EFFECT OF PROSTAGLANDIN-E(1) ON THE RENIN - ALDOSTERONE SYSTEM IN PATIENTS WITH DIABETIC NEPHROPATHY

The effect of prostaglandin E1 (PGE1) on the renin-aldosterone system was investigated in hospitalized patients with non-insulin-dependent d iabetes mellitus presenting with continuous proteinuria but without ne phrotic syndrome. Of the 20 patients studied, 10 had continuous positi ve proteinuria greater-than-or-equal-to 200 mg/day and 10 had continuo us positive proteinuria < 200 mg/day. Prostaglandin E1 (40 mug in 100 ml normal saline) was infused intravenously over 2 h twice daily for 4 weeks. Plasma renin activity (PRA) and the plasma aldosterone concent ration (PAC) were determined by radioimmunoassay at 0 and 120 min afte r a frusemide injection given before the start of PGE1 treatment and d uring administration of PGE1 in week 4. The patients who had proteinur ia < 200 mg/day showed significant decreases in the PRA0 and the ratio of PRA120:PRA0 and a decrease in the PAC120 during prostaglandin PGE1 administration. When the results for the two patient groups were comb ined, both the PAC120 and the PRA120 were found to be significantly lo wered during administration of PGE1. The results indicate that PGE1 ma y be valuable in the treatment of diabetic nephropathy, since the comp ound inhibited the increased reactivity of the renin-aldosterone syste m in patients with non-insulin-dependent diabetes mellitus.