Effect of demeclocycline on renal function and urinary prostaglandin E2 and kallikrein in hyponatremic cirrhotics.
8 cirrhotics with hyponatremia were given demeclocycline (DMC) 900 mg/day to investigate its effect on renal function, plasma renin activity, aldosterone and urinary excretion of prostaglandin E2 and kallikrein. In 7 patients DMC induced an increase of free water clearance (from -0.36 +/- 0.06 to 0.13 +/- 0.06 ml/min) and serum sodium concentration (from 125.4 +/- 0.09 to 131.1 +/- 1.0 mEq/l, mmol/l). In 5 of these patients DMC also induced a marked reduction of glomerular filtration rate (from 72.2 +/- 6.2 to 31,2 +/- 4.7 ml/min) and renal plasma flow (from 468 +/- 98 to 195 +/- 55 ml/min) which could not be explained on the basis of hypovolemia. In each case this renal impairment was not associated with changes in urinary concentration of beta 2-microglobulin, urinary casts excretion, fresh urine sediment or urine protein content and disappeared after discontinuation of the drug. DMC induced a marked increase in the urinary excretion of prostaglandin E2 (from 0.82 +/- 0.27 to 6.16 +/- 1.91 ng/min) in 6 out of the 7 patients who responded to DMC and a marked reduction in urinary kallikrein (from 16.1 +/- 4.4 to 4.2 +/- 1.6 pkat/min) in the 5 patients who developed renal insufficiency. The serum DMC concentration was greater than 5 micrograms/ml in all patients who responded to DMC, greater than 8 micrograms/ml in all cases who developed renal insufficiency and of 3 micrograms/ml in the case not responding to DMC. (ABSTRACT TRUNCATED AT 250 WORDS)
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000503:physiopathology / Q000652:urine; D003707:Demeclocycline / Q000009:adverse effects / Q000494:pharmacology*; D015232:Dinoprostone; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007010:Hyponatremia / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D007610:Kallikreins / Q000652:urine*; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008103:Liver Cirrhosis / Q000150:complications*; D011458:Prostaglandins E / Q000652:urine*; D012084:Renin-Angiotensin System / Q000187:drug effects
D011458:Prostaglandins E; D003707:Demeclocycline; D007610:Kallikreins; D015232:Dinoprostone