The kallikrein-kinin system and prostaglandins in the kidney: their relation to forosemide-induced diuresis and to the renin-angiotensin-aldosterone system in man.

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Abstract
Relations among the renin-angiotensin-aldosterone system, renal prostaglandin[Pg]E, the renal kallikrein-kinin system and furosemide diuresis were studied in 16 healthy volunteers. Diuretic and natriuretic effects of furosemide were accompanied by an increase in excretion rates of urinary Pg E (UPGEV), urinary kallikrein (UKallV) and urinary kinin (UkininV), as well as in plasma renin activity (PRA) and plasma aldosterone concentration (PAC). However, time courses of the increase in PRA and PAC following furosemide administration and assumption of an upright posture were different from those of UPGEV, U kallV, UkininV, urine flow (UV), and urinary Na output (UNaV). In comparison with the early increase in UPGEV, UkallV, UkininV, UV and UNaV, increases in PRA and PAC were delayed. Augmentation of UPGEV, UkallV, and UkininV was closely related to diuretic and natriuretic effects of furosemide. Highly significant correlations were found between UPGEV and UkallV, UPGEV and UkininV, and UkallV and UkininV. There were no significant correlations between UPGEV and PRA or PAC, between UkalLV and PRA or PAC, or between UkininV and PRA or PAC before and after the furosemide injection. Augmentation of urinary PgE and urinary kallikrein-kinin system following furosemide administration may be independent of the renin-angiotension-aldosterone system but directly dependent on effects of furosemide. Renal PgE and the renal kallikrein-kinin system may be involved in diuretic and antriuretic effects of furosemide.