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The Effect of Dietary Nitrate on Vascular Function in Chronic Kidney Disease
Author(s) -
Ramick Meghan G.,
Kirkman Danielle L.,
Stock Joseph M.,
Muth Bryce J.,
Chirinos Julio A.,
Edwards David G.
Publication year - 2018
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.2018.32.1_supplement.846.17
Subject(s) - medicine , ingestion , arterial stiffness , brachial artery , crossover study , pulse wave velocity , renal function , blood pressure , kidney disease , placebo , cardiology , pathology , alternative medicine
PURPOSE The purpose of this study was to test the hypothesis that an acute dose of 12.6 mmol dietary nitrate in the form of concentrated beetroot juice (BRJ) would improve measures of microvascular and conduit artery endothelial function in patients with moderate to severe chronic kidney disease (CKD). METHODS Fifteen adults with moderate to severe CKD participated in this double blind, randomized, crossover study (61±4 yrs; 11 males; eGFR 49.2±3.4 ml•min −1 •1.73 m 2 ). Participants reported to the laboratory and baseline blood pressure (BP) was measured and a baseline blood sample obtained for determination of NO metabolites (NOm; Nitrate, nitrite, s‐nitrosothiols and metal bound NO). Participants were then randomized to ingest 12.6 mmol of BRJ or a nitrate depleted placebo (PLA). Vascular testing began 2.5 hours post beverage ingestion. A second blood sample was obtained and post‐ingestion BP was recorded. Microvascular function was assessed via the cutaneous response to local heating measured by laser Doppler flowmetry coupled with microdialysis, and conduit artery function was assessed via brachial artery flow‐mediated dilation (FMD). Arterial stiffness (via carotid‐femoral pulse wave velocity, PWV) was also measured. The entire protocol was repeated a minimum of 7 days later in the other condition. RESULTS Plasma NOm was not different between conditions at baseline but was significantly increased 2.5 hours post BRJ ingestion compared to pre‐ingestion values, as well as compared to post PLA values (PRE PLA 53.0±11.6 POST PLA 33.2±9.9 mM; PRE BRJ 57.3±21.4 vs POST BRJ 1068.0±106.6 mM). Mean arterial pressure (MAP) was not different between conditions at baseline or 2.5 hours post, however the change in MAP from pre‐ingestion baseline to 2.5 hours post ingestion was significantly different between conditions (ΔMAP PLA 2.0±2.1 vs ΔMAP BRJ −3.2±2.6 mmHg, p>0.05). The plateau phase of the cutaneous response to local heating was significantly greater in the BRJ condition compared to PLA (PLA 83.4±2.2 vs BRJ 88.8±1.7%CVC max ; p<0.05). The NOS mediated contribution to the plateau phase as assessed via L‐NAME infusion was not different between conditions. We did not observe any improvements in FMD or PWV. CONCLUSION An acute dose of 12.6 mmol dietary nitrate significantly improves microvascular function in patients with moderate to severe CKD. Support or Funding Information This research was supported by an ACSM Foundation Research Grant from the American College of Sports Medicine Foundation and NIH grant HL113514. This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .