Effects of indomethacin on renal function in normotensive patients with chronic glomerulonephritis with preserved renal function

Abstract

Thirteen normotensive patients with biopsy verified chronic glomerulonephritis (GN) with preserved renal function and 12 healthy control subjects (CS) were studied before and during prostaglandin synthesis inhibition by indomethacin. Glomerular filtration rate (GFR), renal plasma flow (RPF), urinary output (V), sodium excretion (U_NaV), fractional lithium excretion (ir-ET), plasma levels of angiotensin II (Ang II), aldosterone (Aldo), atrial natiuretic peptide (ANP), arginine vasopressin (AVP) and endothelin (ir-ET) and urinary excretion rates of PGE₂, mean blood pressure (MBP) and heart rate (HB) were determined on two separate occasions at least 7 days apart. During basal conditions without indomethacin administration no significant differences were found between the two groups. Indomethacin administration (lOOmg 12 h and lh before clearance investigations) resulted in significant and almost identical decreases in GFR, RPF, V, U_NaV, FE_Lj and HR and increases in MBP in both the GN group and the CS group.

It is concluded that normotensive patients with a biopsy verified chronic glomerulonephritis but with preserved renal function and without nephrotic syndrome have no increased risk of acute deterioration of renal function during administration of a non-steroidal anti-inflammatory drug compared with healthy control subjects.

Key Words:

• glomerulonephritis
• renal haemodynamics
• sodium excretion
• indomethacin
• angiotensin
• atrial natiuretic peptide
• aldosterone
• arginine vasopressin