The role of prostanoids in pediatric diseases employing mass spectrometric techniques.

Urinary excretion rates of primary prostanoids and their metabolites are useful parameters to assess as well renal as systemic prostanoid activity under clinical conditions. Children with renal diseases with systemic involvement, such as Bartter syndrome, renal diabetes insipidus, postobstructive hydronephrosis, and acute renal allograft rejection, have exclusively elevated excretion rates of primary prostanoids. In patients with systemic diseases and additional renal involvement, such as hyperprostaglandin E syndrome and hemolytic uremic syndrome, rates of primary prostanoids and of their metabolites are elevated. In contrast, systemic vascular diseases without renal involvement, such as Henoch-Schönlein purpura and persistent pulmonary hypertension in the newborn, are associated only with increased systemic prostanoid activity indicated by elevated excretion rates of prostanoid metabolites, whereas excretion rates of primary metabolites are in the normal range.