Postoperative decline of renal function remains a common and unpredictable complication after abdominal aortic aneurysm (AAA) reconstruction. The oxidative stress that occurs during perioperative ischemia/reperfusion injury (I/R) may contribute to the development of this complication. In this study, the influence of intraoperative prostaglandin E (alprostadil) administration on erythrocyte and platelet antioxidants as well as postoperative kidney function modulation were verified. AAA patients were randomly divided into control and study/alprostadil groups. Blood samples were collected directly before aortic clamping and 5 min after aortic declamping. Superoxide dismutase, catalase, glutathione, glutathione peroxidase (GPx), and glutathione transferase (GST) were measured using spectrophotometry. During I/R, the activity of catalase (57.14+/-30.65 vs 128.35+/-91.94 U/mg protein; P < 0.009), GPx (0.21+/-0.18 vs 0.35+/-0.21 mU/g protein; P = 0.028), and GST (217.49+/-101.39 vs 310.66+/-88.86 mU/g protein; P = 0.0006) significantly increased in the control group. GST activity before the aortic clamping was significantly lower in the study/alprostadil group (2.84+/-2.28 vs 3.48+/-2.30 U/g Hb; P = 0.05). The activity of the selected antioxidants proved to be of a diagnostic value for predicting postoperative decline in renal function. In conclusion, during I/R after AAA reconstruction, activation of various erythrocyte and platelet antioxidants occurs. Perioperative administration of alprostadil is associated with disruption of this activation.