American Journal of Kidney Diseases
Volume 44, Issue 3 , Page 574, September 2004

In reply

  • Matthias Lorenz, MD

      Affiliations

    • Department of Internal Medicine III, Division of Nephrology, University Hospital Vienna, Vienna, Austria
    • ,
  • Elke Billensteiner

      Affiliations

    • Department of Internal Medicine III, Division of Nephrology, University Hospital Vienna, Vienna, Austria
    • ,
  • Martin Bodingbauer, MD

      Affiliations

    • Department of Internal Medicine III, Division of Nephrology, University Hospital Vienna, Vienna, Austria
    • ,
  • Rainer Oberbauer, MD

      Affiliations

    • Department of Internal Medicine III, Division of Nephrology, University Hospital Vienna, Vienna, Austria
    • ,
  • Walter H. Hörl, MD

      Affiliations

    • Department of Internal Medicine III, Division of Nephrology, University Hospital Vienna, Vienna, Austria
    • ,
  • Martin Haas, MD

      Affiliations

    • Department of Internal Medicine III, Division of Nephrology, University Hospital Vienna, Vienna, Austria

Article Outline

 

We thank Drs Keven and Ekmekçi for their comments on our article. Adenosine, similar to other factors, such as nitric oxide1 or thromboxane,2 seems to have a role in the physiology of the tubuloglomerular feedback mechanism. However, because angiotensin-converting enzyme inhibitors and angiotensin II blockers do not influence adenosine levels, any potentially protective effect from these agents could not be explained through this mechanism. One could argue that they counteract the vasoconstriction of adenosine, but direct modulation of renin release probably is much more effective. However, we believe it would be too early to postulate a true protective effect of angiotensin-converting enzyme inhibitors or angiotensin II blockers on posttransplantation kidney function. Our results rather should be interpreted as evidence for the safety of the administration of these drugs immediately after transplantation.

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References 

  1. Welch WJ, Wilcox CS, Thomson SC . Nitric oxide and tubuloglomerular feedback . Semin Nephrol . 1999;19:251–262
  2. Welch WJ, Wilcox CS . Potentiation of tubuloglomerular feedback in the rat by thromboxane mimetic (Role of macula densa) . J Clin Invest . 1992;89:1857–1865

PII: S0272-6386(04)00964-3

doi:10.1053/j.ajkd.2004.07.003

Refers to article:

  • The effect of ACE inhibitor and angiotensin II blocker therapy on early posttransplant kidney graft function

    Matthias Lorenz, Elke Billensteiner, Martin Bodingbauer, Rainer Oberbauer, Walter H. Hörl, Martin Haas
    American Journal of Kidney Diseases June 2004 (Vol. 43, Issue 6, Pages 1065-1070)

  • Opposing mechanisms in tubuloglomerular feedback

    Kenan Keven, Yakup Ekmekçi
    American Journal of Kidney Diseases September 2004 (Vol. 44, Issue 3, Page 574)

American Journal of Kidney Diseases
Volume 44, Issue 3 , Page 574, September 2004

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