Urinary Prostaglandins and Renal Function in Obstructive Jaundice

Abstract

Changes in urinary prostaglandin E₂ (PGE₂), 6–keto PGF_1α, and thromboxane (TXB₂) excretion in 12 patients with obstructive jaundice were observed in relation to renal function and the renin-angiotensin (R-A) system. In obstructive jaundice before percutaneous biliary drainage the creatinine clearance (C_Cr) was significantly lower (p < 0.001) and the PGE₂ and plasma angiotensin II (AII) concentrations were significantly higher (p < 0.005 and p < 0.005, respectively) than those in normal subjects. Both 6–keto PGF_1α and TXB₂ were widely distributed. When C_cr returned to normal after drainage, PGE₂ and plasma AII also returned to normal, but when C_cr decreased after drainage, PGE₂ and plasma AII increased. Before drainage, PGE₂ correlated negatively with C_cr (r = -0.72, p < 0.01) and positively with plasma A11 (r = 0.69, P < 0.02). 6–Keto PGF_1α correlated positively with serum total bilirubin (r = 0.66, p < 0.02). The percentage change in PGE₂ after drainage correlated negatively with that in C_Cr (r = -0.95, p < 0.005). The percentage change in plasma AII correlated positively with that in urine PGE₂ (r = 0.94, p < 0.005) and negatively with that in C_cr (r= -0.85, p < 0.02). These results suggest that PGE₂ is closely related to the R-A system and might assist in the maintenance of renal circulation in obstructive jaundice.

Key Words:

• Obstructive jaundice
• prostaglandin
• renal function
• renin-angiotensin system