Calcium channel blockade blunts the renal effects of acute nitric oxide synthase inhibition in healthy humans

Am J Physiol Renal Physiol. 2017 May 1;312(5):F870-F878. doi: 10.1152/ajprenal.00568.2016. Epub 2017 Feb 8.

Abstract

Our aim was to investigate whether blockade of calcium channels (CCs) or angiotensin II type 1 receptors (AT1R) modulates renal responses to nitric oxide synthesis inhibition (NOSI) in humans. Fourteen sodium-replete, healthy volunteers underwent 90-min infusions of 3.0 μg·kg-1·min-1 NG-nitro-l-arginine methyl ester (l-NAME) on 3 occasions, preceded by 3 days of either placebo (PL), 10 mg of manidipine (MANI), or 50 mg of losartan (LOS). At each phase, mean arterial pressure (MAP), glomerular filtration rate (GFR; inulin), renal blood flow (RBF; p-aminohippurate), urinary sodium (UNaV), and 8-isoprostane (U8-iso-PGF2αV; an oxidative stress marker) were measured. With PL + l -NAME, the following changes were observed: +6% MAP (P < 0.005 vs. baseline), -10% GFR, -20% RBF, -49% UNaV (P < 0.001), and +120% U8-iso-PGF2αV (P < 0.01). In contrast, MAP did not increase during LOS + l-NAME or MANI + l-NAME (P > 0.05 vs. baseline), whereas renal changes were the same during LOS + l-NAME vs. PL + l-NAME (ANOVA, P > 0.05). However, during MANI + l-NAME, changes vs. baseline in GFR (-6%), RBF (-12%), and UNaV (-34%) were blunted vs. PL + l-NAME and LOS + l-NAME (P < 0.005), and the rise in U8-iso-PGF2αV was almost abolished (+37%, P > 0.05 vs. baseline; P < 0.01 vs. PL + l-NAME or LOS + l-NAME). We conclude that, since MANI blunted l-NAME-induced renal hemodynamic changes, CCs participate in the renal responses to NOSI in healthy, sodium-replete humans independent of changes in MAP and without the apparent contribution of the AT1R. Because the rise in U8-iso-PGF2αV was essentially prevented during MANI + l-NAME, CC blockade may oppose the renal effects of NOSI in part by counteracting oxidative stress responses to acutely impaired renal NO bioavailability.

Keywords: NG-nitro-l-arginine methyl ester; losartan; manidipine; nitric oxide; renal hemodynamic function.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Arterial Pressure / drug effects
  • Biomarkers / urine
  • Calcium Channel Blockers / administration & dosage*
  • Dihydropyridines / administration & dosage*
  • Dinoprost / analogs & derivatives
  • Dinoprost / urine
  • Enzyme Inhibitors / administration & dosage*
  • Female
  • Glomerular Filtration Rate / drug effects
  • Healthy Volunteers
  • Hemodynamics / drug effects*
  • Humans
  • Infusions, Intravenous
  • Kidney / blood supply*
  • Kidney / drug effects*
  • Kidney / enzymology
  • Losartan / administration & dosage*
  • Male
  • NG-Nitroarginine Methyl Ester / administration & dosage*
  • Natriuresis / drug effects
  • Nitric Oxide / antagonists & inhibitors*
  • Nitric Oxide / metabolism
  • Nitrobenzenes
  • Oxidative Stress / drug effects
  • Piperazines
  • Renal Circulation / drug effects*
  • Time Factors

Substances

  • Biomarkers
  • Calcium Channel Blockers
  • Dihydropyridines
  • Enzyme Inhibitors
  • Nitrobenzenes
  • Piperazines
  • 8-epi-prostaglandin F2alpha
  • Nitric Oxide
  • manidipine
  • Dinoprost
  • Losartan
  • NG-Nitroarginine Methyl Ester