期刊
DIABETES RESEARCH AND CLINICAL PRACTICE
卷 99, 期 2, 页码 136-144出版社
ELSEVIER IRELAND LTD
DOI: 10.1016/j.diabres.2012.11.004
关键词
BOLD-MRI; Hypertension; Renal; Angiotensin receptor blocker; ACE-inhibitor; Furosemide
资金
- Swiss Society of Hypertension (Astra Zeneca grant)
- Swiss National Science Foundation [FN 32003B-132913]
- Centre d'Imagerie BioMedicale (CIBM) of the University of Lausanne (UNIL)
- Swiss Federal Institute of Technology Lausanne (EPFL)
- University of Geneva (UniGe)
- Centre Hospitalier Universitaire Vaudois (CHUV)
- Hopitaux Universitaires de Geneve (HUG)
- Leenaards Foundation
- Jeantet Foundation
- SPUM-grant from the Swiss National Science Foundation [33CM30-124087]
Aim: To assess whether blockade of the renin-angiotensin system (RAS), a recognized strategy to prevent the progression of diabetic nephropathy, affects renal tissue oxygenation in type 2 diabetes mellitus (T2DM) patients. Methods: Prospective randomized 2-way cross over study; T2DM patients with (micro) albuminuria and/or hypertension underwent blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) at baseline, after one month of enalapril (20 mg qd), and after one month of candesartan (16 mg qd). Each BOLD-MRI was performed before and after the administration of furosemide. The mean R-2* (=1/T-2*) values in the medulla and cortex were calculated, a low R-2* indicating high tissue oxygenation. Results: Twelve patients (mean age: 60 +/- 11 years, eGFR: 62 +/- 22 ml/min/1.73 m(2)) completed the study. Neither chronic enalapril nor candesartan intake modified renal cortical or medullary R-2* levels. Furosemide significantly decreased cortical and medullary R-2* levels suggesting a transient increase in renal oxygenation. Medullary R-2* levels correlated positively with urinary sodium excretion and systemic blood pressure, suggesting lower renal oxygenation at higher dietary sodium intake and blood pressure; cortical R-2* levels correlated positively with glycemia and HbA1c. Conclusion: RAS blockade does not seem to increase renal tissue oxygenation in T2DM hypertensive patients. The response to furosemide and the association with 24 h urinary sodium excretion emphasize the crucial role of renal sodium handling as one of the main determinants of renal tissue oxygenation. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据