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Statins improve cardiovascular survival in both nondia-betic and diabetic patients, but diabetic patients benefit more, in both primary and secondary prevention. Statins seem to have multiple effects beyond cholesterol lowering, that is, pleiotropic effects that may include changes in renal function. This study tests the hypothesis that acute treatment with atorvastatin may change glomerular filtration rate, tubular function, vasoactive hormones, blood pressure, and pulse rate in patients with type 2 diabetes. In an acute, randomized, placebo-controlled, double-blinded, crossover trial, the effects of atorvastatin on renal function, vasoactive hormones, blood pressure, and pulse rate are measured in 21 patients with type 2 diabetes. Patients are randomized to either 2 doses of atorvastatin 80 mg or placebo before 2 different study days. Treatment with atorvastatin induces a significant reduction in fractional sodium excretion compared with placebo, and sodium clearance tends to be reduced. No significant differences in glomerular filtration rate, albumin/creatinine ratio, vasoactive hormones, and blood pressure by acute treatment with atorvastatin are found in diabetic patients. Acute treatment with atorvastatin reduces renal fractional sodium excretion in patients with type 2 diabetes. No changes are measured in glomerular filtration rate, albumin/creatinine ratio, vasoactive hormones, and blood pressure. [ABSTRACT FROM AUTHOR]

OBJECTIVE The effect of food ingestion on the gastrointestinal absorption and antidiuretic action of oral desmopressin. An oral preparation of desmopressin, a synthetic analogue of vasopressin, has recently become available for clinical use. DESIGN A randomized, single-blind, crossover study with four treatment arms. Day A, no meal + placebo; B, no meal + 400 μg oral desmopressin; C, standard meal + 400 μg oral desmopressin; D, standard meal + 400 μg oral desmopressin after 1.5 hours. Plasma desmopressin was measured every 15–30 minutes for 6 hours after drug intake. An intravenous hydration regimen was employed on each study day. SUBJECTS Sixteen healthy, non-smoking, men aged 20–35 years (mean 27.8 years). MEASUREMENTS Plasma desmopressin concentrations were measured throughout each study day to calculate the area under the desmopressin plasma-concentration–time curve to infinity (AUCinf ), the maximum plasma desmopressin concentration (Cmax ), the time at which Cmax was reached (Tmax ) and the time at which plasma desmopressin was first detected (Tlag ). Urine volume, urine osmolality and plasma sodium concentrations were also measured at specified times on each study day. RESULTS The total absorption of oral desmopressin, reflected by the AUCinf , was significantly higher when taken during the fasting state (day B) compared with its administration with or 1.5 hours after a standard meal (days C and D). In addition, Cmax was higher and both Tmax and Tlag were shorter on day B compared with days C and D. No effect of food ingestion was observed on the pharmacodynamics of oral desmopressin: urine volume was decreased and urine osmolality was increased to similar extents on all active treatment days (B, C and D). No significant reductions in plasma sodium concentrations (a safety parameter) was observed during the trial.... [ABSTRACT FROM AUTHOR]

Aims To investigate the acute effects of prostacyclin (Flolan® ) on renal haemodynamics, renal tubular function, plasma concentration of angiotensin II (Ang II), aldosterone (Aldo), atrial natriuretic peptide (ANP), arginine vasopressin (AVP), mean arterial blood pressure (MBP), and heart rate (HR). Methods Thirteen healthy control subjects were investigated on two separate occasions in a placebo controlled, randomized, dose-response study of the effect of intravenous infusion of prostacyclin (PGI2, Flolan®, 2, 4 and 8 ng kg−1min−1 ). Glomerular filtration rate (GFR) and renal plasma flow (RPF) were measured by the use of constant infusion of []> 51Cr]-EDTA and [125I]-hippurane. Urinary output, urinary sodium excretion, fractional sodium excretion, fractional lithium excretion were measured and hormones were measured using radioimmunoassay. Results During prostacyclin (PGI2 ) infusion we observed a significant increase in RPF (PGI2: 4.8%; 6.1% and 5.2%vs Plac: −1.5%; −1.9% and −5.8% for 2,4 and 8 ng kg−1min−1 respectively; P≤0.05 for 4 and 8 ng kg−1min−1 ) in Ang II (PGI2: 20.0%; 42.9% and 88.9%vs Plac: 0.1%; 8.0% and 0.0%, P≤0.01 for 4 and 8 ng kg−1 min−1 ) in ANP (PGI2: 13.6%; 12.7% and 37.5%vs Plac: −10.2%; −6.6% and −2.4%, P≤0.05 for 2 ng kg−1min−1 and P≤0.01 for 4 and 8 ng kg−1min−1 ), and in HR (PGI2: 8.8%; 17.6% and 32.7%vs Plac: 0.8%; 4.1% and 3.5%, P≤0.05 for 2 and P≤0.01 for 4 and 8 ng kg−1min−1.). A significant decrease was observed in MBP (MBP:PGI2: −1.7%; −1.9% and −5.6%vs Plac: −0.4%; −1.6% and +2.1%, P≤0.01 for 8 ng kg−1min−1 ). No significant changes were seen in the other effect variables. Conclusions Infusion of prostacyclin in healthy control subjects increases renal plasma flow, angiotensin II, atrial natriuretic peptide, and heart rate and decreases mean blood pressure. Furthermore prostacyclin infusion does not change net sodium excretion in healthy controls. [ABSTRACT FROM AUTHOR]