Effect of Thromboxane and Nitric Oxide Blockade on Renal Blood Flow Increase during Volume Expansion in Hydronephrotic Rats

Wåhlin, Nils; Stenberg, Arne; Ae, Persson

doi:10.1080/003655901750170362

Cited by 3 publications

(2 citation statements)

References 16 publications

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“…In our previous studies, we demonstrated that hydronephrosis, induced by partial unilateral obstruction, leads to the development of hypertension in both rats and mice [ 9 , 10 ]. Underlying pathological mechanisms in this model include altered prostaglandin and thromboxane signaling [ 35 , 36 ] in the diseased kidney together with oxidative stress and reduced NO bioavailability [ 12 – 15 ]. To the best of our knowledge, the above-mentioned pathological mechanisms have never been investigated in patients with hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

et al. 2017

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ObjectiveRecent clinical studies have suggested an increased risk of elevated arterial pressure in patients with hydronephrosis. Animals with experimentally induced hydronephrosis develop hypertension, which is correlated to the degree of obstruction and increased oxidative stress. In this prospective study we investigated changes in arterial pressure, oxidative stress, and nitric oxide (NO) homeostasis following correction of hydronephrosis.MethodsAmbulatory arterial pressure (24 h) was monitored in pediatric patients with hydronephrosis (n = 15) before and after surgical correction, and the measurements were compared with arterial pressure measurements in two control groups, i.e. healthy controls (n = 8) and operated controls (n = 8). Markers of oxidative stress and NO homeostasis were analyzed in matched urine and plasma samples.ResultsThe preoperative mean arterial pressure was significantly higher in hydronephrotic patients [83 mmHg; 95% confidence interval (CI) 80–88 mmHg] than in healthy controls (74 mmHg; 95% CI 68–80 mmHg; p < 0.05), and surgical correction of ureteral obstruction reduced arterial pressure (76 mmHg; 95% CI 74–79 mmHg; p < 0.05). Markers of oxidative stress (i.e., 11-dehydroTXB2, PGF2α, 8-iso-PGF2α, 8,12-iso-iPF2α-VI) were significantly increased (p < 0.05) in patients with hydronephrosis compared with both control groups, and these were reduced following surgery (p < 0.05). Interestingly, there was a trend for increased NO synthase activity and signaling in hydronephrosis, which may indicate compensatory mechanism(s).ConclusionThis study demonstrates increased arterial pressure and oxidative stress in children with hydronephrosis compared with healthy controls, which can be restored to normal levels by surgical correction of the obstruction. Once reference data on ambulatory blood pressure in this young age group become available, we hope cut-off values can be defined for deciding whether or not to correct hydronephrosis surgically.

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Section: Discussionmentioning

confidence: 99%

Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

et al. 2017

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“…The current retrospective study does not provide evidence regarding the mechanism, but in several previous experimental studies we have investigated underlying mechanisms contributing to hydronephrosis-induced hypertension. These include increased adenosine receptor-mediated contraction in the kidney, activation of renin-angiotensin-aldosterone system, enhanced renal sympathetic nerve activity (8,11,13), together with altered prostaglandin and thromboxane signaling (26,27), oxidative stress, and impaired nitric oxide signaling in the affected kidney (10–13). In support of these findings, our recent clinical study also demonstrated that children with hydronephrosis have abnormal prostaglandin and thromboxane signaling, oxidative stress, nitric oxide homeostasis (18), and increased plasmin levels in the urine (28).…”

Section: Discussionmentioning

confidence: 99%

Changes of arterial pressure following relief of obstruction in adults with hydronephrosis

Al-Mashhadi

Häggman

Läckgren

et al. 2018

Upsala Journal of Medical Sciences

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Background: As much as 20% of all cases of hypertension are associated with kidney malfunctions. We have previously demonstrated in animals and in pediatric patients that hydronephrosis causes hypertension, which was attenuated by surgical relief of the ureteropelvic junction (UPJ) obstruction. This retrospective cohort study aimed to investigate: (1) the proposed link between hydronephrosis, due to UPJ obstruction, and elevated arterial pressure in adults; and (2) if elevated blood pressure in patients with hydronephrosis might be another indication for surgery.Materials and methods: Medical records of 212 patients undergoing surgical management of hydronephrosis, due to UPJ obstruction, between 2000 and 2016 were assessed. After excluding patients with confounding conditions and treatments, paired arterial pressures (i.e. before/after surgery) were compared in 49 patients (35 years old; 95% CI 29–39). Split renal function was evaluated by using mercaptoacetyltriglycine (MAG3) renography before surgical management of the hydronephrotic kidney.Results: Systolic (−11 mmHg; 95% CI 6–15 mmHg), diastolic (−8 mmHg; 95% CI 4–11 mmHg), and mean arterial (-9 mmHg; 95% CI 6–12) pressures were significantly reduced after relief of the obstruction (p < 0.001). Split renal function of the hydronephrotic kidney was 39% (95% CI 37–41). No correlations were found between MAG3 and blood pressure level before surgery or between MAG3 and the reduction of blood pressure after surgical management of the UPJ obstruction.Conclusions: In adults with hydronephrosis, blood pressure was reduced following relief of the obstruction. Our findings suggest that elevated arterial pressure should be taken into account as an indication to surgically correct hydronephrosis.

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Ureteropelvic junction obstruction causes histologic alterations in contralateral kidney

Ekinci

Çiftçi

Atilla

et al. 2003

Journal of Pediatric Surgery

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Effect of Thromboxane and Nitric Oxide Blockade on Renal Blood Flow Increase during Volume Expansion in Hydronephrotic Rats

Abstract: It is concluded that a thromboxane- and/or nitric oxide-dependent RBF redistribution takes place in hydronephrotic kidneys during volume expansion.

Cited by 3 publications

References 16 publications

Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

Changes in arterial pressure and markers of nitric oxide homeostasis and oxidative stress following surgical correction of hydronephrosis in children

Changes of arterial pressure following relief of obstruction in adults with hydronephrosis

Ureteropelvic junction obstruction causes histologic alterations in contralateral kidney

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