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Prostaglandin inhibitors in the treatment of nephrotic syndrome

  • Practical Pediatric Nephrology
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Abstract

The management of nephrotic syndrome resistant to corticosteroid and cytotoxic therapy is unclear. In such patients, prostaglandin inhibitors can reduce protein-uria. Mechanisms may include a reduction in transcapillary hydraulic pressure and a decrease in capillary wall permeability. The antiproteinuric effect of these agents is enhanced by volume depletion induced by sodium restriction and thiazide diuretics. Complications may include aggravation of edema, hemodynamic renal failure, hyperkalemia, and drug nephrotoxicity. Although a reduction in protein excretion may improve the clinical status of nephrotic patients, it is unclear whether such methods will improve renal survival.

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References

  1. Klahr S, Schreiner G, Ichikawa I (1988) The progression of renal disease. N Engl J Med 318:1657–1666

    PubMed  Google Scholar 

  2. Cameron JS (1990) Proteinuria and progression in human glomerular diseases. Am J Nephrol 10 [Suppl 1]:81–87

    PubMed  Google Scholar 

  3. Hart D, Lifschitz MD (1987) Renal physiology of the prostaglandins and the effects of nonsteroidal anti-inflammatory agents on the kidney. Am J Nephrol 7:408–418

    PubMed  Google Scholar 

  4. Patrono C, Dunn MJ (1987) The clinical significance of inhibition of renal prostaglandin synthesis. Kidney Int 32:1–12

    PubMed  Google Scholar 

  5. Dibona GF (1986) Prostaglandins and nonsteroidal anti-inflammatory drugs. Effects on renal hemodynamics. Am J Med 80 [Suppl 1 A]: 12–21

    Google Scholar 

  6. Raymond KH, Lifschitz MD (1986) Effect of prostaglandins on renal salt and water excretion. Am J Med 80 [Suppl 1 A]:22–32

    Google Scholar 

  7. Gribnau FWJ (1975) Indomethacin in experimental nephritis. Thesis, Drukkerij Brakkenstein, Nijmegen, The Netherlands

    Google Scholar 

  8. Donker AJ (1982) The effect of indomethacin on renal function and glomerular protein loss. In: Dunn MJ, Patrono C, Cinotti GA (eds) Prostaglandins and the kidney. Plenum, New York, p 251

    Google Scholar 

  9. Kirschenbaum MA, Liebross BA, Serros ER (1985) Effect of indomethacin on proteinuria in rats with autologous immune complex nephropathy. Prostaglandins 30:295–303

    PubMed  Google Scholar 

  10. Zoja C, Benigni A, Verroust P, Ronco P, Bertani T, Remuzzi G (1987) Indomethacin reduces proteinuria in passive Heymann nephritis in rats. Kidney Int 31:1335–1343

    PubMed  Google Scholar 

  11. Sessa A, Come F, Cioffi A, D'Amico G (1975) Aminonucleoside nephrosis in rats. Ultrastructural findings in the glomerulus by concomitant influence of indomethacin and aminonucleoside. Nephron 14:299–308

    PubMed  Google Scholar 

  12. Arisz L, Donker AJM, Brentjens JRH, Van der Hem GK (1976) The effect of indomethacin on proteinuria and kidney function in the nephrotic syndrome. Acta Med Scand 199:121–125

    PubMed  Google Scholar 

  13. Donker AJM, Brentjens JRH, Van der Hem GK, Arisz L (1987) Treatment of the nephrotic syndrome with indomethacin. Nephron 22:374–381

    Google Scholar 

  14. Alavi N, Lianos EA, Venuto RC, Mookerjee BK, Bentzel CJ (1986) Reduction of proteinuria by indomethacin in patients with nephrotic syndrome. Am J Kidney Dis 8:397–403

    PubMed  Google Scholar 

  15. Tiggeler RGWL, Hulme B, Wijdeveld PGAB (1979) Effect of indomethacin on glomerular permeability in the nephrotic syndrome. Kidney Int 16:312–321

    PubMed  Google Scholar 

  16. Golbetz H, Black V, Shemesh O, Myers BD (1989) Mechanism of the antiproteinuric effect of indomethacin in nephrotic humans. Am J Physiol 256:F44-F51

    PubMed  Google Scholar 

  17. Garin EH, Williams RL, Fennell RS III, Richard GA (1978) Indomethacin in the treatment of idiopathic minimal lesion nephrotic syndrome. J Pediatr 93:138–140

    PubMed  Google Scholar 

  18. Vriesendorp R, Donker AJM, De Zeeuw D, De Jong PE, Van der Hem GK, Brentjens JRH (1986) Effects of nonsteroidal anti-inflammatory drugs on proteinuria. Am J Med 8 [Suppl 2B]:84–94

    Google Scholar 

  19. Velosa JA, Torres VE, Donadio JV Jr, Wagoner RD, Holley KE, Offord KP (1985) Treatment of severe nephrotic syndrome with meclofenamate: an uncontrolled pilot study. May Clin Proc 60: 586–592

    Google Scholar 

  20. Laurent J, Belghiti D, Bruneau C, Lagrue G (1987) Diclofenac, a nonsteroidal anti-inflammatory drug, decreases proteinuria in some glomerular diseases. A controlled study. Am J Nephrol 7:198–202

    PubMed  Google Scholar 

  21. Vriesendorp R, Donker AJM, De Zeeuw D, De Jong PE, Van der Hem GK (1985) Antiproteinuric effect of naproren and indomethacin. Am J Nephrol 5:236–242

    PubMed  Google Scholar 

  22. Vriesendorp R, De Zeeuw D, De Jong PE, Donker AJM, Pratt JJ, Van der Hem GK (1986) Reduction of urinary protein and prostaglandin E2 excretion in the nephrotic syndrome by non-steroidal anti-inflammatory drugs. Clin Nephrol 25:105–110

    PubMed  Google Scholar 

  23. Carmichael J, Shankel SW (1985) Effects of nonsteroidal anti-inflammatory drugs on prostaglandins and renal function. Am J Med 78:992–1000

    PubMed  Google Scholar 

  24. Pirson Y, Van Ypersele de Strihou C (1986) Renal side effects of nonsteroidal antiinflammatory drugs: clinical relevance. Am J Kidney Dis 8:338–344

    PubMed  Google Scholar 

  25. Abraham PA, Keane WF (1984) Glomerular and interstitial disease induced by nonsteroidal anti-inflammatory drugs. Am J Nephrol 4: 1–6

    PubMed  Google Scholar 

  26. Keane WF, Anderson S, Aurell M, De Zeeuw D, Norins RG, Povar G (1989) Angiotensin converting enzyme inhibitors and progressive renal insufficiency. Ann Intern Med 111:503–516

    PubMed  Google Scholar 

  27. Glassock RJ (1990) Focus on proteinuria. Am J Nephrol 10 [Suppl 1]:88–93

    PubMed  Google Scholar 

  28. Allon M, Pasque CB, Rodriguez M (1990) Acute effects of captopril and ibuprofen on proteinuria in patients with nephrosis. J Lab Clin Med 116:462–468

    PubMed  Google Scholar 

  29. Heeg JE, De Jong PE, Vriesendorp R, De Zeeuw D (1990) Additive antiproteinuric effect of the NSAID indomethacin and the ACE inhibitor lisinopril. Am J Nephrol 10 [Suppl 1]:94–97

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana, USA

    Jerry M. Bergstein

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  1. Jerry M. Bergstein
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Bergstein, J.M. Prostaglandin inhibitors in the treatment of nephrotic syndrome. Pediatr Nephrol 5, 335–338 (1991). https://doi.org/10.1007/BF00867497

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  • DOI: https://doi.org/10.1007/BF00867497

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