Nitric Oxide And The Kidney

A number of remarkable recent breakthroughs have made the study of nitric oxide one of the most exciting fields in physiology and pathophysiology. This authoritative edited volume reviews the progress to date and opens perspectives to novel diagnostic and therapeutic strategies. The contributors are leading authorites, in most cases the investigators who have pioneered the ideas explored in the book.

Nitric oxide (NO) is a key regulator of various cellular signaling pathways throughout the body and plays an important role in renal function under normal physiological and pathophysiological conditions. NO plays a major role in the regulation of renal hemodynamics, tubuloglomerular feedback, sodium transport in the nephron, pressure natriuresis, and renal fibrosis and injury; moreover, a deficiency in NO is characteristic of chronic kidney disease in both human patients and in experimental animal models. The goal of this book is to highlight the actions of NO within the kidney and its effects on the regulation of renal blood flow and tubular transport.

A timely update Acute kidney injury (AKI) is a serious and as yet incompletely understood disorder in which sudden impairment of kidney function occurs secondary to one or more of a variety of underlying conditions. This disorder is very common in (elderly) ICU patients and is associated with very high mortality. Many of those who survive suffer from permanent kidney failure and other long-term morbidities, which may include cardiovascular disease and immune dysfunction. Epidemiologic evidence suggests that AKI is not a single disease, but a syndrome comprised of multiple, often coexisting, etiologies. Being usually part of multiorgan failure syndrome, it calls for multiple organ support therapy. The publication at hand contains sections on prerenal azotemia syndromes, dying of' or with' AKI, pathophysiology of sepsis- induced acute kidney injury, developments in prevention / treatment / rehabilitation, and renal support. Reporting the latest recommendations from experts, it provides valuable information for those that are interested in understanding the disorder and its treatment options.

Nitric oxide (NO), plays an important role in sodium excretion. The hypothesis that renal nitric oxide synthase (NOS) activity is directly related to salt intake was studied in rats fed low (0.05% NaCI, LSD), normal (0.3%, NSD), or high (8%, HSD) salt diet for 14 days. NOS activity was measured in kidney tissue by conversion of L-$\sp$C-arginine to L-$\sp$C-citrulline. Ca$\sp{2+}$-dependent NOS activity which was 10-20 times higher in the outer and inner medulla compared to cortex was similar in all dietary groups. HSD increased urinary nitrite/nitrate (U$\sb{\rm NOx}$) excretion significantly by 3 days, however no significant differences were observed in NOS activity, serum NOx, or clearance of creatinine. Inhibition of NOS activity in vivo abolished the increase in UNOx excretion seen with HSD, and decreased fractional excretion of sodium. It is concluded that HSD increases NO production by the kidney but this is not due to an induction of NOS enzyme.

Chronic kidney disease is one of the world's major public health problems, and the prevalence of kidney failure is rising steadily. Among the risk factors for a faster progression of renal disease are hypertension and proteinuria, many studies clearly demonstrating that hypertension is both a cause and consequence of chronic kidney disease. Namely, renal blood pressure regulation seems to be involved in five major pathophysiological mechanisms (all closely related to the renin-angiotensin system): Pressure-natriuresis, renal sympathetic nervous system, renal blood flow, intraglomerular pressure and tubuloglomerular feedback. This book reviews experimental data which form the basis of our current understanding of the association between hypertension and kidney diseases: The pathogenesis of increased blood pressure, the mechanisms by which systemic hypertension promotes progressive kidney failure, and the impact of antihypertensive agents on experimental renal mechanisms involved in hypertension. Furthermore, the role of angiotensin II receptor blockers in both the control of systemic blood pressure and the reduction of proteinuria is examined in an attempt to define optimal therapeutic strategies to prevent the otherwise inexorable deterioration of renal function in patients with chronic kidney disease.

Leading clinical and experimental investigators comprehensively review the chemistry, biochemistry, molecular biology, physiology, and pathophysiology of nitric oxide in the cardiovascular systems. These experts particularly illuminate nitric oxide biology, its cardiovascular pathophysiology, and its role in cardiovascular therapeutics. Topics also included are the development of nitric oxide donors for the treatment of myocardial ischemia and thrombosis, the development of gene therapeutic restoration of endothelial function in atherosclerosis, and the application of nitric oxide biology to investigative arenas in cardiovascular medicine. With its balanced presentation of basic and clinically relevant information, Nitric Oxide and the Cardiovascular System provides a comprehensive, authoritative guide for all those cardiovascular biologists, cardiologists, physiologists, and cardiovascular surgeons engaged in today's clinical or experimental research.