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Effects of Prostaglandin A1 on Renal Handling of Salt and Water in Congestive Heart Failure

Summary Prostaglandin A1 (PGA1) was infused at the rate of 1/μg/kg/min in 10 patients with decompensated heart failure under conditions of water loading (5 patients) or water deprivation (5 patients). During water loading, PGA1 increased urinary excretion of sodium, potassium, chloride, calcium, and magnesium, as well as free-water clearance. During water deprivation, it increased free-water reabsorption. Glomerular filtration rate was increased slightly by PGA1 only when it was given with an infusion of hypertonic mannitol during water deprivation. This selective action of PGA1, which increased the excretion but not the reabsorption of free water, suggests its use to correct certain hypo-osmolar conditions. The site of action of PGA1 on the kidney seems to be in the tubules and mainly in the proximal tubules. These findings might be important in the understanding of the role of renal prostaglandins.