A double blind comparison of naproxen and sulindac in female patients with heart failure.
The objective of this investigation was to study the effects of the two NSAIDs sulindac and naproxen on renal hemodynamics and excretion of water, salt and the prostacyclin metabolite 6-keto-PGF1 alpha in patients with well controlled congestive heart failure. Ten elderly females with congestive heart failure treated with oral furosemide were given four doses of sulindac and naproxen every twelve hours after a control day in a double-blind cross-over fashion. Naproxen significantly decreased the urinary excretion of water (19%), sodium (26%), chloride (26%), 6-keto-PGF1 alpha (76%) and decreased osmolal clearance by 18%. Sulindac had no significant effect on those parameters. There were no significant changes in glomerular filtration rate, renal blood flow, plasma renin activity, plasma aldosterone, free-water clearance or clearance of furosemide with either treatment. We conclude that renal prostaglandins are involved in the control of sodium excretion and urinary volume in patients with congestive heart failure even if renal hemodynamics are unaffected. Sulindac seems to be a selective inhibitor of extrarenal cyclooxygenase and consequently an appropriate drug for patients who require both diuretics and anti-inflammatory therapy.
D015121:6-Ketoprostaglandin F1 alpha / Q000652:urine; D000368:Aged; D002712:Chlorides / Q000652:urine; D002986:Clinical Trials as Topic; D004231:Diuresis / Q000187:drug effects; D004311:Double-Blind Method; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006333:Heart Failure / Q000503:physiopathology* / Q000652:urine; D006801:Humans; D007192:Indenes / Q000494:pharmacology*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D009288:Naproxen / Q000494:pharmacology*; D012964:Sodium / Q000652:urine; D013467:Sulindac / Q000494:pharmacology*
D002712:Chlorides; D007192:Indenes; D013467:Sulindac; D009288:Naproxen; D015121:6-Ketoprostaglandin F1 alpha; D012964:Sodium