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Nitric oxide (NO) is a double-edged sword. Synthesized in appropriate amounts by endothelial cells, neurons or macrophages it contributes to blood pressure regulation, neuronal communication and immune defence to name but a few important functions. On the other hand, excessive and uncontrolled production of NO by the inducible isoform of NO synthase (iNOS) is associated with several severe diseases like septic shock, stroke, neurodegeneration, diabetes, arthritis and other forms of chronic inflammation. The kidney does not escape from the impact of NO. I will highlight how increased understanding of the role of NO in renal pathophysiology has modified our way of thinking and the concepts of how to approach kidney diseases therapeutically.

Nitric oxide triggers the expression of proinflammatory and protective gene products in mesangial cells and the inflamed glomerulus