L-arginine to Reduce Sympathetic Nerve Activity in CKD Patients
Role of Decreased Nitric Oxide in the Tonic Elevation of Resting Sympathetic Nerve Activity in Chronic Kidney Disease Patients
The University of Texas at Arlington
15 participants
Feb 1, 2018
INTERVENTIONAL
Conditions
Summary
Chronic kidney disease (CKD) is associated with a higher risk of cardiovascular disease and death. An overactive sympathetic nervous system in CKD patients is one of the major mechanisms increasing the cardiovascular risks in this patient population. A potential signal driving sympathetic nerve activity (SNA) involves accumulation of the endogenous nitric oxide synthase (NOS) inhibitor asymmetric dimethylarginine (ADMA). ADMA is elevated in CKD and is a strong, independent predictor of future cardiovascular events in these patients. . The goal of this study is to determine whether overcoming the accumulation of endogenous ADMA with acute L-arginine infusion reduces SNA in CKD patients.
Eligibility
Inclusion Criteria2
- CKD patients classified as Stage 3 and 4 of National Kidney Foundation Classification with estimated glomerular filtration rate (GFR) between 15 and 59 mL/min/1.73 m2 according to the Modification of Diet in Renal Disease (MDRD) formula based on serum creatinine, age, gender, and race.
- Men and women 35 to 75 years of age
Exclusion Criteria13
- myocardial infarction
- heart failure
- anemia (hemoglobin \<8 g/dl)
- cancer with current treatment
- previous organ transplantation
- immunosuppressant therapy
- human immunodeficiency virus infection
- pregnancy and/or lactating
- current tobacco use
- taking menopausal drugs (estradiol)
- treatment for diabetic neuropathy
- resting heart rate ≥ 100 bpm and
- systolic blood pressure ≤ 90 mmHg
Interventions
Arginine Hydrochloride 60% concentration injection 15 g in 25 mL, contains arginine hydrochloride 600 mg/mL in water for injections to 25 mL.
Saline
Locations(2)
View Full Details on ClinicalTrials.gov
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NCT03982160