Comparative Effect of PGE2 and PGI2 on Renal Function

Abstract Rapid degradation of prostacyclin (PGI2) inherent to its molecular structure has long been a major limitation in assessing the natriuretic effect of this prostaglandin. The recent availability of the stable PGI2 analogue iloprost now allows for a comparative study with prostaglandin E2 (PGE2). In the present study conducted in six anesthetized dogs, the intrarenal effects of two consecutive doses (1 and 4 ng · kg−1 · min −1) of PGE2 on renal blood flow, glomerular filtration rate, and urinary sodium excretion were compared with the effects of two identical doses of iloprost. The selected doses of PGE2 were those producing a maximal natriuretic and vasodilator response without affecting mean arterial pressure. A washout period was allowed between administration of PGE2 and iloprost. PGE2 infusion significantly increased fractional sodium excretion from 0.69±0.1 to 2.79±1.1% and 4.27±1.2%% ( P <.05), respectively. These changes in fractional sodium excretion induced by PGE2 were associated with significant increases in renal blood flow from 151.1±62 to 185±64.3 and 185.6±64.3 mL/min ( P <.05), respectively; however, no significant alterations were seen in glomerular filtration rate, from 29.5±9.4 to 35.2±12.2 and 32.7±7.8 mL/min (NS), and mean arterial pressure, from 117.6±26 to 113.9±24.1 and 112.3±24.1 mm Hg (NS) during control and PGE2 infusion. At identical doses, sequential infusion of PGI2 had no effect on renal blood floww and glomerular filtration rate, producing natriuresis only at the highest dose, a fractional sodium excretion from 0.69±0.1 to 0.8±0.28 mm Hg (NS) and 1.05±0.34% ( P <.05), respectively. In conclusion, the present study confirms that PGE2 exerts a natriuretic effect during increases in renal blood flow. In contrast, PGI2 had no hemodynamic effect, and the natriuresis was markedly blunted.