High Blood Pressure
Oral arginine improves blood pressure in renal transplant and hemodialysis
patients.
Kelly BS; Alexander JW; Dreyer D; Greenberg NA; Erickson A; Whiting
JF; Ogle CK; Babcock GF; First MR
Journal of Parenteral and Enteral Nutrition 2001 Jul-Aug;25(4):194-202
BACKGROUND: Hypertension in kidney transplant (KT) patients may result
from attenuated whole-body nitric oxide (NO) content and abnormal NO-mediated
vasodilation. Increasing NO bioavailability with L-arginine (ARG) could
theoretically restore the NO-mediated vasodilatory response and lower
blood pressure. METHODS: In a prospective pilot study, 6 normotensive
volunteers and 10 KT patients received oral supplements of ARG (9.0 g/d)
for 9 days, then 18.0 g/d for 9 more days. Six hemodialysis (HD) and 4
peritoneal dialysis patients received the same dose for 14 days. Five
KT patients received 30 mL/d of canola oil (CanO) in addition to ARG.
Systolic (SBP) and diastolic (DBP) blood pressure, creatinine clearance
(CCr), and serum creatinine (Cr) were measured at baseline, day 9, and
day 18. In a subsequent study, 20 hypertensive KT patients with stable
but abnormal renal function were randomized in a crossover study to start
ARG-only or ARG+CanO supplements for two 2-month periods with an intervening
month of no supplementation. SBP, DBP, CCr, and Cr were measured monthly
for 7 months. RESULTS: In the pilot study, ARG reduced the SBP in HD patients
from 171.5 +/- 7.5 mmHg (baseline) to 142.8 +/- 8.3 mmHg (p = .028). In
the crossover study, SBP was reduced from baseline (155.9 +/- 5.0 mmHg),
after the first 2 months (143.2 +/- 3.2 mmHg; p = .03) and subsequent
2 months (143.3 +/- 2.5 mmHg; p = .014) of supplementation. DBP was also
reduced after supplementation in both studies. CanO had no effect on blood
pressure. Renal function did not change. CONCLUSIONS: Oral preparations
of ARG (+/-CanO) were well tolerated for up to 60 consecutive days and
had favorable effects on systolic blood pressure and diastolic blood pressure
in hypertensive kidney transplant and hemodialysis patients.
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