The effects of low and high doses of sugammadex on kidney tissue in streptozotocin-induced diabetic rats

Abstract

BACKGROUND: Sugammadex is primarily excreted via renal route. We investigated effects of low and high doses of sugammadex (16 mg/kg versus 96 mg/kg) on renal tissue samples of streptozotocin-induced diabetic rats. MATERIAL AND METHODS: Twenty-four Wistar albino rats were divided into 4 groups. Group C (control -0.9 % NaCl), Group DC (diabetes control; 55 mg/kg streptozotocin, IP, only), Group DR-16S (diabetes-rocuronium -16 mg sugammadex, IV.) and Group DR-96S (diabetes-rocuronium -96 mg sugammadex, IV). Renal tissue histopathological evaluation and antioxidant status (measurements of MDA levels and NO activities) were studied. RESULTS: Signifi cantly higher levels of all infl ammation parameters (infl ammation, degeneration/necrosis, tubular dilatation, tubular cell degeneration, dilatation in Bowman's space, tubular hyaline casts, and lymphocyte infi ltration) were found in the 96 mg/kg sugammadex group. Higher MDA tissue levels and lower NO activity were found in the 96 mg/kg sugammadex group. DISCUSSION: We can conclude that high-dose (96 mg/kg) sugammadex administration resulted in signifi cant renal tissue damage in diabetic rats. As a consequence, low doses of sugammadex have to be preferred in diabetic patients (Tab. 2, Fig. 4, Ref. 26). Text in PDF www.elis.sk.

Impact on grafted kidney function of rocuronium-sugammadex vs cisatracurium-neostigmine strategy for neuromuscular block management. An Italian single-center, 2014-2017 retrospective cohort case-control study

“…Diabetic nephropathy predisposes to changes in kidney tissues, including inflammation, degeneration, necrosis, tubular dilatation, tubular cell degeneration, dilatation in Bowman’s space, tubular hyaline casts, and lymphocyte infiltration. In renal tissue samples, a significant increase in histopathological changes was found after sugammadex 96 mg/kg but not sugammadex 16 mg/kg treatment compared to diabetic control (Kip et al 2015 ). These results suggest that, at recommended doses, sugammadex does not significantly impact renal function (Bostan et al 2011 ), also in case of diabetic nephropathy (Kip et al 2015 ).…”

“…In renal tissue samples, a significant increase in histopathological changes was found after sugammadex 96 mg/kg but not sugammadex 16 mg/kg treatment compared to diabetic control (Kip et al 2015 ). These results suggest that, at recommended doses, sugammadex does not significantly impact renal function (Bostan et al 2011 ), also in case of diabetic nephropathy (Kip et al 2015 ). In a dose-finding and safety study in adult patients, abnormal levels of N-acetyl-glucosaminidase were only found in 5 of 20 patients included in the intent-to-treat population and safety population (Sorgenfrei et al 2006 ).…”

“…This study confirmed the advantage of the rocuronium-sugammadex over the cisatracurium-neostigmine strategy not only in improving postoperative kidney function (Vargas et al 2020 ) but also in promoting a better general recovery, independently from the level of NMB at the end of surgery. This may be explained by different impacts of the two reversal drugs on renal function (Munro et al 2004 ; Sorgenfrei et al 2006 ; Flockton et al 2008 ; Staals et al 2011 ; Bostan et al 2011 ; Kip et al 2015 ; Isik et al 2016 ; Büyükfırat et al 2018 ; Vargas et al 2020 ), a restoration of glomerular filtration after surgery that minimizes the stasis of the sugammadex (and rocuronium-sugammadex complex) in the glomeruli and tubules (Bostan et al 2011 ; Kip et al 2015 ; Vargas et al 2020 ), and a potential protective effect of sugammadex against ischemia-reperfusion injury (Vargas et al 2020 ). In an experimental study, sugammadex 16 mg/kg and 100 mg/kg, administered to evaluate the benefit of cyclodextrins against transient global cerebral ischemia, showed a dose-dependent neuroprotective effect in a transient global cerebral ischemia/reperfusion rat model (Ozbilgin et al 2016 ).…”

Sugammadex Compared to Neostigmine for Reversal of Neuromuscular Block in Patients Undergoing Kidney Transplantation. A Retrospective Cohort, Case-Control Study.

“…Diabetic nephropathy predisposes to changes in kidney tissues including in ammation, degeneration, necrosis, tubular dilatation, tubular cell degeneration, dilatation in Bowman's space, tubular hyaline casts, and lymphocyte in ltration. In renal tissue samples, a signi cant increase in histopathological changes was found after sugammadex 96 mg/kg but not sugammadex 16 mg/kg treatment compared to diabetic control (Kip et al 2015). These results suggest that, at recommended doses, sugammadex doesn't signi cantly impact renal function (Bostan et al 2011), also in case of diabetic nephropathy (Kip et al 2015).…”

“…In renal tissue samples, a signi cant increase in histopathological changes was found after sugammadex 96 mg/kg but not sugammadex 16 mg/kg treatment compared to diabetic control (Kip et al 2015). These results suggest that, at recommended doses, sugammadex doesn't signi cantly impact renal function (Bostan et al 2011), also in case of diabetic nephropathy (Kip et al 2015). In a dose-nding and safety study in adult patients, abnormal levels of N-acetyl-glucosaminidase were only found in 5 of 20 patients included in the intent-totreat population and safety population (Sorgenfrei et al 2006).…”