PATHOPHYSIOLOGY OF THE VASCULAR WALL - THE ROLE OF NITRIC-OXIDE IN RENAL-DISEASE

Nitric oxide (NO) is formed in the endothelium by the constitutive enz yme NO synthase from the substrate amino acid L-arginine. As an endoge nous vasodilator it contributes to renal arteriolar tone and modulates relaxation of the mesangium, thus contributing to regulation of glome rular microcirculation. NO also plays a role in regulating renal sodiu m excretion and renin release. It has antiplatelet and antithrombogeni c effects and thus helps prevent thrombosis within the glomerular capi llaries. In sepsis and sepsis-related syndromes, NO has a renoprotecti ve role in that it aids in maintaining renal vasodilation and inhibiti ng platelet adhesion and aggregation. More knowledge of these effects may lead to the design of therapeutic interventions for preventing glo merular injury.