Please use this identifier to cite or link to this item: https://hdl.handle.net/11499/5838
Title: The effect of phlebotomy and mannitol on acute renal injury induced by ischemia/reperfusion of lower limbs in rats
Authors: Gökşin, İbrahim
Adali, F.
Enli, Yaşar
Akbulut, M.
Teke, Z.
Sackan, G.
Ocak, E.
Keywords: glutathione
malonaldehyde
mannitol
myeloperoxidase
superoxide dismutase
acute kidney tubule necrosis
animal experiment
animal model
animal tissue
aorta clamping
article
bolus injection
controlled study
drug effect
enzyme activity
kidney injury
laparotomy
limb ischemia
lipid peroxidation
male
nephritis
neutrophil chemotaxis
nonhuman
phlebotomy
priority journal
rat
Acute Kidney Injury
Animals
Aorta, Abdominal
Combined Modality Therapy
Constriction
Disease Models, Animal
Extremities
Glutathione
Kidney
Male
Malondialdehyde
Mannitol
Oxidative Stress
Peroxidase
Phlebotomy
Rats
Rats, Wistar
Reperfusion Injury
Superoxide Dismutase
Time Factors
Abstract: Background: Abdominal aortic surgery can cause ischemic/reperfusion (I/R) injury not only in the lower limbs but also in remote organs such as kidneys. Venous blood volume exclusion from the inferior vena cava (phlebotomy) or/and mannitol are used as a treatment for I/R injury of kidney in humans, despite the fact that the effectiveness of these treatments is still debated. The aim of this study was to evaluate the effects of phlebotomy or/and mannitol on rat kidneys in a model of lower limbs I/R-induced acute renal injury (ARI). Material and Methods: Thirty male Wistar albino rats were used and divided into five groups: (I) sham-operated group, laparotomy without I/R injury (group [S], n = 6); (II) I/R group, infrarenal aortic cross-clamp was used for lower limbs I/R, 3 hours of ischemia followed by 2 hours of reperfusion (group [I/R], n = 6); (III) I/R + phlebotomy group, identical to group [I/R] except for 1 mL of blood aspiration from the inferior caval vein just after ischemia (group [P], n = 6); (IV) I/R + mannitol-treated group, these rats were subjected to I/R and received a bolus injection of mannitol (group [M], n = 6); and (V) I/R + phlebotomy + mannitol-treated group (group [P + M], n = 6), the same procedures were performed as those described for previous groups. At the end of 2-hour reperfusion, all rats were sacrificed. Both kidneys were harvested for biochemical assay (myeloperoxidase [MPO] and superoxide dismutase [SOD] activities, and malondialdehyde [MDA] and reduced glutathione levels) and for histopathological examination (tubular necrosis and acute inflammation on kidney [ARI score]). Results: Aortic I/R significantly increased the level of MDA (reflecting lipid peroxidation), SOD (enzymatic endogenous antioxidant), and MPO (reflecting neutrophil infiltration) activity (p < 0.05). Phlebotomy or/and mannitol treatments significantly decreased the level of MDA, SOD, and MPO activity and increased glutathione level (nonenzymatic antioxidant in the kidney tissues) (p < 0.05). Histological evaluation of ARI score showed that aortic I/R significantly increased (p value for group [S] versus group [I/R] was 0.012), whereas phlebotomy or/and mannitol treatments significantly decreased tubular necrosis and inflammatory infiltration (p values for group [I/R] versus group [P], [M], and [P + M] were 0.043, 0.043, and 0.003, respectively). Conclusion: This experiment clearly indicated that the lower limbs I/R-induced ARI attenuated significantly by phlebotomy or/and mannitol treatments. Phlebotomy plus mannitol is more effective treatment than phlebotomy or mannitol alone in preventing lower limbs I/R-induced ARI in rats. Further clinical studies are required to clarify whether phlebotomy or/and mannitol treatments are beneficial in alleviating of ARI during abdominal aortic surgery. © 2011 Annals of Vascular Surgery Inc.
URI: https://hdl.handle.net/11499/5838
https://doi.org/10.1016/j.avsg.2011.07.007
ISSN: 0890-5096
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
Tıp Fakültesi Koleksiyonu
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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