title: Dose-dependent effects of oral misoprostol on renal function in alcoholic cirrhosis.
abstract: OBJECTIVE
  Prostaglandins are important modulators of renal physiology, particularly when the effective circulatory volume is decreased. The aim of this study was to determine the dose-dependent effects of an oral prostaglandin E1 analogue, misoprostol, on renal function in patients with well-compensated alcoholic cirrhosis.
  
  
  METHODS
  Renal hemodynamics and tubular function were assessed by clearance techniques, before and after 100-microgram, 200-microgram, 400-microgram, or 800-microgram oral doses of misoprostol.
  
  
  RESULTS
  Overall, the results indicate that low-dose misoprostol is vasodilatory, natriuretic, and diuretic whereas high-dose misoprostol increases renal vascular tone and inhibits sodium and water excretion. The 200-microgram dose produced a transient but significant increase in the glomerular filtration rate and effective renal plasma flow and a decrease in renal vascular resistance. Urinary volume and urinary sodium excretion increased and urinary osmolality decreased.
  
  
  CONCLUSIONS
  The results suggest that, in patients with well-compensated cirrhosis, the renal effects of misoprostol are determined by a bell-shaped dose-response curve. The renal vasodilatory, natriuretic, and diuretic potential of 200-micrograms of misoprostol suggests that it may be of therapeutic value in patients with cirrhosis.
authors.affiliation: Department of Gastroenterology, Alfred Hospital, Victoria, Australia.
authors.forename: F
authors.initials: F
authors.lastname: Wong
authors.forename: D
authors.initials: D
authors.lastname: Massie
authors.forename: P
authors.initials: P
authors.lastname: Hsu
authors.forename: F
authors.initials: F
authors.lastname: Dudley
mesh_terms: D000284:Administration, Oral; D001834:Body Water / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology*; D008104:Liver Cirrhosis, Alcoholic / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D016595:Misoprostol / Q000494:pharmacology*; D012079:Renal Circulation; D012964:Sodium / Q000378:metabolism
chemical_list: D016595:Misoprostol; D012964:Sodium