Pressor effects of indomethacin in two anephric patients with chronic hypotension

Two anephric patients with chronic hypotension were treated with indomethacin (150 mg/day). Indomethacin increased supine blood pressures from 63 +/- 4/37 +/- 3 mm Hg (mean +/- SD) to 76 +/- 5/48 +/- 6 mm Hg (patient 1) and 93 +/- 6/47 +/- 6 mm Hg to 112 +/- 8/61 +/- 5 mm Hg (patient 2), P less than .01. Similar changes occurred in standing pressures. The increases in pressures were associated with decreases in blood concentrations of prostaglandins 6-keto-F1 alpha, E2, and F2 alpha, measured by radioimmunoassay. These results suggest that indomethacin may raise blood pressure in certain anephric patients by inhibiting synthesis of extra-renal, vasoactive prostaglandins. Indomethacin may be useful in the treatment of chronic hypotension in anephric patients.