Effect of prostaglandin synthesis inhibition on glomerular filtration rate in renal transplant recipients.

To determine the influence of prostaglandin (PG) synthesis inhibition on the renal function in renal transplant recipients, we carried out a crossover, double-blind, placebo controlled study of 18 ambulatory patients. Glomerular filtration rate (GFR) was measured using 51-Cr EDTA, before and after indomethacin (50 mgr. three times a day for three days), and placebo. Overnight urinary PGE excretion decreased 88.9 +/- SEM 4.81% after indomethacin, but remained unchanged following placebo. GFR decreased 15.3 +/- SEM 3.94% (p = 0.0139) after indomethacin. There was no correlation between PGE urinary excretion and GFR changes. Pre-existing renal functional impairment was not a significant risk factor. Caution should be exercised when using non-steroidal anti-inflammatory drugs in renal transplant patients.