[High-dosage aprotinin (Trasylol) therapy--is it safe for the kidney?]

In canine experiments the infusion of 50000 KIE/kg body weight aprotinin (Trasylol) resulted in a transient significant reduction of sodium resorption and a lower potassium excretion. This functional impairment coincides with the accumulation of 90% of the infused aprotinin in the proximal tubular cells of the kidney, which has been reported in the literature. Glomerular filtration as well as kidney perfusion and PAH secretion (measured by clearances of inulin or creatinine and PAH) did not change significantly during 24 h following the application of aprotinin. Thus in normothermia in normal kidneys the functional changes following a single infusion of a high dosage of aprotinin are small and transient. The severe damage seen in aprotinin loaded kidneys preserved hypothermically thus seems to be confined to the hypothermic situation.