vi medicine informatics




In patients with states of effective volume depletion, such as heart failure and cirrhosis, the secretion of the vasoconstrictors angiotensin II and norepinephrine increases. In these cases, secretion of prostaglandins (mostly prostacyclin and prostaglandin E2) increases to maintain renal blood flow by counteracting the vasoconstrictive effects of these hormones at preglomerular vessels (eg, the afferent arteriole). When prostaglandin synthesis is inhibited by NSAIDs in these patients, preglomerular resistance increases and renal blood flow (and thus glomerular filtration rate) is reduced. This is reversible with stopping the NSAID.

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