dinoprost and Nephrotic-Syndrome

The increased permeability of the glomerular capillary wall in adriamycin nephropathy may be mediated by increased generation of free radicals, possibly also by the non-enzymatic production of isoprostanes induced by oxidative stress. ACE inhibitors and angiotensin II antagonists may reduce proteinuria, perhaps by decreasing intraglomerular pressure and increasing the selective permeabiity of the glomerular capillary wall.. We compared the effect of an ACE inhibitor, enalapril, and an angiotensin II antagonist, losartan, on total malodialdehyde in blood and the urinary excretion of certain eicosanoids and their metabolites (TxB(2), 6-keto-PGF(1alpha), bicyclo-PGE(2) and 8-isoprostane) in experimental adriamycin-induced nephrotic syndrome in rats.. Increased proteinuria in adriamycin-treated rats was not prevented by losartan, but tended to be partly mitigated by enalapril. However, both losartan and enalapril prevented the adriamycin-induced increase of total MDA in serum, but urinary excretion of 8-isoprostane was increased in nephrotic rats treated by losartan compared to controls. The enalapril-induced increase in urinary excretion of bicyclo-PGE(2) was possibly mediated by kinins. Proteinuria positively correlated with urinary excretion of 8-isoprostane, and proteinuric rats also had a significantly higher urinary excretion of 8-isoprostane than non-proteinuric rats.. Proteinuria in the acute phase of adriamycine nephropathy may be dependent on free radical generation and the formation of 8-isoprostane. The mild antiproteinuric effect of enalapril, but not losartan, may suggest the contributory role of the inhibition of kinin degradation in the antiproteinuric action of enalapril in this model of nephrotic syndrome.

Topics: Angiotensin II; Angiotensin-Converting Enzyme Inhibitors; Animals; Dinoprost; Enalapril; F2-Isoprostanes; Losartan; Nephrotic Syndrome; Rats

The nephrotic syndrome (NS) is associated with an increased risk of coronary heart disease. Increased oxidant stress may contribute to this by means of hyperlipidaemia and/or hypoalbuminaemia. In this study we assessed the contributory role of oxidant stress, as measured by F(2)-isoprostanes and plasma oxygen radical absorbance capacity (ORAC), in subjects with NS.. We studied 14 subjects with NS and 17 age- and sex-matched healthy non-proteinuric controls. Measurement of plasma and urinary F(2)-isoprostanes was carried out using a combination of silica and reverse-phase cartridges, high-performance liquid chromatography, and gas chromatography mass spectrometry using electron-capture negative ionization. The plasma ORAC assay measured the decrease in fluorescence of phycoerythrin added to plasma in the presence of a free-radical generator. The ORAC value (microM) was calculated as the ratio of the area under the fluorescence decay curve for plasma to the area under the fluorescence decay curve for a Trolox standard.. Plasma ORAC was significantly lower in NS patients compared with controls: mean (standard error) NS patients 3306 microM (286); controls 4882 microM (496), P=0.011. In univariate linear regression analysis, plasma albumin was significantly positively correlated with plasma ORAC (r=0.40, P=0.03). Plasma and urinary F(2)-isoprostanes did not differ significantly between NS and control groups.. This study demonstrates that in the NS there is decreased free-radical trapping capacity of plasma that is inversely correlated with hypoalbuminaemia, but no increase in plasma and urinary F(2)-isoprostanes. Decreased total plasma antioxidant potential in combination with hyperlipidaemia may contribute to the increased risk of cardiovascular disease seen in NS.

Topics: Absorption; Adult; Aged; Blood Physiological Phenomena; Cross-Sectional Studies; Dinoprost; F2-Isoprostanes; Female; Humans; Male; Middle Aged; Nephrotic Syndrome; Oxidative Stress; Reactive Oxygen Species; Reference Values

Increased permeability of glomerular capillary wall in adriamycin nephropathy may be mediated by increased generation of free radicals and possibly also by the non-enzymatic production of isoprostanes induced by oxidative stress. ACE inhibitors may reduce proteinuria, possibly due to the decrease of intraglomerular pressure and increased permselectivity of the glomerular capillary wall. These effects may be partly mediated by the inhibition of the degradation of kinins. It is not clear if newly available angiotensin II antagonists have the same antiproteinuric and renoprotective effects.. We compared the effect of an ACE inhibitor (enalapril, 0.4 mg/kg bw i.p. daily for 3 weeks) and angiotensin II antagonist (losartan, 2 mg/kg bw in the same way) on experimental nephrotic syndrome induced in rats by the administration of adriamycin (5 mg/kg bw i.v. in a single dose). To elucidate the potential differences between these two drugs we also measured total malondialdehyde in blood and urinary excretion some eicosanoids and their metabolites (TxB2, 6-keto-PGF1alfa, bicyclo-PGE2 and 8-isoprostane). Proteinuria increased in adriamycin treated rats after 3 weeks from 0.18 +/- 0.01 to 0.44 +/- 0.14 g/mmol creat, p < 0.01. This increase was not prevented by losartan (increase from 0.18 +/- 0.12 to 0.50 +/- 0.11 g/mmol creat, p < 0.05), but tended to be partly blunted by enalapril (increase from 0.20 +/- 0.10 to only 0.32 +/- 0.08 g/mmol creat, p < 0.05). Similarly there was no increase of serum cholesterol, only in enalapril treated rats. On the other hand, both losartan (1.27 +/- 0.13 vs. 1.91 +/- 0.30 mumol/l, p < 0.05) and enalapril (0.93 +/- 0.06 mumol/l, p < 0.001) prevented adriamycin induced increase of total MDA in serum, but urinary excretion of 8-isoprostane was increased in nephrotic rats treated by losartan compared to controls. Enalapril induced increase of urinary excretion of bicyclo-PGE2 (4.32 +/- 0.62 vs. 1.66 +/- 0.81 ng/mmol creat, p < 0.001) was possibly mediated by kinins. There was no significant difference in the urinary excretion of other eicosanoids between different groups, but proteinuria correlated positively with urinary excretion of 8-isoprostane (p < 0.01). Proteinuric rats had also significantly higher urinary excretion of 8-isoprostane than non-proteinuric rats (44.8 +/- 7.1 vs. 26.7 +/- 3.4 ng/mmol. creat, p < 0.05).. Our data suggest that proteinuria in adriamycin nephropathy may mainly depend on free radical generation and the formation of 8-isoprostane. Haemodynamic parameters (glomerular pressure) do not seem to be so important. The mild antiproteinuric effect of enalapril may suggest a contributory role of the inhibition of kinin degradation in this model of nephrotic syndrome.

Topics: Angiotensin II; Angiotensin-Converting Enzyme Inhibitors; Animals; Dinoprost; Doxorubicin; Eicosanoids; Enalapril; F2-Isoprostanes; Losartan; Male; Nephrotic Syndrome; Proteinuria; Rats; Rats, Wistar

In accordance with the results of examining 40 children with nephrotic and mixed glomerulonephritis, it has been established that in the pathogenesis of the nephrotic syndrome of paramount importance is imbalance of the output of renal prostanoids, manifesting in the predominance of the vasopressor and proaggregate fraction--thromboxane A2 and in the deficiency of its antagonist prostacyclin that exerts a protective action on glomerular filtration. Sodium and water retention in patients with the nephrotic syndrome favours an increase of the content of antidiuretic hormone and plasma renin activity.

Topics: 6-Ketoprostaglandin F1 alpha; Child; Circadian Rhythm; Dinoprost; Dinoprostone; Humans; Nephrotic Syndrome; Renin-Angiotensin System; Thromboxane B2; Vasopressins; Water-Electrolyte Balance

The urinary excretion rate of prostaglandin E2 (PGE2) and prostaglandin F2 alpha (PGF2 alpha) was determined in patients with the nephrotic syndrome both before and after an oral water load in 21 patients and 17 control subjects, and before and after remission of the syndrome in 8 of the patients. In the nephrotic syndrome PGE2 excretion rate varied considerably during basal conditions, remission was accompanied by an increase in the PGE2 excretion, and both basal PGF2 alpha excretion rate and the normal response in PGF2 alpha water loading were reduced. A significant, positive correlation was found between urine flow rate and excretion rate of PGE2 in the periods with the largest urine flow rate in both patients and control subjects. It is suggested that a relatively suppressed renal prostaglandin production may be a pathogenetic factor for sodium and water retention in the nephrotic syndrome, although it cannot be excluded that the abnormal prostaglandin excretion pattern is secondary, at least partially, to the reduction of urine flow rate.

Topics: Adult; Aged; Blood Pressure; Body Water; Dinoprost; Dinoprostone; Drinking; Female; Humans; Male; Middle Aged; Nephrotic Syndrome; Prostaglandins E; Prostaglandins F; Proteinuria; Urodynamics

In children in the acute phase of steady state edema in minimal change nephrotic syndrome renal prostaglandin synthesis as determined by urinary PGE2 and PGE2alpha excretion was evaluated. Age matched healthy children served as controls. In our patients highly significantly increased PGF2alpha excretion accompanied by high urinary aldosterone excretion with normal PGE2 were found. It is possible that abnormal prostaglandin synthesis within the kidney may play a role in pathogenesis of minimal change nephrotic syndrome.

Topics: Aldosterone; Child; Child, Preschool; Dinoprost; Dinoprostone; Female; Humans; Infant; Kidney; Male; Nephrotic Syndrome; Prostaglandins E; Prostaglandins F