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Table 5 Animal and human studies investigating the effects of inhaled nitric oxide (iNO) on the kidneys

From: Inhaled nitric oxide therapy and risk of renal dysfunction: a systematic review and meta-analysis of randomized trials

Study (year)


Protocols of iNO

Main findings

Valvini (1995) [38]


40 ppm for 3 days followed by 90 ppm for 2 days

1. Inhaling 40 ppm nitric oxide would result in a daily nitrogen oxide load of about 25 mmol.

2. Impairment of renal function would cause an increase in serum nitrogen oxides.

Troncy (1997) [9]


40 ppm iNO

Inhaled nitric oxide increased renal blood flow, glomerular filtration rate and urinary flow.

Preiser (1998) [37]


1 to 20 ppm

1. Renal excretion of NO2 and NO3 was unaltered by nitric oxide inhalation.

2. Long-term nitric oxide inhalation was associated with a consistent increase in the NO3 plasma concentration.

Wraight (2001) [36]


40 ppm for 2 h

Inhaled nitric oxide may alter tubular salt and water resorbtion.

Kielbasa (2001) [35]


49 or 107 ppm iNO for 4 h

High dose of iNO increased nitric oxide synthase III protein expression, and nitrotyrosine and phosphotyrosine immunoreactivity.

Da (2007) [34]


30 ppm iNO for 3.5 h

Decreased swelling and necrosis of glomeruli.

Gozdzik (2009) [33]


40 ppm iNO for 30 h

1. Transient natriuretic effect.

2. Renal tubular apoptosis promotion after 30 h of iNO treatment.

Göranson (2014) [44]


30 ppm iNO for 30 h

Combined therapy with iNO and intravenous steroid is associated with partial protection of kidney function.