Aspirin-induced depression of glomerular filtration rate in normal humans: role of sodium balance.
The renal clearance of endogenous creatinine, inulin and para-aminohippurate was measured in 10 healthy human volunteers taking aspirin during severe dietary sodium restriction (10 meq/d) to clarify the clinical significance and pathophysiology of aspirin-induced changes in renal function. Sodium restriction alone had no effect on renal clearances but did increase plasma renin activity and urinary prostaglandin E excretion. The addition of aspirin decreased the urinary clearance of prostaglandin E but not plasma renin activity, and caused a significant fall in both endogenous creatinine (from 92.3 +/- 4.1 SE ml/min . 1.73 m2 body surface area to 80.8 +/- 4.4 mL/min . 1.73 m2, p = 0.02) and inulin (from 95.3 +/- 7.0 mL/min . 1.73 m2 to 80.9 +/- 7.0 mL/min . 1.73 m2, p less than 0.001). The fall in inulin clearance was directly related to the salicylate level. The clearance of para-aminohippurate showed only a slight, statistically insignificant decline with aspirin. The results of this study suggest that aspirin-induced depression of glomerular filtration rate may be independent of total renal plasma flow. Aspirin should be used cautiously, with careful attention to dosage, in sodium-restricted patients whose glomerular filtration rate may, in part, be under the homeostatic control of renal prostaglandins.
D000328:Adult; D001241:Aspirin / Q000009:adverse effects* / Q000097:blood; D003864:Depression, Chemical; D004032:Diet; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D007444:Inulin / Q000378:metabolism; D007678:Kidney Glomerulus / Q000378:metabolism; D008297:Male; D008657:Metabolic Clearance Rate / Q000187:drug effects; D009318:Natriuresis / Q000187:drug effects; D011458:Prostaglandins E / Q000652:urine; D012083:Renin / Q000097:blood; D012964:Sodium / Q000378:metabolism*; D010130:p-Aminohippuric Acid / Q000378:metabolism
D011458:Prostaglandins E; D007444:Inulin; D012964:Sodium; D012083:Renin; D001241:Aspirin; D010130:p-Aminohippuric Acid