Effect of prostaglandin E2 (PGE2) in the prevention of acute renal failure in anesthetized dogs. In situ renal preservation.

Six healthy dogs, after control measurements, were subjected to renal artery occlusion for 90 min, under general anesthesia. 5 mg of PGE2 (Prostin E2, Upjohn) diluted in 100 mL of normal saline was infused directly into the left renal artery for 90 min (PG group), while only normal saline was infused into the right renal artery (control group). After removal of the clamps blood and urine samples were collected every hour for the first 3 h of revascularization and both kidneys were then removed for histological study by light microscopy. PG kidneys regained urine flow above the oliguric levels within 3 hr of revascularization (0.30 +/- 0.04 mL/min vs 0.14 +/- 0.03 mL/min in controls (p less than 0.001). Creatinine, urea, and osmolar clearances were also significantly higher in PG group (p less than 0.01 or p less than 0.001 for 2 and 3 hr of follow-up after revascularization). Urine sodium concentration and fractional sodium excretion (FENa) (%) were not significantly lower in the PG group compared to the controls. Histology showed focal brushborder loss, hyaline and granular casts, focal tubular dilation, and focal necrotic lesions on the tubular cells in both groups of kidneys. A direct cytoprotective effect of the PGE2 was not found. It is suggested that PGE2 is effective in the protection of renal function when it is administered during the mechanical occlusion model of acute renal failure in anesthetized dogs.