Objective: The influence of pregnancy (P) on the evolution of primary
renal disease is still controversial. In rats with early adriamycin ne
phropathy (ADR), pregnancy enhanced mean arterial pressure (MAP) and u
rine protein excretion (UP). It has been suggested that the developmen
t of hypertension in pregnancy may be related to a decreased synthesis
of vasodilatory substance(s) by endothelial cells. In the present stu
dy, the effect of L-arginine, a precursor of the endothelium-derived r
elaxing factor nitric oxide (NO), was evaluated. Methods: Four groups
of rats were studied (n = 10 each): 1-normal pregnancy (NP); 2-normal
pregnancy treated with L-arginine (NP+LA); 3-ADR pregnant rats (ADRP);
and 4-ADR pregnant rats treated with L-arginine (ADRP + LA). L-argini
ne, 2 g/l, was added to the drinking water from midpregnancy. Results:
In ADRP rats, MAP increased to 135 +/- 4.1 mm Hg, significantly above
the values of 91 +/- 1.2 mm Hg found in NP rats, P < .01. Treatment w
ith L-arginine did not influence MAP in NP+LA rats, whereas in ADRP+LA
animals, MAP decreased to 89 +/- 5 mm Hg, P < .01 vs. ADRP. In ADRP r
ats, UP increased from 11 +/- 4 mg/d before P to 315 +/- 55 mg/d at en
d P. By contrast, in ADRP+LA rats, UP increased only to 98 +/- 23 mg/d
, P < .01 vs. ADRP rats. Inulin clearance was significantly greater in
ADRP+LA than in ADRP rats, 2.37 +/- .21 vs. 1.45 +/- .01 ml/min, resp
ectively, P < .01. Conclusions: These preliminary results suggested th
at in rats with incipient adriamycin nephropathy, the endogenous synth
esis of NO might be inadequately low during pregnancy, leading to the
development of hypertension and enhancement of urine protein excretion
.