Key result
Indomethacin triggers fatal malignant hypertension and acute renal failure in ~40% of renovascular hypertensive rabbits.
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Indomethacin inhibits the synthesis of prostaglandin and the release of renin. These effects were studied in normal rabbits and rabbits with two-kidney Goldblatt hypertension (2KGH) and one-kidney Goldblatt hypertension (1KGH) by giving daily intravenous injections of indomethacin (3mg/kg after two initial doses of 9 mg/kg), and in appropriate control rabbits given diluent phosphate buffer without indomethacin. In normal rabbits, indomethacin significantly decreased immunoreactive plasma prostaglandin E-like substance (IPGE) and plasma renin activity (PRA). Indomethacin did not change plasma creatinine (PCr) or mean blood pressure but it decreased renal blood flow (RBF) and glomerular filtration rate (GFR). In 2KGH rabbits, responses depended on the level of renal function and, to a lesser extent, on the level of PRA. In six of10 2KGH rabbits in which hypertension developed without significant changes in PRA, IPGE, PCr, RBF, and GFR, indomethacin produced changes similar to those seen in normals. In the other four rabbits, development of 2KGH was accompanied by increased PRA, increased IPGE, and decreased RBF and GFR, and indomethacin produced renal failure, oliguria, malignant hypertension, and death within 5 days. In 1KGH rabbits, indomethacin decreased IPGE, PRA, and renal function but increased mean blood pressure. These observations suggest that prostaglandins exert a protective effect on renal function in renovascular hypertension.
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Romero et al. (1977) studied Renovascular hypertension (two-kidney and one-kidney Goldblatt hypertension). Indomethacin vs. Diluent phosphate buffer without indomethacin was evaluated on Blood pressure, renal function (RBF, GFR, plasma creatinine), plasma renin activity, and immunoreactive plasma prostaglandin E-like substance. Indomethacin (3 mg/kg/day) caused renal failure, malignant hypertension, and death within 5 days in 4 of 10 two-kidney Goldblatt hypertensive rabbits with elevated renin and impaired renal function.
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