Prostaglandins: Modulators of Renal Function and Pressor Resistance in Chronic Liver Disease*

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Abstract
Prostaglandins may modulate renal function and play a role in the hyperreninism and angiotensin pressor resistance of chronic liver disease. To study this possibility, we evaluated 12patients with alcoholic cirrhosis and ascites. Urine immunoassayable prostaglandin E in 5 female patients was 3.3 ± 0.5 μg/day [normal, 0.3 ± 0.1 (SE)], renin was 14.6 ± 3.7 ng/ml. h, and aldosterone was 76 ± 19 ng/dl. After either indomethacin (200 mg) or ibuprofen (2000 mg) for 1 day, urine immunoassayable prostaglandin E fell to 0.8 ± 0.4 μg/day, renin to 8.0 ± 2.4 ng/ml. h, and aldosterone to 54 ± 14 ng/dl (all P < 0.01). Pressor sensitivity increased dramatically, and creatinine clearance transiently fell from 73 ± 10 to 32 ± 7 cc/min (P < 0.01). Because a primaryeffect on renin might explain the renal impairment, an additional study used propranolol to lower renin activity. Renal function was unaltered by propranolol. We conclude that prostaglandins play a supportive role in maintaining renal function and are involved in the hyperreninism and pressor resistance of patients with liver disease.