Study of the role of prostaglandin E2 in urine flow regulation in chronic renal failure.

Objective: This study was carried out to investigate the role of prostaglandin E2 in the regulation of urine flow and ion excretion in patients with chronic renal failure.

Material And Methods: Twenty patients with chronic renal failure (CRF) and 13 healthy people were studied. CRF develops as a terminal stage of glomerulonephritis, pyelonephritis or polycystic renal disease. Osmolality and sodium, potassium, magnesium, calcium and creatinine concentrations were measured in urine and blood serum. Urine prostaglandin E2 was determined using kits for imminoenzyme analysis.

Results: The average creatinine clearance was 19.9 +/- 6.3 ml/min, but it varied from 30 to 10 ml/min in different patients. In patients with CRF a correlation was revealed between diuresis and Na excretion (r = 0.78, p < 0.001) and between Na excretion and PGE2 excretion (r = 0.65, p < 0.001), a correlation that lacking in the healthy subject. A correlation was also found between diuresis and Mg excretion (r = 0.68, p < 0.001) and between Mg excretion and Na excretion (r = 0.83, p < 0.001) in patients with CRF but not in healthy subject.

Conclusion: It is suggested that in patients with CRF who experience a decrease in the glomerular filtration rate (to 75-90% of the normal value) the increase in urine flow is due to prostaglandin-dependent inhibition of ion reabsorption in the thick ascending limb of the loop of Henle.