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World J Nephrol. Nov 6, 2013; 2(4): 125-128
Published online Nov 6, 2013. doi: 10.5527/wjn.v2.i4.125
Published online Nov 6, 2013. doi: 10.5527/wjn.v2.i4.125
Vascular response to vasodilator treatment in microalbuminuric diabetic kidney disease
Narisa Futrakul, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Bangkok 10330, Thailand
Prasit Futrakul, Bhumirajanagarindra Kidney Institute, Bangkok 10400, Thailand
Prasit Futrakul, Academy of Science, the Royal Institute of Thailand, Dusit District 10300, Thailand
Author contributions: Futrakul N is the principle investigator; Futrakul N and Futrakul P contributed equally to the work.
Supported by Thailand Research-Fund, Bhumirajanagarindra Kidney Institute and National Research Council Fund of Thailand
Correspondence to: Narisa Futrakul, MD, PhD, Professor, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, Phayathai Road, Pathumwan, Bangkok 10330, Thailand. fmednft@yahoo.com
Telephone: +66-2-81351214 Fax: +66-2-2564911
Received: May 1, 2013
Revised: June 4, 2013
Accepted: September 3, 2013
Published online: November 6, 2013
Revised: June 4, 2013
Accepted: September 3, 2013
Published online: November 6, 2013
Core Tip
Core tip: This manuscript demonstrates the therapeutic resistance to vasodilator treatment in restoring the renal functions in microalbuminuric diabetic nephropathy. It is supported by the intrarenal hemodynamic study which reveals a decline in renal plasma flow, peritubular capillary flow and glomerular filtration rate following vasodilator treatment. The above finding concerns with the recent study on vascular homeostasis which reveals a defective angiogenesis associated with an impaired nitric oxide production, which explains the therapeutic resistance to vasodilator and clinical failure in restoring renal perfusion in late stage diabetic nephropathy.