Nitric oxide modulates premature renal circulation in hypoxic newborn piglets.

We studied the role of nitric oxide (NO) on the regulation of blood flow in the immature kidney during hypoxia, resuscitation and the recovery period using the NO inhibitor N(omega)-nitro-L-arginine (L-NNA) in a newborn piglet model, and the possibility of urinary cGMP as an index of renal function. After administration of L-NNA, the blood flow in both the cortex and medulla significantly decreased, indicating that NO is constantly released to maintain renal circulation. During hypoxia, the renal blood flow fell remarkably, and there were no differences between the control and L-NNA groups. During the post-resuscitation period, the recovery of renal blood flow was significantly suppressed in L-NNA administration, and it was speculated that NO might be an important factor for recovery of circulation from vasoconstriction due to hypoxemia. Urinary cGMP/cr was significantly increased on recovery from hypoxemia and was suppressed by L-NNA administration. This result suggested that the change in cGMP/cr represents renal blood flow change. We conclude that NO may play an important role in maintaining basal hemodynamics, and may also be a crucial factor for recovery from post-hypoxic vasoconstriction in premature kidneys. Urinary cGMP/cr might serve as one of the indices for assessment of premature renal circulation.