Renal Functional Effects of Prostaglandin Synthesis Inhibition in Patients with Insulin-Dependent Diabetes Mellitus of Long Duration without Nephropathy

Summary

The short-term effects of prostaglandin synthesis inhibition (PGSI; single dose 500 mg of naproxen) on renal function were studied in six women (age: 21.9 ± 2.4 yrs) with insulin dependent diabetes mellitus (IDDM) of 14.3 ± 2.8 yrs' duration, and in nine age- and sex-matched controls. The diabetics had no overt signs of nephropathy (Albustix^® neg, normal serum creatinine, and blood pressure). The clearance of inulin (C_In) and PAH; the filtration fraction (FF); and the excretion of Na, albumin and PGE₂ were studied under water diuresis on two separate mornings, first without and then with PGSI. With PGSI all individuals had lower PGE₂ excretion. The C_In and FF were significantly (p < 0.05) higher in the diabetics than in the controls both without (129.4 ± 23.9 ml/min/1.73m ² and 23.4 ± 2.8% vs. 107.6 ± 10.3 and 19.7 ± 1.6) and with (133.7 ± 29.4 and 22.6 ± 2.1, vs. 106.8 ± 10.3 and 20.1 ± 1.5) PGSI. The diuresis and Na excretion were significantly lower with PGSI, than without, in both groups. The albumin excretion was significantly higher in the diabetics under both conditions (29.9 ± 16.6 and 34.2 ± 19.9 μg/min/100 ml GFR, vs. 14.5 ± 10.6 and 12.9 ± 8.3 in controls). We conclude that the hyperfiltration in this stage of IDDM does not appear to be PG dependent, and that PGSI does not give any immediate effects on the albumin excretion.

Insulin-Dependent Diabetes Mellitus - Prostaglandin Synthesis Inhibition - Naproxen - Renal Function - Microalbuminuria