Nephrol Dial Transplant (2003) 18: 1512-1517
© 2003 European Renal Association-European Dialysis and Transplant Association
Vitamin C augments the renal response to L-arginine in smokers
Department of Medicine/Nephrology, University of Erlangen-Nürnberg, Germany
Correspondence and offprint requests to: Prof. Roland E. Schmieder, Universität Erlangen-Nürnberg, Medizinische Klinik IV/4, Klinikum Nürnberg Süd, Breslauer Straße 201, D-90471 Nürnberg, Germany. Email: roland.schmieder{at}rzmail.uni-erlangen.de
Background. In the coronary and the forearm circulations, endothelium-dependent vasomotion is impaired in smokers, but can be augmented by L-arginine or vitamin C. We examined whether smoking similarly affects the renal circulation.
Methods. In 20 smokers (age 26 ± 4 years) and in 20 non-smokers (age 28 ± 3 years) changes of renal plasma flow (RPF), glomerular filtration rate (GFR), blood pressure and heart rate in response to the subsequent intravenous infusions of NG-monomethyl-L-arginine (L-NMMA), L-arginine and L-arginine plus vitamin C were studied by use of a constant infusion input clearance technique.
Results. Systemic haemodynamic parameters did not differ between smokers and non-smokers during each experimental phase. At baseline, RPF and GFR were similar between the groups. The infusion of L-NMMA led to a similar decrease of RPF, while GFR did not change in either group. During the infusion of L-arginine RPF increased similarly. Finally, the co-infusion of L-arginine plus vitamin C led to a significantly greater increase of RPF (+277 ± 395 vs +79 ± 76 ml/min, P = 0.03) and GFR (+12.1 ± 10.6 vs +3.4 ± 11.2 ml/min, P = 0.02) in smokers as compared to non-smokers.
Conclusions. L-NMMA-induced vasoconstriction of the renal vasculature was similar in smokers compared to non-smokers. L-arginine alone induced a similar increase of RPF. The co-infusion of vitamin C and L-arginine led to a greater increase of RPF and GFR in smokers. This might suggest that oxidative stress is increased in the renal vasculature of smokers.
Keywords: nitric oxide; oxidative stress; renal haemodynamics; smoking; vitamin C
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