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Prostaglandins are autacoids that contribute importantly to renal physiology, and to the function of many other organs . Five prostaglandin subtypes (PGE2, PGI2, PGD2, PGF2α, and thromboxane [TXA2] are synthesized in the kidney and have receptors in this organ. The role of some of these receptors in renal physiology is not yet completely understood. However, PGE2 (acting on EP1, EP3, and possibly EP2) has been shown to play a role in the activity of certain diuretics. Among its many actions, PGE2 blunts Na+ reabsorption in the TAL of Henle’s loop and ADH-mediated water transport in collecting tubules. These actions of PGE2 contribute significantly to the diuretic efficacy of loop diuretics. Blockade of prostaglandin synthesis with NSAIDs can therefore interfere with loop diuretic activity.
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