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Preconditioning strategies for kidney ischemia reperfusion injury: implications of the "time-window" in remote ischemic preconditioning.

Yoon YE, Lee KS, Choi KH, Kim KH, Yang SC, Han WK - PLoS ONE (2015)

Bottom Line: However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined.The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia.Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Remote ischemic preconditioning (IP) is a potential renoprotective strategy. However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined. Using a single-kidney porcine model, we evaluated organ protective function of remote IP in renal ischemia reperfusion injury. Fifteen Yorkshire pigs, 20 weeks old and weighing 35-38 kg were used. One week after left nephrectomy, we performed remote IP (clamping right external iliac artery, 2 cycles of 10 minutes) and right renal artery clamping (warm ischemia; 90 minutes). The animals were randomly divided into three groups: control group, warm ischemia without IP; group 1 (remote IP with early window [IP-E]), IP followed by warm ischemia with a 10-minute time window; and group 2 (remote IP with late window [IP-L]), IP followed by warm ischemia after a 24-hour time window. There were no differences in serum creatinine changes between groups. The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia. At 72 hours post-ischemia, the urinary kidney injury molecule-1 (KIM-1) was lower in the IP-L group than in the control and IP-E groups, and the IP-L group KIM-1 was near pre-ischemic levels, whereas the control and IP-E group KIM-1 levels were rising. Microalbumin also tended to be lower in the IP-L group. Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury. To effectively provide kidney protection, remote IP might require a considerable, rather than short, time window of ischemia.

No MeSH data available.


Related in: MedlinePlus

Changes in serum creatinine.There were no differences between groups throughout the whole experiment. SCr, serum creatinine; IP-E, remote Ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.
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pone.0124130.g002: Changes in serum creatinine.There were no differences between groups throughout the whole experiment. SCr, serum creatinine; IP-E, remote Ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.

Mentions: Before the left nephrectomy, all porcine SCr values were within the normal range (1.0–1.5 ng/dL), with a median of 1.2 (IQR 1.0–1.2) ng/dL. At 1 week after nephrectomy, the median pre-ischemic SCr of all groups was 1.8 (IQR 1.5–2.0) ng/dL (Fig 2). In all groups, the SCr was most up-regulated at 24 hours after the ischemic injury; however, the SCr at this time did not differ between the control, IP-E, and IP-L groups (4.2 [IQR 3.25–5.5] ng/dL, 4.7 [IQR 3.6–6.55] ng/dL, and 3.2 [IQR 2.9–6.55] ng/dL, respectively; p = 0.566). At 72 hours after ischemic injury, the SCr was still elevated above the pre-ischemic level in all groups, but again there was still no difference between the control, IP-E, or IP-L groups (3.1 [IQR 2.5–5.8] ng/dL, 2.3 [2.15–4.65] ng/dL, and 2.4 [1.95–5.4] ng/dL, respectively; p = 0.610).


Preconditioning strategies for kidney ischemia reperfusion injury: implications of the "time-window" in remote ischemic preconditioning.

Yoon YE, Lee KS, Choi KH, Kim KH, Yang SC, Han WK - PLoS ONE (2015)

Changes in serum creatinine.There were no differences between groups throughout the whole experiment. SCr, serum creatinine; IP-E, remote Ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4400007&req=5

pone.0124130.g002: Changes in serum creatinine.There were no differences between groups throughout the whole experiment. SCr, serum creatinine; IP-E, remote Ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window.
Mentions: Before the left nephrectomy, all porcine SCr values were within the normal range (1.0–1.5 ng/dL), with a median of 1.2 (IQR 1.0–1.2) ng/dL. At 1 week after nephrectomy, the median pre-ischemic SCr of all groups was 1.8 (IQR 1.5–2.0) ng/dL (Fig 2). In all groups, the SCr was most up-regulated at 24 hours after the ischemic injury; however, the SCr at this time did not differ between the control, IP-E, and IP-L groups (4.2 [IQR 3.25–5.5] ng/dL, 4.7 [IQR 3.6–6.55] ng/dL, and 3.2 [IQR 2.9–6.55] ng/dL, respectively; p = 0.566). At 72 hours after ischemic injury, the SCr was still elevated above the pre-ischemic level in all groups, but again there was still no difference between the control, IP-E, or IP-L groups (3.1 [IQR 2.5–5.8] ng/dL, 2.3 [2.15–4.65] ng/dL, and 2.4 [1.95–5.4] ng/dL, respectively; p = 0.610).

Bottom Line: However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined.The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia.Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury.

View Article: PubMed Central - PubMed

Affiliation: Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT
Remote ischemic preconditioning (IP) is a potential renoprotective strategy. However, there has been no demonstrated result in large animals and the role of time window in remote IP remains to be defined. Using a single-kidney porcine model, we evaluated organ protective function of remote IP in renal ischemia reperfusion injury. Fifteen Yorkshire pigs, 20 weeks old and weighing 35-38 kg were used. One week after left nephrectomy, we performed remote IP (clamping right external iliac artery, 2 cycles of 10 minutes) and right renal artery clamping (warm ischemia; 90 minutes). The animals were randomly divided into three groups: control group, warm ischemia without IP; group 1 (remote IP with early window [IP-E]), IP followed by warm ischemia with a 10-minute time window; and group 2 (remote IP with late window [IP-L]), IP followed by warm ischemia after a 24-hour time window. There were no differences in serum creatinine changes between groups. The IP-L group had lower urinary neutrophil gelatinase-associated lipocalin than control and IP-E at 72 hours post-ischemia. At 72 hours post-ischemia, the urinary kidney injury molecule-1 (KIM-1) was lower in the IP-L group than in the control and IP-E groups, and the IP-L group KIM-1 was near pre-ischemic levels, whereas the control and IP-E group KIM-1 levels were rising. Microalbumin also tended to be lower in the IP-L group. Taken together, remote IP showed a significant reduction in renal injury biomarkers from ischemia reperfusion injury. To effectively provide kidney protection, remote IP might require a considerable, rather than short, time window of ischemia.

No MeSH data available.


Related in: MedlinePlus