The Furosemide Effects on Renal Blood Flow of Cats Treated with Indomethacin / 대한신장학회잡지

ABSTRACT

Indomethacin, a prostaglandin synthetase inhibitor, is widely used for constriction or closure of patent ductus arteriosus in premature infants. Following indomethacin therapy, a majority of the infants develop transient renal dysfunction, as manifested by decrease in urine output, glomerular filtration rate, fractional excretion of sodium and free water clearance. A decrease in urinary excretion of prostaglandins also has been noted in premature infants following indomethacin therapy. Furosemide , on the other hand, has recently been shown to increase urinary excretion of prostaglandins. The hemodynamic and tubular effects of furosemide have been proposed to be mediated by renal prostaglandins. Therefore, the present study was conducted to determine if furosemide therapy would prevent the changes of renal blood flow which are considered indomethacin effects. The results obtained are as follows 1) In the non-furosemide group, after indomethacin administration renal blood flow decreased to its lowest level, 30 minutes, and then recovered its baseline level at 90 minutes(P<0.05). But there were no significant changes in the furosemide-treated group. 2) After indomethacin administration, urinary prostaglandin E2 decreased to its lowest level at 90 minutes in the non-furosemide group(P<0.05), but there was no significant changes in the furosemide- treated group. 3) Plasma renin activity did not change in the non-furosemide group, while measuring significantly higher in the treated group(P<0.05). 4) Antidiuretic hormone(ADH) level was increased significantly in the non-furosemide group(P<0.05), while did not change in the furosemide-treated group. 5) There was no significant changes on plasma aldosterone blood pressure, electrolytes, BUN,and creatinine. These findings of our present study may have clinical implications when indomethacin is to be used to close the ductus in premature infants. In such cases, simultaneous administration of furosemide may prevent some effects on renal blood flow of indomethacin but further clinical studies are necessary to recognize whether this furosemide therapy may affect the efficacy of indomethacin in the closure of the ductus arteriosus.