0 20 40 60 80 Increase In RVR above control, %

Impaired production of endothelium-dependent nitric oxide (EDNO) contributes to the vasoconstriction associated with established acute renal failure (ARF). Ischemia-reperfu-sion injury in the isolated erythrocyte-perfused kidney induced persistant intarenal vasoconstriction. The endothelium-independent vasodilators (atrial natriuretic peptide [ANP] and nitroprusside) administered during the reflow period caused vasodilation and restored the elevated intrarenal vascular resistance (RVR) to normal. In marked contrast, two endothelium-dependent vasodilators (acetylcholine and A23187) had no effect on renal vascular resistance after ischemia-reflow. These data suggest that EDNO production is impaired following ischemic injury and that this loss of EDNO activity contributes to the vasoconstriction associated with ARF. (Adapted from Lieberthal [11]; with permission.)

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