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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 urinary NGAL (A) and urinary NGAL percent change from baseline (B) normalized to urinary creatinine.At 72 hours postoperatively, urinary NGAL was lower in the IP-L group than in the control and IP-E groups (p = 0.076 and 0.047, respectively). NGAL, neutrophil gelatinase-associated lipocalin; Ucr, urine creatinine; IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window. * p<0.05 vs. Control, † p<0.05 vs. IP-E.
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pone.0124130.g003: Changes in urinary NGAL (A) and urinary NGAL percent change from baseline (B) normalized to urinary creatinine.At 72 hours postoperatively, urinary NGAL was lower in the IP-L group than in the control and IP-E groups (p = 0.076 and 0.047, respectively). NGAL, neutrophil gelatinase-associated lipocalin; Ucr, urine creatinine; IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window. * p<0.05 vs. Control, † p<0.05 vs. IP-E.

Mentions: Before index ischemia, the median urinary NGAL was 0.12 (IQR 0.1–0.26) ng/mg (Fig 3). At 6 hours after the ischemic injury, there was no difference in urinary NGAL levels between groups. At 24 hours after ischemia, the urinary NGAL was lower in the IP-L than in the control and IP-E groups; however, the difference did not reach the statistical significance (p = 0.602 and 0.347, respectively; Fig 3). At 72 hours post-ischemia, the NGAL was still lower in the IP-L group than in the other two groups (p = 0.076 and 0.047, respectively). There was no difference between the control and IP-E group NGAL levels throughout the observational period (up to 72 hours after IRI).


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 urinary NGAL (A) and urinary NGAL percent change from baseline (B) normalized to urinary creatinine.At 72 hours postoperatively, urinary NGAL was lower in the IP-L group than in the control and IP-E groups (p = 0.076 and 0.047, respectively). NGAL, neutrophil gelatinase-associated lipocalin; Ucr, urine creatinine; IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window. * p<0.05 vs. Control, † p<0.05 vs. IP-E.
© Copyright Policy
Related In: Results  -  Collection

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

pone.0124130.g003: Changes in urinary NGAL (A) and urinary NGAL percent change from baseline (B) normalized to urinary creatinine.At 72 hours postoperatively, urinary NGAL was lower in the IP-L group than in the control and IP-E groups (p = 0.076 and 0.047, respectively). NGAL, neutrophil gelatinase-associated lipocalin; Ucr, urine creatinine; IP-E, remote ischemic preconditioning with early window; IP-L, remote ischemic preconditioning with late window. * p<0.05 vs. Control, † p<0.05 vs. IP-E.
Mentions: Before index ischemia, the median urinary NGAL was 0.12 (IQR 0.1–0.26) ng/mg (Fig 3). At 6 hours after the ischemic injury, there was no difference in urinary NGAL levels between groups. At 24 hours after ischemia, the urinary NGAL was lower in the IP-L than in the control and IP-E groups; however, the difference did not reach the statistical significance (p = 0.602 and 0.347, respectively; Fig 3). At 72 hours post-ischemia, the NGAL was still lower in the IP-L group than in the other two groups (p = 0.076 and 0.047, respectively). There was no difference between the control and IP-E group NGAL levels throughout the observational period (up to 72 hours after IRI).

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