Renal ischemia-reperfusion-induced metabolic and micro-rheological alterations and their modulation by remote organ ischemic preconditioning protocols in the rat

Issue title: Selected Papers of the Joint Conference of the ESCHM-ISCH-ISB-2018, 2-6 July, 2018, Krakow, Poland

Guest editors: F. Jung and M. Fornal

Article type: Research Article

Authors: Varga, Gabor | Ghanem, Souleiman | Szabo, Balazs | Nagy, Kitti | Pal, Noemi | Tanczos, Bence | Somogyi, Viktoria | Barath, Barbara | Deak, Adam | Peto, Katalin | Nemeth, Norbert^{; *}

Affiliations: Department of Operative Techniques and Surgical Research, Institute of Surgery, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

Correspondence: [*] Corresponding author: Norbert Nemeth MD, PhD, DSc, Department of Operative Techniques and Surgical Research, Institute of Surgery, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Nagyerdei krt. 98., Hungary. Tel./Fax: +36 52 416 915; E-mail: [email protected].

Abstract: BACKGROUND:Pathomechanism and optimal renoprotective protocol for remote ischemic preconditioning (RIPC) have not been completely revealed yet. OBJECTIVE: To investigate micro-rheological effects of early and delayed RIPC in renal ischemia-reperfusion (I/R) in the rat. METHODS:In Control group the left femoral artery was cannulated and the left kidney was gently exposed. In the I/R group 45-minute renal ischemia with 120-minute reperfusion period was monitored. In the RIPC groups a 3×10-minute protocol was applied using tourniquet around the right hind-limb 1 hour (RIPC-1) or 24 hours (RIPC-24) prior to the I/R. Blood samples were taken for testing blood gas, acid-base, metabolic and hemorheological parameters. RESULTS:Lactate and potassium concentration significantly increased in I/R that could be reduced by RIPC, especially in RIPC-24. Creatinine concentration increased further in RIPC groups. I/R and RIPC-1 decreased the pH, RIPC-24 increased. RIPC-24 reduced the drop in base excess. Erythrocyte deformability worsened by renal I/R. In RIPC groups deformability decreased additively. However, RIPC-1 could improve the condition. RIPC-24 showed the highest erythrocyte aggregation values during reperfusion. CONCLUSIONS:Renal I/R worsened metabolic and micro-rheological parameters that could be modulated by RIPC protocols. However, it could not be decided whether the early or the delayed protocol is better.

Keywords: Ischemia-reperfusion, remote ischemic preconditioning, kidney, red blood cell deformability, red blood cell aggregation

DOI: 10.3233/CH-189414

Journal: Clinical Hemorheology and Microcirculation, vol. 71, no. 2, pp. 225-236, 2019