Effects of nutritional status on the L-arginine-nitric oxide pathway in platelets from hemodialysis patients

Effects of nutritional status on the L-arginine-nitric oxide pathway in platelets from hemodialysis patients. Malnutrition is a common feature in chronic renal failure and adversely affects patient morbidity and mortality. We here investigate the effects of nutritional status on the L-arginine-nitri...

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Bibliographic Details
Published in:Kidney international 2005-11, Vol.68 (5), p.2173-2179
Main Authors: Da Silva, Clarissa Demézio, Brunini, Tatiana M.C., Reis, Patricia F., Moss, Monique B., Santos, Sergio F.F., Roberts, Norman B., Ellory, John C., Mann, Giovanni E., Mendes-Ribeiro, Antonio C.
Format: Article
Language:English
Subjects:
Adult
Aged
Amino Acids - blood
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Arginine - metabolism
Biological and medical sciences
Blood Platelets - metabolism
Cyclic GMP - metabolism
Emergency and intensive care: renal failure. Dialysis management
Female
Humans
Intensive care medicine
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - metabolism
Kidney Failure, Chronic - therapy
L-arginine transport
Male
malnutrition
Malnutrition - diet therapy
Malnutrition - metabolism
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Nephropathies. Renovascular diseases. Renal failure
nitric oxide
Nitric Oxide - metabolism
Nitric Oxide Synthase - metabolism
Nutritional Status
Platelet Aggregation
platelets
Renal Dialysis
Renal failure
Tumor Necrosis Factor-alpha - metabolism
uremia
Uremia - diet therapy
Uremia - metabolism
Uremia - therapy
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Summary:Effects of nutritional status on the L-arginine-nitric oxide pathway in platelets from hemodialysis patients. Malnutrition is a common feature in chronic renal failure and adversely affects patient morbidity and mortality. We here investigate the effects of nutritional status on the L-arginine-nitric oxide signaling pathway and platelet function in chronic renal failure patients on regular hemodialysis. Platelet aggregation was correlated with plasma amino acid profiles, L-arginine transport, and nitric oxide synthase (NOS) activity determined by conversion of L-[3H]-arginine to L-[3H]-citrulline and accumulation of intracellular cyclic guanosine monophospate (cGMP) in platelets from malnourished and well-nourished chronic renal failure patients on regular hemodialysis (N = 78). Transport of L-arginine (pmol/109cells/min) via y+ L system was increased in well-nourished (104 ± 15) compared to controls (57 ± 11) or malnourished chronic renal failure patients (55 ± 13). Basal NOS activity (pmol/108cells) was enhanced in well-nourished chronic renal failure patients (0.51 ± 0.01) compared to controls (0.18 ± 0.01) or malnourished chronic renal failure patients (0.08 ± 0.03). In addition, basal cGMP levels are elevated in platelets from well-nourished chronic renal failure compared to malnourished uremic patients. Platelet aggregation induced by collagen is impaired in well-nourished chronic renal failure patients compared to malnourished patients and controls. Plasma L-arginine levels are reduced in chronic renal failure patients and even lower in malnourished patients. Our findings provide the first evidence that L-arginine transport via the high affinity system y+ L and nitric oxide synthesis are only stimulated in platelets from well-nourished chronic renal failure patients, leading to impaired platelet aggregation. The absence of this adaptive response in the L-arginine-nitric oxide pathway in platelets from malnourished chronic renal failure patients may account for the enhanced occurrence of thrombotic events in these patients.
ISSN:0085-2538
1523-1755
DOI:10.1111/j.1523-1755.2005.00673.x