No registrations found.
Source
Brief title
Health condition
hypertension
mild renal insufficiency
ADMA
hypertensie
milde nierfunctiestoornsisen
ADMA
Sponsors and support
P. Debyelaan 25, P.O. Box 5800
6202 AZ Maastricht
Phone: +31 43 387 7005 (secretary
Intervention
No registrations found.
Outcome measures
Primary outcome
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 outcome
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
Study objective
ADMA (asymmetric dimethylarginine) plasma concentrations are higher in persons with mild renal insufficiency compared to persons with normal kidney function. ADMA plasma concentrations are inversely proportional to renal perfusion and endothelial nitric oxide (NO) availibility in the kidney. Medical treatment with statins and/or angiotensin II receptor blockers (ARB) will reduce ADMA plasma concentrations, improves kidney perfusion and NO availibility.
Study design
- 3 weeks before renal angiography --> start medication treatment
- after 3 weeks treatment --> renal angiography with additional measurements
Intervention
- 3 weeks treatment with ARB and/or statin
- Intrarenal L-NMMA (monomethyl-L
arginine, NO synthase inhibitor) infusion
Department of Internal Medicine <br>
P.O. Box 5800
R.A. Ronden
P. Debyelaan 25
Maastricht 6202 AZ
The Netherlands
+31 (0)43 3881432
Department of Internal Medicine <br>
P.O. Box 5800
R.A. Ronden
P. Debyelaan 25
Maastricht 6202 AZ
The Netherlands
+31 (0)43 3881432
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
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
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
Register | ID |
---|---|
NTR-new | NL1383 |
NTR-old | NTR1443 |
Other | : |
ISRCTN | ISRCTN wordt niet meer aangevraagd |