal uninephrectomy (uni-x) in sheep, a species that similar to humans complete nephrogenesis before birth. This model results in a 30% reduction in nephron number rather than 50%, due to compensatory nephrogenesis in the remaining kidney. Similar to children with a congenital SFK, uni-x sheep demonstrate a progressive increase in arterial pressure and a loss of renal function with aging. This review summarizes the compensatory changes in renal hemodynamics and tubular sodium handling that drive impairments in renal function and highlights the existence of sex differences in the functional adaptations following the loss of a kidney during fetal life.

Polymorphisms of antioxidant enzymes, blood pressure and risk of hypertension

OBJECTIVE

To assess the association of single-nucleotide polymorphisms (SNPs) in genes codifying for antioxidant enzymes to blood pressure (BP) values and risk of hypertension.

METHODS

Population-based study including 1388 participants (704 women) older than 18 years in which 300 were untreated hypertensive patients. In 335 untreated hypertensive patients referred to one hypertension clinic, the study was replicated. Thirty-five SNP throughout 13 genes were analyzed using SNPlex. In a subgroup of hypertensive patients, the amount of 8-oxo-deoxyguanosine and GPX activity levels was measured in mononuclear cells.

RESULTS

In the general population, genotypes with the G allele of the c.172G>A polymorphism in the SOD3 gene and those with the T allele of the c.-20C>T polymorphism in the CAT gene were associated with significant lower values of BP. Likewise, these genotypes were associated with less risk for hypertension after adjusting for confounder variables. Haplotypes in both genes increased the strength of associations. In the hypertensive patients, the same alleles of the two polymorphisms were associated with lower BP values too. In addition, two others, the CT-TT genotypes of the c.891C>T polymorphism in the GPX1 gene and the CT-CC genotypes of the c.-793T>C polymorphism of the TXN gene were also significantly associated to lower BP values. Furthermore, the CC genotype of the c.891C>T polymorphism in the GPX1 gene was associated with higher values of 8-oxo-dG and GPX activity levels as compared to those for the CT-TT genotype.

CONCLUSIONS

The results of the present study support the influence of antioxidant enzyme genes in BP values and hypertension risk.

Nitric oxide in the kidney : its physiological role and pathophysiological implications

Nitric oxide has been implicated in many physiologic processes that influence both acute and long-term control of kidney function. Its net effect in the kidney is to promote natriuresis and diuresis, contributing to adaptation to variations of dietary salt intake and maintenance of normal blood pressure. A pretreatment with nitric oxide donors or L-arginine may prevent the ischemic acute renal injury. In chronic kidney diseases, the systolic blood pressure is correlated with the plasma level of asymmetric dimethylarginine, an endogenous inhibitor of nitric oxide synthase. A reduced production and biological action of nitric oxide is associated with an elevation of arterial pressure, and conversely, an exaggerated activity may represent a compensatory mechanism to mitigate the hypertension.