As part of a study on the interaction between diuretics and renal prostaglandins, four healthy medical students receiving indomethacin for 8 days were also given triamterene for 3 days. Whereas renal function was initially normal in all four subjects, creatinine clearance decreased in two by 62% and 72% after concomitant administration of the two drugs, and was only restored to normal after 4 weeks. In control periods when triamterene or indomethacin was given alone renal function was preserved in all subjects. Urinary prostaglandin E2 was stimulated by triamterene and inhibited by indomethacin in all four subjects; both changes were more marked in the two sensitive subjects. Thus prostaglandin inhibition by indomethacin may unmask triamterene toxicity and contribute to the pathogenesis of the renal failure observed in sensitive subjects. As alternative therapy is readily available, avoidance of this potentially nephrotoxic association is recommended.

No abstract

The prevalence of circulating immune complexes (CIC) was investigated using the Clq binding assay (Clq BA) and the conglutinin binding assay (Kg BA) in 200 patients undergoing maintenance hemodialysis. Increased C1 q binding was found in 45 % (87 of 194) of the patients, and the modified Kg BA gave elevated values in 31 % (20 of 65). The prevalence of CIC was similar in American and Swiss patients, and in patients undergoing hemodialysis, self-dialysis or peritoneal dialysis. In patients with ‘nonimmunologicaΓ renal diseases, CIC were detected with similar frequency. No change in CIC was noted during hemodialysis in 6 additional patients tested. The abnormality was not related to age, sex, duration of dialysis, hepatitis B antigenemia, bacterial infections, or transfusions. Anti-DNA antibodies were absent in all subjects tested and the results of the Clq BA were not changed by DNase digestion of eight sera with high Clq binding. Rheumatoid factor activity (RF) was detected in approximately one-fifth of the patients, and there was a direct correlation between positive Clq binding and RF. There was no correlation between CIC and lymphocytotoxic antibodies. This study demonstrated a high prevalence of CIC in dialyzed uremic patients and established its relationship to other immunological abnormalities.

No abstract

In this minireview studies performed in man are mainly summarized and the data obtained interpreted with the help of knowledge gained in previous animal and in vitro experiments. From all those results the picture of a rather tight interplay between renal prostaglandins, renin-angiotensin, aldosterone, and antidiuretic hormone (ADH) emerges, whereby renal prostaglandins synthesis appears to be partially regulated by angiotensin II and ADH; renal prostaglandins antagonize the biological effects of these peptide hormones, and directly or indirectly affect in their turn the release of renin and ADH.