EFFECTS OF IMIDAZOLE-SALICYLATE ON RENAL-FUNCTION AND THE DIURETIC ACTION OF FUROSEMIDE IN CIRRHOTIC-PATIENTS WITH ASCITES

Imidazole-salicylate is a non-steroidal anti-inflammatory drug with li mited inhibitory effects on prostaglandin synthesis. The renal effects of this drug were investigated by a double-blind cross-over study in IO patients with cirrhosis and ascites. Two therapeutic doses of imida zole-salicylate (750 mg each) were given at midnight and 08:00 h and 8 0 mg of furosemide were injected intravenously at 09:00 h. The same pr ocedure was followed on another day but a placebo replaced imidazole-s alicylate. Renal function (creatinine clearance, free water and electr olyte excretions) and urinary excretion of prostaglandin E, 6-keto-pro staglandin F-1 alpha and thromboxane B-2 were evaluated for 8 h after the first dose of the drug and for 2 h after furosemide injection. Pla telet thromboxane production was also determined 9 h after the first a dministration of drug or placebo. Imidazole-salicylate did not affect renal function or inhibit kidney prostanoid production either under ba sal conditions or after the stimulating effect of furosemide. On the c ontrary, imidazole-salicylate significantly inhibited platelet thrombo xane production (45.8 +/- 9 vs. 69.4 +/- 7.5 ng/ml, P < 0.05). These r esults suggest that imidazole-salicylate is an anti-inflammatory drug that can be given to patients with decompensated cirrhosis without ris k of inhibiting kidney prostaglandin synthesis or the renal response t o furosemide.