Alavi N, Lianos E A, Venuto R C, Mookerjee B K, Bentzel C J
Am J Kidney Dis. 1986 Dec;8(6):397-403. doi: 10.1016/s0272-6386(86)80165-2.
Immediate and longer-term (five-day) effects of indomethacin on proteinuria and renal function were examined in a group of nephrotic subjects with glomerular filtration rates (GFR) that ranged from near normal to moderately impaired. The modifying role of the patients' sodium/volume (S/V) status on renal prostaglandin inhibition was systematically evaluated by renal clearance and balance studies. After patients were S/V-depleted for five days, indomethacin (75 mg/d) decreased protein excretion by 45%. The decrement in proteinuria was greater than 2 times greater than the fall in creatinine clearance and was unrelated to baseline clearance. In acute clearance studies, 75 mg indomethacin administered orally immediately reduced protein excretion, effective renal plasma flow (CPAH), GFR (C inulin), Na, K, and free water excretion. Indomethacin responsiveness (reduced proteinuria) correlated with the change in PGE2 excretion. The effect of indomethacin on protein excretion and renal hemodynamics was apparent, but blunted, when dietary Na intake was increased to 200 mEq/d. Mean BP increased during indomethacin therapy only when patients were S/V-expanded.
在一组肾小球滤过率（GFR）从接近正常到中度受损的肾病患者中，研究了吲哚美辛对蛋白尿和肾功能的即时及长期（五天）影响。通过肾脏清除率和平衡研究，系统评估了患者钠/容量（S/V）状态对肾脏前列腺素抑制的调节作用。在患者S/V耗竭五天后，吲哚美辛（75毫克/天）使蛋白排泄减少了45%。蛋白尿的减少幅度比肌酐清除率的下降幅度大两倍多，且与基线清除率无关。在急性清除率研究中，口服75毫克吲哚美辛可立即减少蛋白排泄、有效肾血浆流量（CPAH）、GFR（菊粉清除率）、钠、钾和自由水排泄。吲哚美辛反应性（蛋白尿减少）与PGE2排泄的变化相关。当饮食钠摄入量增加到200毫当量/天时，吲哚美辛对蛋白排泄和肾脏血流动力学的影响明显，但减弱。仅当患者S/V扩张时，吲哚美辛治疗期间平均血压才会升高。
