Document Detail

Amelioration of metabolic acidosis in patients with low GFR reduced kidney endothelin production and kidney injury, and better preserved GFR.
MedLine Citation:
PMID:  20072112     Owner:  NLM     Status:  MEDLINE    
Metabolic acidosis often accompanies low glomerular filtration rate and induces secretion of endothelin, which in turn might mediate kidney injury. Here we tested whether treatment of metabolic acidosis in patients with low glomerular filtration rate reduced the progression of kidney disease. Fifty-nine patients with hypertensive nephropathy and metabolic acidosis had their blood pressure reduced with regimens that included angiotensin-converting enzyme inhibition. Thirty patients were then prescribed sodium citrate, and the remaining 29, unable or unwilling to take sodium citrate, served as controls. All were followed for 24 months with maintenance of their blood pressure reduction. Urine endothelin-1 excretion, a surrogate of kidney endothelin production, and N-acetyl-beta-D-glucosaminidase, a marker of kidney tubulointerstitial injury, were each significantly lower, while the rate of estimated glomerular filtration rate decline was significantly slower. The estimated glomerular filtration rate was statistically higher after 24 months of sodium citrate treatment compared to the control group. Hence it appears that sodium citrate is an effective kidney-protective adjunct to blood pressure reduction and angiotensin-converting enzyme inhibition.
Sorot Phisitkul; Apurv Khanna; Jan Simoni; Kristine Broglio; Simon Sheather; M Hasan Rajab; Donald E Wesson
Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-13
Journal Detail:
Title:  Kidney international     Volume:  77     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-12     Completed Date:  2010-06-08     Revised Date:  2013-04-04    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  617-23     Citation Subset:  IM    
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas, USA.
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MeSH Terms
Acetylglucosaminidase / urine
Acidosis / drug therapy*,  etiology,  urine
Biological Markers / urine
Citrates / pharmacology,  therapeutic use*
Endothelin-1 / urine*
Glomerular Filtration Rate / drug effects
Hypertension / complications,  urine
Kidney / drug effects*,  metabolism
Middle Aged
Prospective Studies
Renal Insufficiency, Chronic / complications,  drug therapy*,  metabolism
Reg. No./Substance:
0/Biological Markers; 0/Buffers; 0/Citrates; 0/Endothelin-1; 1Q73Q2JULR/sodium citrate; EC
Comment In:
Kidney Int. 2010 Apr;77(7):567-9   [PMID:  20224583 ]

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