Diuresis and improved renal hemodynamics produced by prostaglandin E1 in the dog with norepinephrine-induced acute renal failure.

Unilateral acute renal failure was induced in dogs by renal artery infusion of norepinephrine. Renal hemodynamics and function were studied before and 5 days after norepinephrine infusion, and during subsequent renal artery infusion of prostaglandin E1. After norepinephrine, the infused kidney exhibited decreased urine volume, sodium excretion, and creatinine clearance. Cortical blood flow, determined with radioactive microspheres, also decreased. No redistribution of intracortical blood flow occurred. Arteriographically, proximal vessels were constricted and the cortical nephrogram density diminished. During prostaglandin E1 infusion, urine volume, sodium excretion, and cortical blood flow increased. Creatinine clearance did not change significantly. Blood flow was redistributed from the outer third to the inner third of the cortex. Proximal vessels were dilated and the cortical nephrogram density was enhanced. The apparent dissociation of cortical blood flow from creatinine clearance suggests that prostaglandin E1-induced diuresis and natriuresis result from a mechanism other than increased glomerular filtration.