Renal endothelin system in obstructive jaundice: its role in impaired renal function of bile-duct ligated rats.

1. Obstructive jaundice predisposes the kidney to acute renal failure. Endothelin (ET), a potent renal vasoconstrictor and modulator of the tubular action of arginine vasopressin, has been suggested to play a pathogenetic role in acute renal failure. In the present study we therefore investigated renal function and the renal ET system in rats on day 4 after bile-duct ligation (BDL) or sham-operation (SO), without (n = 7 in each group) and with treatment with bosentan, a combined ETA/ETB receptor blocker, (n = 5 in each group). 2. On day 4 after BDL, serum bilirubin had increased to 226 +/- 10 mumol/l (SEM) as compared with 6 +/- 2 mumol/l in SO rats. Endogenous creatinine clearance, an index of glomerular filtration rate, was significantly reduced to 0.7 +/0 0.1 ml min-1 g-1 of kidney weight after BDL as compared with 1.1 +/- 0.1 ml min-1 g-1 of kidney weight after SO (P < 0.05). Bosentan prevented the decrease in glomerular filtration rate (1.0 +/- 0.2 ml min-1 g-1 of kidney weight), as well as polyuria and defective concentrating ability, in BDL rats. 3. Plasma ET concentration on day 4 after surgery (28.2 +/- 1.5 pmol/l) was higher (P < 0.01) in BDL than in SO rats (12.9 +/- 1.5 pmol/l) and rose further in bosentan-treated BDL and SO rats (43.4 +/- 5.1 compared with 21.9 +/- 6.6 pmol/l). Urinary ET excretion was significantly higher in BDL rats than in SO rats (1.58 +/- 0.22 compared with 1.28 +/- 0.18 pmol 24 h-1 100 g-1 of body weight; P < 0.05). 4. ET synthesis by glomeruli isolated from BDL rats was lower [81 +/- 19 fmol h-1 (mg of protein)-1] than that from SO-rats [139 +/- 28 fmol h-1 (mg of protein)-1; P < 0.05], whereas papillary ET synthesis was higher in BDL [10 +/- 3 fmol h-1 (mg of protein)-1] than in SO rats [4 +/- 1 fmol h-1 (mg of protein)-1; P < 0.05]. 5. The results indicate that BDL is associated with increased plasma ET concentration and suppression of GFR. Enhanced renal inner medullary collecting-duct ET synthesis, which is reflected by increased urinary ET excretion, may reduce distal tubular water absorption in BDL rats. Increased circulating and renal papillary ET synthesis may thus contribute to renal dysfunction and predispose the kidney to acute renal failure in obstructive jaundice.