The role of prostaglandins in NSAID induced renal dysfunction

Renal prostaglandins (PG) play an important role in regulating renal hemodynamics and excretory function in 2 conditions (1) which effective arterial blood volume is reduced and (2) chronic renal failure is reduced. The use of nonsteroidal antiinflammatory drugs (NSAID) in patients with these conditions can produce a significant decline in renal function, including decreased glomerular filtration rate and solute and water excretion, by inhibiting renal cyclooxygenase, and thus, PG production. Results of preliminary investigation with the PGE1 analog misoprostol suggest that exogenous PG analogs may be effective in counteracting the effects of NSAID in such settings. Further clinical studies will be needed to establish the role of PG in this setting.