hypertension mild renal insufficiency ADMA hypertensie milde nierfunctiestoornsisen ADMA
Conditions
Interventions
- 3 weeks treatment with ARB and/or statin
- Intrarenal L-NMMA (monomethyl-L
arginine, NO synthase inhibitor) infusion
Sponsors
Dr. A.A. Kroon
P. Debyelaan 25, P.O. Box 5800
6202 AZ Maastricht
Phone: +31 43 387 7005 (secretary
Eligibility
Inclusion criteria
Inclusion criteria: 1. Hypertension (Office blood pressure: >140 and/or >90 mmHg or mean ABPM blood pressure: >125 and/or >80 mmHg) 2. Age: 18-75 jaar 3. Creatinin clearance of 60-90 mL/min (Cockcroft-Gault formule) 4. Renal angiography indicated based on the following criteria: - Refractory hypertension - Accelerating or malignant hypertension - Elevating serum creatinin after an ACE-inhibitor or ARB - Kidney size < 8 cm measured by ultrasound - Unexplained hypokalemia - Abdominal or renal souffle - Manifestations of atherosclerosis elsewhere - “Flash” oedema
Exclusion criteria
Exclusion criteria: 1. Primary kidney diseases or urological complaints 2. Diabetes Mellitus 3. Chronic inflammatory diseases 4. Recent infections (< 3 weeks) 5. Unilateral or bilateral renal artery stenosis 6. Fibromuscular dysplasia 7. Contraindication for ARB or statin
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| o Basal renal perfusion measured o Fractional change in renal perfusion after intrarenal L-NMMA infusion o Arterial en venous ADMA, SDMA (symmetric dimethylarginine) and L-arginine concentrations o Renal elimination of systemic ADMA, SDMA and L-arginine | — |
Secondary
| Measure | Time frame |
|---|---|
| o Microalbuminuria (24-hour urine collection) o Creatinin clearance (24-hour urine collection) o Blood pressure o Plasma LDL (low density lipoproteins), HDL (high density lipoproteins), triglycerides and total cholesterol concentrations | — |
Contacts
Public ContactR.A. Ronden
University Hospital Maastricht Department of Internal Medicine P.O. Box 5800
Outcome results
None listed