Department of Nephrology, Ankara Educational and Research Hospital, Ankara, Turkey.
Nephron Clin Pract. 2010;114(3):c213-7. doi: 10.1159/000262304. Epub 2009 Nov 28.
Renal artery stenosis (RAS) is a progressive disease and may lead to chronic kidney disease by deterioration of renal functions. Endothelial dysfunction is an important causative factor for kidney damage after RAS revascularization. Nebivolol, a new generation beta blocker induces endothelium-related arterial relaxation by nitric oxide (NO) and may improve endothelial dysfunction. This pilot study tested the effect of nebivolol on the glomerular filtration rate (GFR) in a series of 33 patients with severe RAS (>70%) who underwent revascularization. After revascularization, nebivolol was added to antihypertensive treatment in 17 randomly selected patients while 16 patients (control group) continued their standard treatment. Estimated glomerular filtration rate (eGFR), proteinuria as well as nitrite and nitrate levels were measured at baseline and 6 months after the revascularization procedure. Six months after revascularization, eGFR increased from 44.8 to 50.6 ml/min in the nebivolol group. In contrast, eGFR did not change in the control group. Nitrite/nitrate levels decreased to a significant extent both in the nebivolol and in the control group. Proteinuria decreased more in the nebivolol group compared to the control group. These pilot data support a full-fledged clinical trial, testing whether nebivolol may be beneficial in the post-revascularization phase in patients with RAS.
肾动脉狭窄（RAS）是一种进行性疾病，可通过肾功能恶化导致慢性肾脏病。内皮功能障碍是 RAS 血运重建后肾脏损害的一个重要致病因素。比索洛尔是一种新一代的β受体阻滞剂，可通过一氧化氮（NO）诱导与内皮相关的动脉松弛，并可能改善内皮功能障碍。这项初步研究测试了比索洛尔对 33 例严重 RAS（>70%）患者肾小球滤过率（GFR）的影响，这些患者接受了血运重建。血运重建后，17 例随机选择的患者在降压治疗中添加了比索洛尔，而 16 例患者（对照组）继续接受标准治疗。在基线和血运重建程序后 6 个月测量估计肾小球滤过率（eGFR）、蛋白尿以及亚硝酸盐和硝酸盐水平。血运重建后 6 个月，比索洛尔组的 eGFR 从 44.8 增加到 50.6ml/min。相比之下，对照组的 eGFR 没有变化。比索洛尔组和对照组的亚硝酸盐/硝酸盐水平均显著降低。与对照组相比，比索洛尔组的蛋白尿减少更多。这些初步数据支持进行一项全面的临床试验，以测试比索洛尔是否可能在 RAS 患者血运重建后阶段有益。
