Significant natriuretic and antihypertensive action of the epithelial sodium channel blocker amiloride in diabetic patients with and without nephropathy

Journal of Hypertension

Volumn 34, Issue 8, 2016, Pages 1621-1629

  Andersen, Henrik ^a   Hansen, Pernille B L ^a   Bistrup, Claus ^b   Nielsen, Flemming ^a   Henriksen, Jan Erik ^b   Jensen, Boye L ^a  

^a UNIVERSITY OF SOUTHERN DENMARK   (Denmark)

^b ODENSE UNIVERSITY HOSPITAL   (Denmark)

Author keywords

albuminuria; blood pressure; diabetic nephropathy; epithelial sodium channel; hypertension; microalbuminuria; proteinuria

Indexed keywords

ALBUMIN; ALDOSTERONE; AMILORIDE; CREATININE; EPITHELIAL SODIUM CHANNEL; PHOSPHATE; PLASMIN; PLASMINOGEN; POTASSIUM; RENIN; SODIUM; URIC ACID; EPITHELIAL SODIUM CHANNEL BLOCKING AGENT; SODIUM INTAKE;

ADULT; ALBUMINURIA; ALDOSTERONE BLOOD LEVEL; ANTIHYPERTENSIVE ACTIVITY; ARTICLE; BLOOD PRESSURE REGULATION; BODY WEIGHT; CLINICAL ARTICLE; CONTROLLED STUDY; CREATININE CLEARANCE; CREATININE URINE LEVEL; DIABETIC NEPHROPATHY; DIABETIC PATIENT; DIARRHEA; DIURETIC ACTIVITY; DIZZINESS; FATIGUE; FEMALE; GLOMERULUS FILTRATION; GLOMERULUS FILTRATION RATE; HEADACHE; HUMAN; HYPERKALEMIA; IC50; INSULIN DEPENDENT DIABETES MELLITUS; INTERVENTION STUDY; KIDNEY DISEASE; LIMIT OF DETECTION; MALE; MIDDLE AGED; NATRIURESIS; OPEN STUDY; PHOSPHATE BLOOD LEVEL; PLASMA RENIN ACTIVITY; PLASMINOGEN ACTIVATION; POTASSIUM BLOOD LEVEL; PRIORITY JOURNAL; RENIN ANGIOTENSIN ALDOSTERONE SYSTEM; SODIUM INTAKE; SODIUM RETENTION; SODIUM URINE LEVEL; URIC ACID BLOOD LEVEL; WEIGHT REDUCTION; ADMINISTRATION AND DOSAGE; BLOOD; BLOOD PRESSURE; COMPLICATION; DIABETIC NEPHROPATHIES; DRUG EFFECTS; KIDNEY; PATHOPHYSIOLOGY; URINE;

ALBUMINURIA; AMILORIDE; BLOOD PRESSURE; DIABETES MELLITUS, TYPE 1; DIABETIC NEPHROPATHIES; EPITHELIAL SODIUM CHANNEL BLOCKERS; EPITHELIAL SODIUM CHANNELS; FEMALE; FIBRINOLYSIN; HUMANS; KIDNEY; MALE; MIDDLE AGED; NATRIURESIS; PLASMINOGEN; RENIN; SODIUM; SODIUM, DIETARY; WEIGHT LOSS;

EID: 84969801219     PISSN: 02636352     EISSN: 14735598     Source Type: Journal    
DOI: 10.1097/HJH.0000000000000967     Document Type: Article

References (32)

1. Krolewski AS, Warram JH, Christlieb AR, Busick EJ, Kahn CR. The changing natural history of nephropathy in type I diabetes. Am J Med 1985; 78:785-794.
2. Feldt-Rasmussen B, Mathiesen E, Deckert T, Giese J, Christensen NJ, Bent-Hansen L, et al. Central role for sodium in the pathogenesis of blood pressure changes independent of angiotensin, aldosterone and catecholamines in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1987; 30:610-617.
3. Strojek K, Grzeszczak W, Lacka B, Gorska J, Keller C, Ritz E. Increased prevalence of salt sensitivity of blood pressure in IDDM with and without microalbuminuria. Diabetologia 1995; 38:1443-1448.
4. Bigazzi R, Bianchi S, Baldari D, Sgherri G, Baldari G, Campese VM. Microalbuminuria in salt-sensitive patients. A marker for renal and cardiovascular risk factors. Hypertension 1994; 23:195-199.
5. Andersen H, Friis UG, Hansen PB, Svenningsen P, Henriksen JE, Jensen BL. Diabetic nephropathy is associated with increased urine excretion of proteases plasmin, prostasin and urokinase and activation of amiloride-sensitive current in collecting duct cells. Nephrol Dial Transplant 2015; 30:781-789.
6. Buhl KB, Oxlund CS, Friis UG, Svenningsen P, Bistrup C, Jacobsen IA, et al. Plasmin in urine from patients with type 2 diabetes and treatmentresistant hypertension activates ENaC in vitro. J Hypertens 2014; 32:1672-1677.
7. Svenningsen P, Bistrup C, Friis UG, Bertog M, Haerteis S, Krueger B, et al. Plasmin in nephrotic urine activates the epithelial sodium channel. J Am Soc Nephrol 2009; 20:299-310.
8. Passero CJ, Mueller GM, Rondon-Berrios H, Tofovic SP, Hughey RP, Kleyman TR. Plasmin activates epithelial Na+ channels by cleaving the gamma subunit. J Biol Chem 2008; 283:36586-36591.
9. Zachar RM, Skjødt K, Marcussen N, Walter S, Toft A, Nielsen MR, et al. The epithelial sodium channel g-subunit is processed proteolytically in human kidney. J Am Soc Nephrol 2015; 26:95-106.
10. Vassalli J-D, Belin D. Amiloride selectively inhibits the urokinase-Type plasminogen activator. FEBS Lett 1987; 214:187-191.
11. Svenningsen P, Uhrenholt TR, Palarasah Y, Skjødt K, Jensen BL, Skøtt O. Prostasin-dependent activation of epithelial Na+ channels by low plasmin concentrations. Am J Physiol Regul Integr Comp Physiol 2009; 297:R1733-R1741.
12. Topouchian JA, El Assaad MA, Orobinskaia LV, El Feghali RN, Asmar RG Validation of two devices for self-measurement of brachial blood pressure according to the International Protocol of the European Society of Hypertension: The SEINEX SE-9400 and the Microlife BP3AC1-1. Blood Press Monit 2005; 10:325-331
13. Rennings A, Russel F, Li Y, Deen P, Masereeuw R, Tack C, et al. Preserved response to diuretics in rosiglitazone-Treated subjects with insulin resistance: a randomized double-blind placebo-controlled crossover study. Clin Pharmacol Ther 2011; 89:587-594.
14. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130:461-470.
15. Poulsen K, Jorgensen J. An easy radioimmunological microassay of renin activity, concentration and substrate in human and animal plasma and tissues based on angiotensin I trapping by antibody. J Clin Endocrinol Metab 1974; 39:816-825.
16. Staehr M, Buhl KB, Andersen RF, Svenningsen P, Nielsen F, Hinrichs GR, et al. Aberrant glomerular filtration of urokinase-Type plasminogen activator in nephrotic syndrome leads to amiloride-sensitive plasminogen activation in urine. Am J Physiol Renal Physiol 2015; 309:F235-F241.
17. Jones KM, Liao E, Hohneker K, Turpin S, Henry MM, Selinger K, et al. Pharmacokinetics of amiloride after inhalation and oral administration in adolescents and adults with cystic fibrosis. Pharmacotherapy 1997; 17:263-270.
18. Weiss P, Hersey RM, Dujovne CA, Bianchine JR. The metabolism of amiloride hydroloride in man. Clin Pharmacol Ther 1969; 10:401-406.
19. Pickkers P, van Beek M, Hughes AD, Russel FG, Thien T, Smits P. Presence and mechanism of direct vascular effects of amiloride in humans. J Cardiovasc Pharmacol 1999; 34:388-393.
20. Hommel E, Mathiesen E, Giese J, Nielsen M, Schütten H, Parving H. On the pathogenesis of arterial blood pressure elevation early in the course of diabetic nephropathy. Scand J Clin Lab Invest 1989; 49:537-544.
21. Bojestig M, Nystrom FH, Arnqvist HJ, Ludvigsson J, Karlberg BE. The renin-Angiotensin-Aldosterone system is suppressed in adults with type 1 diabetes. J Renin Angiotensin Aldosterone Syst 2000; 1:353-356.
22. Roland J, O'Hare J, Walters G, Corrall R. Sodium retention in response to saline infusion in uncomplicated diabetes mellitus. Diabetes Res (Edinburgh, Scotland) 1986; 3:213-215.
23. O'Hare J, Roland J, Walters G, Corrall R. Impaired sodium excretion in response to volume expansion induced by water immersion in insulindependent diabetes mellitus. Clin Sci 1986; 71:403-409.
24. O'Hare J, Anderson J, Millar N, Bloom S, Corrall R. The relationship of the renin-Angiotensin-Aldosterone system to atrial natriuretic peptide and the natriuresis of volume expansion in diabetics with and without proteinuria. Postgrad Med J 1988; 64 (Suppl 3):35-38.
25. O'Hare J, Anderson J, Millar N, Dalton N, Tymms D, Bloom S, et al. Hormonal response to blood volume expansion in diabetic subjects with and without autonomic neuropathy. Clin Endocrinol 1989; 30:571-579.
26. Blazer-Yost BL, Liu X, Helman SI. Hormonal regulation of ENaCs: insulin and aldosterone. Am J Physiol 1998; 274:C1373-C1379.
27. Oxlund CS, Buhl KB, Jacobsen IA, Hansen MR, Gram J, Henriksen JE, et al. Amiloride lowers blood pressure and attenuates urine plasminogen activation in patients with treatment-resistant hypertension. J Am Soc Hypertens 2014; 8:872-881.
28. Eide IK, Torjesen PA, Drolsum A, Babovic A, Lilledahl NP. Low-renin status in therapy-resistant hypertension: a clue to efficient treatment. J Hypertens 2004; 22:2217-2226.
29. Saha C, Eckert GJ, Ambrosius WT, Chun T-Y, Wagner MA, Zhao Q, et al. Improvement in blood pressure with inhibition of the epithelial sodium channel in blacks with hypertension. Hypertension 2005; 46:481-487.
30. Bobrie G, Frank M, Azizi M, Peyrard S, Boutouyrie P, Chatellier G, et al. Sequential nephron blockade versus sequential renin-Angiotensin system blockade in resistant hypertension: a prospective, randomized, open blinded endpoint study. J Hypertens 2012; 30:1656-1664.
31. Lane DA, Beevers DG. Amiloride 10mg is less effective than spironolactone 25mg in patients with hypertension resistant to a multidrug regime including an angiotensin-blocking agent. J Hypertens 2007; 25:2515-2516.
32. Masilamani S, Kim G-H, Mitchell C, Wade JB, Knepper MA. Aldosterone-mediated regulation of ENaC a, b, and g subunit proteins in rat kidney. J Clin Invest 1999; 104:R19-R23.