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1.
Bioorg Med Chem Lett ; 62: 128632, 2022 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-35189320

RESUMEN

A series of novel spirocyclic DGAT1 inhibitors containing the oxadiazole motif were designed and synthesized for biological evaluation. Several compounds exhibited potent diacylglycerol acyltransferase 1 (DGAT1) inhibitory activity. Optimization of the series led to the identification of five lead compounds 8, 9, 10, 11 and 12 that showed excellent in-vitro activity with IC50 values ranging from 7 to 20 nM against human DGAT1. All compounds demonstrated good druggability as well as microsomal stability and safety profiles such as hERG and CYP. Compound 12 significantly reduced plasma triglyceride levels in-vivo in the mouse model of acute lipid challenge. Significant reduction in plasma TG excursion was observed, thus indicating DGAT1 inhibition in-vivo.


Asunto(s)
Ácidos Carboxílicos , Diacilglicerol O-Acetiltransferasa , Inhibidores Enzimáticos , Animales , Ácidos Carboxílicos/farmacología , Diacilglicerol O-Acetiltransferasa/antagonistas & inhibidores , Modelos Animales de Enfermedad , Diseño de Fármacos , Inhibidores Enzimáticos/farmacología , Ratones , Oxadiazoles/farmacología , Triglicéridos
2.
Can J Physiol Pharmacol ; 100(3): 272-281, 2022 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-35119950

RESUMEN

The activation of Nod-like receptor proteins (NLRP3) containing the pyrin domain inflammasome is a hallmark of the pathogenesis of metabolic disorders. Inhibition of the NLRP3 inflammasome by phytoconstituents has been attempted as a strategy to mitigate these disorders. Therefore, the present study aimed to evaluate the efficacy of an NLRP3 inflammasome inhibitor, parthenolide (PN; 5 mg/kg i.p.) against inflammation and insulin resistance in high-fat diet (HFD) - obese mice. Treatment with PN and pioglitazone (PIO; 30 mg/kg p.o.) attenuated lipopolysaccharide (LPS; 1 ng/ml) - induced elevation of tumor necrosis factor-α and interleukin-1ß in mouse peritoneal macrophages in a dose-dependent manner. Sixty days of PN and PIO treatment marginally reduced obesity-induced insulin resistance in HFD-obese mice. PN treatment also decreased blood glucose from 14th to 60th day, supporting the hypothesis of simultaneous attenuation of inflammation and insulin resistance in obese mice. Thus, PN treatment was also evident with significant improvement in glucose tolerance and peripheral insulin resistance validated through the respective tolerance tests. Therefore, the present study suggests that PN, an NLRP3 inflammasome inhibitor, could be a possible therapeutic agent for attenuating obesity-induced insulin resistance.


Asunto(s)
Dieta Alta en Grasa/efectos adversos , Resistencia a la Insulina , Proteína con Dominio Pirina 3 de la Familia NLR/antagonistas & inhibidores , Obesidad/tratamiento farmacológico , Obesidad/fisiopatología , Sesquiterpenos/farmacología , Animales , Glucemia/metabolismo , Relación Dosis-Respuesta a Droga , Interleucina-1beta/metabolismo , Macrófagos Peritoneales/metabolismo , Masculino , Ratones Endogámicos C57BL , Obesidad/etiología , Pioglitazona/farmacología , Pioglitazona/uso terapéutico , Sesquiterpenos/uso terapéutico , Factor de Necrosis Tumoral alfa/metabolismo
3.
Clin Transl Sci ; 13(1): 57-66, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31343094

RESUMEN

In the last decade, drug development has tackled substantial challenges to improve efficiency and facilitate access to innovative medicines. Integrated clinical protocols and the investigation of targeted oncology drugs in healthy volunteers (HVs) have emerged as modalities with an increase in scope and complexity of early clinical studies and first-in-human (FIH) studies in particular. However, limited work has been done to explore the impact of these two modalities, alone or in combination, on the scientific value and on the implementation of such articulated studies. We conducted an FIH study in HVs with an oncology targeted drug, an Mnk 1/2 small molecule inhibitor. In this article, we describe results, advantages, and limitations of an integrated clinical protocol with an oncology drug. We further discuss and indicate points to consider when designing and conducting similar scientifically and operationally demanding FIH studies.


Asunto(s)
Antineoplásicos/efectos adversos , Enfermedades Cardiovasculares/diagnóstico , Protocolos Clínicos , Inhibidores de Proteínas Quinasas/efectos adversos , Proyectos de Investigación , Administración Oral , Adulto , Antineoplásicos/administración & dosificación , Enfermedades Cardiovasculares/inducido químicamente , Electrocardiografía , Voluntarios Sanos , Neoplasias Hematológicas/tratamiento farmacológico , Humanos , Péptidos y Proteínas de Señalización Intracelular/antagonistas & inhibidores , Masculino , Oncología Médica/métodos , Persona de Mediana Edad , Monitoreo Ambulatorio/métodos , Inhibidores de Proteínas Quinasas/administración & dosificación , Proteínas Serina-Treonina Quinasas/antagonistas & inhibidores , Adulto Joven
4.
Bioorg Med Chem Lett ; 29(16): 2208-2217, 2019 08 15.
Artículo en Inglés | MEDLINE | ID: mdl-31272795

RESUMEN

Targeting nuclear receptor RORγ is recognized to be beneficial in multiple autoimmune disorders. We disclosed new indole analogues as potent RORγ inverse agonists. RO-2 as one of the potent and orally bioavailable compounds was evaluated in various models of autoimmune disorder. It showed potent suppression of downstream markers of RORγt activity in murine and human primary cells, ex vivo PD assay and in multiple animal models of autoimmune diseases. The results indicate the potential of these indole analogues as orally bioavailable small molecule inverse agonists of RORγt, efficacious in various Th17 driven models of autoimmune disorders.


Asunto(s)
Enfermedades Autoinmunes/tratamiento farmacológico , Indoles/química , Miembro 3 del Grupo F de la Subfamilia 1 de Receptores Nucleares/agonistas , Animales , Humanos , Ratones , Modelos Moleculares , Relación Estructura-Actividad
5.
Eur J Med Chem ; 133: 268-286, 2017 Jun 16.
Artículo en Inglés | MEDLINE | ID: mdl-28390958

RESUMEN

Glucokinase activators (GKAs) are among the emerging drug candidates for the treatment of type 2 diabetes (T2D). Despite effective blood glucose lowering in clinical trials, many pan-GKAs "acting both in pancreas and liver" have been discontinued from clinical development mainly because of their potential to cause hypoglycemia. Pan-GKAs over sensitize pancreatic GK, resulting in insulin secretion even at sub-normoglycemic level which might be a possible explanation for hypoglycemia. An alternative approach to minimize the risk of hypoglycemia is to use liver-directed GKAs, which are reported to be advancing well in clinical development. Here, we report the discovery and structure-activity relationship (SAR) studies on a novel 2-phenoxy-acetamide series with the aim of identifying a liver-directed GKA. Incorporation of a carboxylic acid moiety as an active hepatocyte uptake recognizing element at appropriate position of 2-phenoxy-acetamide core led to the identification of 26, a potent GKA with predominant liver-directed pharmacokinetics in mice. Compound 26 on oral administration significantly reduced blood glucose levels during an oral glucose tolerance test (oGTT) performed in diet-induced obese (DIO) mice, while showing no sign of hypoglycemia in normal C57 mice over a 10-fold dose range, even when dosed at fasted condition. Together, these data demonstrate a liver-directed GKA has beneficial effect on glucose homeostasis with reduced risk of hypoglycemia.


Asunto(s)
Activadores de Enzimas/química , Activadores de Enzimas/farmacología , Glucoquinasa/metabolismo , Hiperglucemia/tratamiento farmacológico , Hipoglucemia/inducido químicamente , Hipoglucemiantes/química , Hipoglucemiantes/farmacología , Animales , Glucemia/metabolismo , Células Cultivadas , Activadores de Enzimas/efectos adversos , Activadores de Enzimas/farmacocinética , Humanos , Hiperglucemia/sangre , Hiperglucemia/metabolismo , Hipoglucemia/sangre , Hipoglucemia/metabolismo , Hipoglucemiantes/efectos adversos , Hipoglucemiantes/farmacocinética , Hígado/efectos de los fármacos , Hígado/metabolismo , Ratones Obesos , Simulación del Acoplamiento Molecular , Ratas
6.
Bioorg Med Chem Lett ; 27(8): 1867-1873, 2017 04 15.
Artículo en Inglés | MEDLINE | ID: mdl-28279528

RESUMEN

In a pursuit to identify reversible and selective BTK inhibitors, two series based on 7H-pyrrolo[2,3-d]pyrimidine and 1H-pyrrolo[2,3-b]pyridine as the hinge binding core, have been identified. Structure activity relationship (SAR) exploration led to identification of two advanced lead molecules, 11 and 13, which demonstrated desired BTK inhibitory potency in different cellular assays, excellent selectivity in a panel of 50 diverse kinases, favorable in vivo PK properties in mice and anti-arthritic effect in a mouse model of CIA.


Asunto(s)
Antirreumáticos/química , Antirreumáticos/uso terapéutico , Artritis Reumatoide/tratamiento farmacológico , Inhibidores de Proteínas Quinasas/química , Inhibidores de Proteínas Quinasas/uso terapéutico , Proteínas Tirosina Quinasas/antagonistas & inhibidores , Piridinas/química , Piridinas/uso terapéutico , Pirroles/química , Pirroles/uso terapéutico , Agammaglobulinemia Tirosina Quinasa , Animales , Antirreumáticos/farmacocinética , Antirreumáticos/farmacología , Artritis Reumatoide/enzimología , Humanos , Masculino , Ratones Endogámicos C57BL , Simulación del Acoplamiento Molecular , Inhibidores de Proteínas Quinasas/farmacocinética , Inhibidores de Proteínas Quinasas/farmacología , Proteínas Tirosina Quinasas/metabolismo , Piridinas/farmacocinética , Piridinas/farmacología , Pirroles/farmacocinética , Pirroles/farmacología , Relación Estructura-Actividad
7.
Bioorg Med Chem Lett ; 21(12): 3596-602, 2011 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-21571530

RESUMEN

GPR91, a 7TM G-Protein-Coupled Receptor, has been recently deorphanized with succinic acid as its endogenous ligand. Current literature indicates that GPR91 plays role in various pathophysiology including renal hypertension, autoimmune disease and retinal angiogenesis. Starting from a small molecule high-throughput screening hit 1 (hGPR91 IC(50): 0.8 µM)-originally synthesized in Merck for Bradykinin B(1) Receptor (BK(1)R) program, systematic structure-activity relationship study led us to discover potent and selective hGPR91 antagonists e.g. 2c, 4c, and 5 g (IC(50): 7-35 nM; >1000 fold selective against hGPR99, a closest related GPCR; >100 fold selective in Drug Matrix screening). This initial work also led to identification of two structurally distinct and orally bio-available lead compounds: 5g (%F: 26) and 7e (IC(50): 180 nM; >100 fold selective against hGPR99; %F: 87). A rat pharmacodynamic assay was developed to characterize the antagonists in vivo using succinate induced increase in blood pressure. Using two representative antagonists, 2c and 4c, the GPR91 target engagement was subsequently demonstrated using the designed pharmacodynamic assay.


Asunto(s)
Descubrimiento de Drogas , Receptores Acoplados a Proteínas G/antagonistas & inhibidores , Bibliotecas de Moléculas Pequeñas/síntesis química , Administración Oral , Animales , Concentración 50 Inhibidora , Masculino , Estructura Molecular , Ratas , Ratas Wistar , Bibliotecas de Moléculas Pequeñas/química , Bibliotecas de Moléculas Pequeñas/farmacología
8.
Mol Cell Biochem ; 249(1-2): 53-7, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12956398

RESUMEN

Sarpogrelate, a specific 5-HT2A receptor antagonist is reported to produce a number of beneficial cardiovascular effects in diabetes mellitus. In the present investigation we have studied the effects of sarpogrelate on 5-HT receptors in heart and platelets in streptozotocin (STZ)-diabetic rats. Diabetes was induced by a single tail vein injection of STZ (45 mg/kg) and sarpogrelate (1 mg/kg, i.p.) was administered daily for 6 weeks. Injection of STZ produced significant loss of body weight, polyphagia, polydypsia, hyperglycemia, hypoinsulinemia, hypertension and bradycardia. Treatment with sarpogrelate significantly lowered fasting glucose levels with corresponding increase in insulin levels. It also significantly prevented STZ-induced polydypsia, hyperphagia, hypertension, and bradycardia but not the loss of body weight. 5-HT produced dose-dependent positive inotropic effect that was found to be decreased significantly in STZ-diabetic rats. Hearts obtained from sarpogrelate treated diabetic rats did not show any decrease in responsiveness to 5-HT. Relative platelet aggregation per se was found to be higher in STZ-diabetic rats as compared to control and this was significantly prevented by sarpogrelate treatment. 5-HT produced a dose-dependent increase in platelet aggregation in non-diabetic and sarpogrelate treated diabetic rats. However, 5-HT failed to produce any increase in platelet aggregation in untreated diabetic rats. Our data suggest that STZ-induced diabetes may produce down-regulation of cardiac 5-HT2A receptors and increased platelet aggregation. Treatment with sarpogrelate seems to prevent STZ-induced down-regulation of 5-HT receptors and increase in platelet activity in diabetic rats.


Asunto(s)
Diabetes Mellitus Experimental/inducido químicamente , Serotonina/fisiología , Succinatos/farmacología , Animales , Glucemia/efectos de los fármacos , Miocardio/metabolismo , Agregación Plaquetaria/efectos de los fármacos , Ratas , Receptores de Serotonina/fisiología , Estreptozocina
9.
Mol Cell Biochem ; 249(1-2): 85-90, 2003 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-12956402

RESUMEN

The present investigation was undertaken to study the effect of chronic treatment with angiotensin (AT1) receptor antagonist losartan (2 mg/kg, p.o., 6 weeks) on streptozotocin (STZ) induced (45 mg/kg, i.v., single dose) renal dysfunctions in diabetic rats. Injection of streptozotocin produced not only the cardinal symptoms of diabetes mellitus like loss of body weight, hyperglycemia, and hypoinsulinemia but also the renal dysfunctions. Losartan treatment significantly prevented all these changes except STZ-induced hypoinsulinemia. There was a significant elevation of blood pressure in diabetic rats and treatment with losartan significantly brought it back to normal. Renal dysfunction in diabetic rats was characterized by a significant decrease in creatinine clearance, elevated levels of electrolytes and renal hypertrophy. Treatment with losartan prevented these changes. A good correlation was found between biochemical parameters and histopathological abnormalities. Our data suggests that, losartan may be considered as the drug of choice when there is a co-existence of diabetes mellitus and hypertension with compromised kidney function.


Asunto(s)
Antihipertensivos/uso terapéutico , Diabetes Mellitus Experimental/fisiopatología , Losartán/uso terapéutico , Animales , Presión Sanguínea , Creatinina/sangre , Diabetes Mellitus Experimental/inducido químicamente , Nefropatías Diabéticas , Femenino , Hiperglucemia/tratamiento farmacológico , Hipertensión Renal/tratamiento farmacológico , Riñón/efectos de los fármacos , Riñón/patología , Ratas , Ratas Wistar , Estreptozocina
10.
Clin Exp Hypertens ; 25(4): 221-33, 2003 May.
Artículo en Inglés | MEDLINE | ID: mdl-12797596

RESUMEN

Dopamine and diabetes mellitus are reported to have close link between them. We have studied the effect of six-week treatment with D1 receptor agonist fenoldopam (1 mg/kg, i.p., daily) on glucose, lipid, and renal profile in streptozotocin (STZ)-induced (non-insulin dependent) type 2 diabetic rats. Streptozotocin (90 mg/kg, i.p.) was injected to two day old Sprague-Dawley pups. Streptozotocin produced hyperglycemia, hyperinsulinemia, hyperlipidemia, hypertension, increase in serum urea and creatinine by the time animals were 10 week old. Treatment with fenoldopam significantly decreased serum glucose, insulin, cholesterol, triglyceride, urea, creatinine, and blood pressure. During oral glucose tolerance test (OGTT), diabetic rats showed increase in AUC(glucose) and AUC(insulin). Fenoldopam significantly decreased AUC(glucose) in diabetic rats. Diabetic rats showed lower insulin sensitivity index (K(TTT)) that was significantly increased by treatment with fenoldopam in diabetic rats. Diabetic rats showed decrease in urinary sodium. Fenoldopam treatment significantly increased urine output as well as urinary sodium indicating reduced sodium retention. Our data indicates fenoldopam treatment improves peripheral insulin sensitivity and renal function in STZ-induced type 2 diabetic rats.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Agonistas de Dopamina/farmacología , Fenoldopam/farmacología , Hipertensión Renal/tratamiento farmacológico , Resistencia a la Insulina , Animales , Glucemia , Presión Sanguínea/efectos de los fármacos , Diabetes Mellitus Experimental/tratamiento farmacológico , Insulina/sangre , Riñón/efectos de los fármacos , Riñón/fisiología , Lípidos/sangre , Ratas , Orina
11.
Clin Exp Hypertens ; 25(1): 35-47, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12597523

RESUMEN

Angiotensin II (Ang II) via the activation of AT1 receptors and subsequent stimulation of the tubular sodium transporters increases sodium and water reabsorption in the proximal tubule. An enhanced tubular action of Ang II is implicated in obesity related hypertension; however, the mechanism of such a phenomenon is unknown. Present study was designed to determine the AT1 receptor numbers and function in the proximal tubule of obese and lean Zucker rats. Obese Zucker rats were hypertensive and hyperinsulinemic. The plasma renin activity was similar in the lean and obese rats. Angiotensin II stimulated the Na,H-exchanger (NHE) activity in the proximal tubule, but the stimulatory response was markedly greater in obese than in lean rats. Similarly, Ang II caused greater inhibition in cAMP accumulation in the proximal tubule of obese compared to lean rats. The (125I]sar-Ang II binding revealed a 100% increase in the AT1 receptor number in the brush border membrane (BBM) of obese compared to lean rats. The Western blot analysis revealed a 36-51% increase in the Gi(alpha)1 and Gi(alpha)3 in the BBM of obese compared to lean rats. We conclude that increases in the AT1 receptor number and abundance of the Gi(alpha) on BBM may be responsible for the enhanced signaling and subsequent greater stimulation of NHE by Ang II in proximal tubules of obese rats. The greater stimulation of NHE by Ang II may contribute to the increased tubular sodium reabsorption and to the hypertension in obese Zucker rats.


Asunto(s)
Angiotensina II/análogos & derivados , Obesidad/metabolismo , Receptores de Angiotensina/metabolismo , Angiotensina II/metabolismo , Angiotensina II/farmacología , Animales , Colforsina/farmacología , AMP Cíclico/metabolismo , Proteínas de Unión al GTP Heterotriméricas/metabolismo , Radioisótopos de Yodo , Túbulos Renales Proximales/metabolismo , Ratas , Ratas Zucker , Receptor de Angiotensina Tipo 1 , Intercambiadores de Sodio-Hidrógeno/metabolismo
12.
Hypertension ; 40(6): 880-5, 2002 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-12468573

RESUMEN

Earlier we have reported a defective dopamine D1-like receptor function, which was accompanied by a decrease in D1 receptor numbers and the inability of dopamine to inhibit Na,K-ATPase and Na,H-exchanger in proximal tubules of hyperinsulinemic obese Zucker rats. The present study was designed to test the hypothesis that the defect in dopamine receptor function is a result of hyperinsulinemia in obese rats. We designed experiments to study D1 receptor function in obese Zucker rats treated with rosiglitazone, as it lowers plasma insulin by improving insulin sensitivity. A group of untreated lean and obese rats served as controls. Rosiglitazone treatment (10 mg/kg orally, 4 weeks) caused significant decreases in plasma insulin, blood glucose, and blood pressure while causing an increase in renal sodium excretion compared with untreated obese rats. In the isolated proximal tubules obtained from untreated lean rats, dopamine caused concentration-dependent inhibition of the Na,K-ATPase activity, but this inhibitory effect was absent in untreated obese rats. In rosiglitazone-treated obese rats, the inhibitory effect of dopamine on Na,K-ATPase was significantly restored. This was accompanied by a complete restoration of D1 receptor numbers in proximal tubular membranes of treated obese rats. In another set of experiments, treatment of primary proximal tubule epithelial cells in culture medium with insulin caused a significant decrease in the D1 receptor abundance, suggesting a direct role of insulin on D1 receptor regulation. We conclude that hyperinsulinemia causes downregulation of D1 receptor function and lowering of plasma insulin levels leads to restoration of renal D1 receptor function.


Asunto(s)
Riñón/metabolismo , Obesidad/metabolismo , Receptores de Dopamina D1/metabolismo , Tiazoles/farmacología , Tiazolidinedionas , Animales , Benzazepinas/farmacocinética , Unión Competitiva/efectos de los fármacos , Glucemia/efectos de los fármacos , Presión Sanguínea/efectos de los fármacos , Modelos Animales de Enfermedad , Dopamina/farmacología , Relación Dosis-Respuesta a Droga , Regulación hacia Abajo/efectos de los fármacos , Células Epiteliales/citología , Células Epiteliales/efectos de los fármacos , Células Epiteliales/metabolismo , Glucosa/farmacología , Hiperinsulinismo/sangre , Hiperinsulinismo/tratamiento farmacológico , Hipoglucemiantes/farmacología , Insulina/sangre , Insulina/farmacología , Riñón/efectos de los fármacos , Túbulos Renales Proximales/efectos de los fármacos , Túbulos Renales Proximales/metabolismo , Masculino , Ratas , Ratas Zucker , Rosiglitazona , ATPasa Intercambiadora de Sodio-Potasio/efectos de los fármacos , ATPasa Intercambiadora de Sodio-Potasio/metabolismo
13.
Clin Exp Hypertens ; 24(3): 207-19, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11883792

RESUMEN

We have studied the effect of chronic treatment with dopamine D1 receptor agonist fenoldopam (1 mg/kg, i.p. daily for 6 weeks) on renal function and metabolic parameters in streptozotocin (STZ)-diabetic rats. Diabetes was induced by a single tail vein injection of STZ (45 mg/kg). STZ produced severe hyperglycemia, hypoinsulinemia, hypercholesterolemia, hypertriglyceridemia, hypertension and bradycardia. Fenoldopam treatment significantly reduced fasting but not fed blood glucose levels and lowered the blood pressure in diabetic animals. Significant change was not observed in insulin, cholesterol, triglyceride levels. Diabetic animals showed increase in AUCglucose and decrease in AUCinsulin during oral glucose tolerance test. Fenoldopam treatment did not significantly change these values in diabetic animals. STZ produced increase in serum urea, creatinine and blood urea nitrogen. Diuresis and urinary sodium retention was observed in diabetic animals. Renal hypertrophy was observed as seen from increased kidney weight/body weight ratio and increased total RNA content as well as decreased total DNA content. Fenoldopam treatment significantly lowered serum urea, creatinine and blood urea nitrogen. Urinary sodium retention was significantly reduced and renal hypertrophy was prevented with fenoldopam treatment as seen from the improved kidney weight/body weight ratio. Fenoldopam treatment significantly prevented reduction in total DNA content and increase in total RNA content further substantiating reduced renal hypertrophy. Our data suggest that STZ induced diabetes is associated with renal dysfunctions and fenoldopam treatment could be beneficial in a condition where diabetes mellitus co-exists with hypertension and compromised renal function.


Asunto(s)
Antihipertensivos/farmacología , Diabetes Mellitus Experimental/tratamiento farmacológico , Diabetes Mellitus Experimental/fisiopatología , Fenoldopam/farmacología , Riñón/fisiología , Animales , Glucemia , Presión Sanguínea , Nitrógeno de la Urea Sanguínea , Creatinina/sangre , Femenino , Hiperglucemia/tratamiento farmacológico , Hiperglucemia/fisiopatología , Hipertensión Renal/tratamiento farmacológico , Hipertensión Renal/fisiopatología , Insulina/sangre , Riñón/patología , Masculino , Tamaño de los Órganos , Ratas , Ratas Wistar , Receptores de Dopamina D1/agonistas , Sodio/orina , Urea/sangre , Orina
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