No Protection of the Porcine Kidney by Ischaemic Preconditioning

Abstract

One or more episodes of sublethal ischaemia and reperfusion delay infarct development during subsequent, sustained ischaemia in the heart and skeletal muscle. The present study tested whether or not such ischaemic preconditioning (IP) also protects the kidney. Enflurane‐anaesthetized pigs underwent 60 min of right renal vessel occlusion (RVO), followed by 8 h of reperfusion without (placebo group, n = 8) or with three preceding cycles of 10 min RVO and 10 min reperfusion (IP group, n = 8). After 8 h of reperfusion, kidneys were oliguric in both groups (placebo group: 23 ± 21 ml h‐1, IP group: 24 ± 27 ml h‐1). A transient polyuric phase occurred in the IP group at 2 h reperfusion. The reperfused kidneys did not excrete inulin, creatinine or urea in both groups, although renal blood flow during reperfusion was similar to baseline. Morphological damage ranged in both groups from single cell necrosis to disseminated patchy necrosis; the number of pyknotic cells tended to be higher in the IP group than in the placebo group (27.0 ± 7.1 vs. 15.6 ± 5.6%, n.s.). In anaesthetized pigs, IP did not therefore attenuate renal dysfunction and morphological damage resulting from 60 min of renal normothermic ischaemia followed by 8 h of reperfusion.

Ineffectiveness of Remote Ischemic Renal Preconditioning in a Porcine Solitary-Kidney Model

“…4 The majority of R-IPC studies have been conducted looking at cardiac ischemia, such as coronary artery bypass grafting, heart valve surgery, and abdominal aortic aneurysm repair and have generally shown promising results. [8][9][10][11] Within the urologic literature, the effectiveness of R-IPC on renal ischemic injury is limited, 6 and the benefits of R-IPC remain in question. As with L-IPC, studies in small animal models subjected to R-IPC have yielded promising results.…”

“…Larger animal studies are scant, however, and have yielded conflicting results. 9,11 In addition, the goals of this study were to evaluate not only the clinical utility of R-IPC, but to also apply R-IPC in a clinically practical manner. We therefore sought to study, for the first time, the effects of R-IPC on renal function after an ischemic insult in a large animal (porcine) solitary-kidney model.…”

Ischemic Preconditioning Protects the Dog Kidney from Ischemia-Reperfusion Injury

“…However, Behrends et al [5] in a porcine model and Islam et al [6] in a rat model did not achieve the same findings with regard to ischemic preconditioning. In the study by Behrend et al [5] , the animals underwent 3 periods of ischemia with 10-min intervals then 1 h of warm ischemia, and 8 h later pathology and laboratory data were checked [5] .…”

“…In the study by Behrend et al [5] , the animals underwent 3 periods of ischemia with 10-min intervals then 1 h of warm ischemia, and 8 h later pathology and laboratory data were checked [5] . In the study by Islam et al [6] , the interval was more than 30 min.…”

The “kidney–liver” multiorgan ex vivo perfused model improves the circuit’s biochemical milieu during perfusion compared to the “liver–kidney” counterpart

“…Asterisks show timepoints which are significantly different from preperfusion levels Fig. 3 continued models of renal ischemia-reperfusion injury [20], the kidney experimented an initial polyuric phase at the second hour of perfusion followed by progressive normalization of the urine output [17]. Additionally, it is possible that the high glucose acted as an osmotic drive for the polyuria and the differences in the urine production observed between the LK and KL circuits were a reflection of the different glycaemic levels among the groups.…”