Predicting Irreparable Renal Ischemic Injury Using a Real-Time Marker in the Porcine Model
2008; Lippincott Williams & Wilkins; Volume: 180; Issue: 5 Linguagem: Inglês
10.1016/j.juro.2008.07.017
ISSN1527-3792
AutoresKyle J. Weld, Claudio Montiglio, Anneke C. Bush, Patricia S. Dixon, Harvey A. Schwertner, Donna Hensley, Jerry Cowart, R. Duane Cespedes,
Tópico(s)Renal and Vascular Pathologies
ResumoNo AccessJournal of UrologyInvestigative Urology1 Nov 2008Predicting Irreparable Renal Ischemic Injury Using a Real-Time Marker in the Porcine Modelis companion ofPredicting Differential Renal Function Using Computerized Tomography Measurements of Renal Parenchymal Area Kyle J. Weld, Claudio Montiglio, Anneke C. Bush, Patricia S. Dixon, Harvey A. Schwertner, Donna M. Hensley, Jerry R. Cowart, and R. Duane Cespedes Kyle J. WeldKyle J. Weld More articles by this author , Claudio MontiglioClaudio Montiglio More articles by this author , Anneke C. BushAnneke C. Bush More articles by this author , Patricia S. DixonPatricia S. Dixon More articles by this author , Harvey A. SchwertnerHarvey A. Schwertner More articles by this author , Donna M. HensleyDonna M. Hensley More articles by this author , Jerry R. CowartJerry R. Cowart More articles by this author , and R. Duane CespedesR. Duane Cespedes More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.07.017AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the maximal renal tolerance of warm ischemia using renal cortical interstitial metabolic changes to identify a potential real-time marker of irreparable renal function. Materials and Methods: Using a single kidney model 3 groups of 5 pigs each underwent 120, 150 and 180 minutes of warm ischemia, respectively. Microdialysis samples were collected before, during and after ischemia. Renal function assessments consisting of serum creatinine and GFR measurements were performed before ischemia and on post-ischemia days 1, 5, 9, 14 and 28. Kidneys exposed and not exposed to ischemia were collected for histological study. Results: Interstitial glucose and pyruvate concentrations decreased, while lactate concentrations increased to stable levels during ischemia. Glutamate spiked at 30 minutes of ischemia and subsequently tapered, while glycerol increased throughout warm ischemia time. At post-ischemia day 28 renal function returned to pre-ischemia baseline levels in the group with 120 minutes of ischemia but did not recover to baseline in the 150 and 180-minute ischemic groups. Functional data correlated with histological findings. The 120-minute maximal renal tolerance of warm ischemia correlated with a mean ± SD glycerol concentration of 167 ± 24 μmol/l. Conclusions: Interstitial glycerol is a real-time, renal unit specific, minimally invasive marker of renal function deterioration. Exposure of porcine kidneys to ischemic insults resulting in renal cortical interstitial glycerol concentrations higher than 167 μmol/l is associated with irreparable functional damage in this model. 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Google Scholar Departments of Urology and Clinical Research, (ACB, PSD, HAS, DMH, JRC), Wilford Hall Medical Center, Lackland Air Force Base, Texas© 2008 by American Urological AssociationFiguresReferencesRelatedDetailsCited byWeld K, Evearitt K, Dixon P and Cespedes R (2018) Effects of Ischemia on Human Renal Interstitial Fluid MetabolitesJournal of Urology, VOL. 181, NO. 2, (878-883), Online publication date: 1-Feb-2009.Keller A, Jorgensen T, Ravlo K, Nielsen T, Olsen L and Stolle L (2009) Microdialysis for Detection of Renal Ischemia After Experimental Renal TransplantationJournal of Urology, VOL. 182, NO. 4S, (1854-1859), Online publication date: 1-Oct-2009.Related articlesJournal of Urology18 Sep 2008Predicting Differential Renal Function Using Computerized Tomography Measurements of Renal Parenchymal Area Volume 180Issue 5November 2008Page: 2218-2225 Advertisement Copyright & Permissions© 2008 by American Urological AssociationKeywordskidneymicrodialysisglycerolischemiaswineMetricsAuthor Information Kyle J. Weld More articles by this author Claudio Montiglio More articles by this author Anneke C. Bush More articles by this author Patricia S. Dixon More articles by this author Harvey A. Schwertner More articles by this author Donna M. Hensley More articles by this author Jerry R. Cowart More articles by this author R. Duane Cespedes More articles by this author Expand All Advertisement PDF downloadLoading ...
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