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Elevated Urinary Prostaglandins and the Effects of Aspirin on Renal Function in Lupus Erythematosus

ROBERT P. KIMBERLY, M.D.; JOHN R. GILL JR., M.D., F.A.C.P.; ROBERT E. BOWDEN, M.D.; HARRY R. KEISER, M.D., F.A.C.P.; and PAUL H. PLOTZ, M.D., F.A.C.P.
[+] Article and Author Information

Grant support: Dr. Kimberly is a Postdoctoral Fellow of The Arthritis Foundation, Hospital for Special Surgery, New York.

Presented in part at the 41st Annual Scientific Session of the American Rheumatism Association, 9-11 December 1976, Miami, Florida.

▸Requests for reprints should be addressed to Paul H. Plotz, M.D.; Clinical Center 9N210, National Institutes of Health; Bethesda, MD 20014.


Bethesda, Maryland


Ann Intern Med. 1978;89(3):336-341. doi:10.7326/0003-4819-89-3-336
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We studied the urinary excretion of immunoreactive prostaglandin E-like material (iPGE) and renal function in seven women with systemic lupus erythematosus to evaluate the relation between urinary iPGE and the increase in serum creatinine in patients taking aspirin. The mean pretreatment excretion of urinary iPGE in patients with lupus erythematosus, 42.7 ± 6.4 ng/h, was significantly higher than the value of 29.0 ± 1.9 ng/h for normal subjects (P < 0.02). With aspirin, the urinary iPGE decreased an average of 45% (P < 0.001). Increases in serum creatinine and blood urea nitrogen confirmed our previous clinical observations. The concomitant mean fall in creatinine clearance of 18% (P < 0.001) was accompanied by a 14% decrease in inulin clearance (P < 0.005); p-aminohippurate clearance fell 29% (P < 0.005). The decline in urinary iPGE preceded the fall in creatinine clearance but was significantly correlated with it (r=0.78; P < 0.001). The observed changes reversed rapidly when aspirin was stopped. These data show that, in these patients with high urinary iPGE excretion, aspirin causes significant changes in renal function that may be mediated by the inhibition of prostaglandin synthesis.

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