Prostaglandins: modulators of renal function and pressor resistance in chronic liver disease.
Prostaglandins may modulate renal function and play a role in the hyperreninism and angiotensin pressor resistance of chronic liver disease. To study this possibility, we evaluated 12 patients with alcoholic cirrhosis and ascites. Urine immunoassayable prostaglandin E in 5 female patients was 3.3 +/- 0.5 micrograms/day [normal, 0.3 +/- 0.1 (SE)], renin was 14.6 +/- 3.7 ng/ml.h, and aldosterone was 76 +/- 19 ng/dl. After either indomethacin (200 mg) or ibuprofen (2000 mg) for 1 day, urine immunoassayable prostaglandin E fell to 0.8 +/- 0.4 micrograms/day, renin to 8.0 +/- 2.4 ng/mol.h, and aldosterone to 54 +/- 14 ng/dl (all P less than 0.01). Pressor sensitivity increased dramatically, and creatinine clearance transiently fell from 73 +/- 10 to 32 +/- 7 cc/min (P less than 0.01). Because a primary effect on renin might explain the renal impairment, an additional study used propranolol to lower renin activity. Renal function was unaltered by propranolol. We conclude that prostaglandins play a supportive role in maintaining renal function and are involved in the hyperreninism and pressor resistance of patients with liver disease.
D000328:Adult; D000450:Aldosterone / Q000097:blood*; D001201:Ascites / Q000503:physiopathology*; D002908:Chronic Disease; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007052:Ibuprofen; D007213:Indomethacin; D007668:Kidney / Q000503:physiopathology*; D008104:Liver Cirrhosis, Alcoholic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011458:Prostaglandins E / Q000652:urine*; D012083:Renin / Q000097:blood*; D012964:Sodium / Q000652:urine
D011458:Prostaglandins E; D000450:Aldosterone; D012964:Sodium; D003404:Creatinine; D012083:Renin; D007052:Ibuprofen; D007213:Indomethacin