Role of nitric oxide in renal hemodynamic abnormalities of cyclosporin nephrotoxicity

Abstract

To evaluate the participation of nitric oxide (NO) in chronic cyclosporin A (CsA) nephrotoxicity, the glomerular hemodynamic response to NO inhibition with N-nitro-L-arginine-methyl-ester (NAME) and stimulation of NO production with L-arginine was studied in unine-phrectomized rats. Chronic CsA administration produced renal vasoconstriction, characterized by increased afferent (A(R)) and efferent (E(R)) resistances, decrease of glomerular plasma flow (Q(A)) and ultrafiltration coefficient (K(f)) that resulted in a 53% fall of single-nephron glomerular filtration rate (SNGFR). NAME infusion in Vehicle group (V) elevated mean arterial pressure (MAP), A(R) and E(R), reduced Q(A) and K(R), and increased glomerular capillary pressure (P(GC)), resulting in a 28.9% fall of SNGFR, In the CsA group, NAME also increased MAP, but renal vasoconstriction was more intense; a greater rise of AR lowered P(GC) (P < 0.05 vs. V) further decreasing SNGFR by 38.9%. In control rats, L-arginine infusion induced a vasodilatory response of A(R) and E(R), and elevation of Q(A) and K(f), which resulted in a 72.6% increase in SNGFR. In the CsA group, greater vasodilation was observed and SNGFR rose by 114.9%. NO2-/NO3- urinary excretion was similar in CsA and V groups, and it was not modified by NAME in either group, but it increased five- to sixfold during L-arginine infusion in both groups. In conclusion, in CsA nephrotoxicity NO production seems to be normal and the ability of the renal endothelium to produce NO is maintained. Therefore renal vasoconstriction associated with CsA is not mediated by NO deficiency, although NO appears to attenuate it.