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. 2017 Jan 28;17(1):14.
doi: 10.1186/s12871-017-0310-x.

Repeated remote ischemic preconditioning and isoflurane anesthesia in an experimental model of renal ischemia-reperfusion injury

Theo P Menting  1 , Mehmet Ergun  2 , Moira H D Bruintjes  2 , Kimberley E Wever  3 , Roger M L M Lomme  2 , Harry van Goor  2 , Michiel C Warlé  2
Affiliations

Repeated remote ischemic preconditioning and isoflurane anesthesia in an experimental model of renal ischemia-reperfusion injury

Theo P Menting et al. BMC Anesthesiol. .

Abstract

Background: In animal studies, remote ischemic preconditioning (RIPC) and anesthetic preconditioning are successful in reducing renal ischemia reperfusion injury (IRI), however the protective effect of RIPC may be improved by repeating the RIPC stimulus.

Methods: Sprague-Dawley rats underwent unilateral nephrectomy followed by 30 min of renal pedicle clamping. Animals were allocated into six groups: sham, control (IRI), RepISO (daily isoflurane anesthesia), RIPC (single dose isoflurane anesthesia and single dose RIPC), RepISO + RIPC (7-day isoflurane anesthesia and single dose RIPC) and RepISO + RepRIPC (7-day isoflurane anesthesia with 7-day RIPC). RIPC was applied by 3×5 min of cuff inflation on both thighs. Serum creatinine and urea levels were measured and histology was obtained at day two.

Results: RepISO diminished renal IRI, as reflected by a significant reduction in serum creatinine levels as compared to the control group, 170 ± 74 resp. 107 ± 29 μmol/L. The other preconditioning protocols showed similar reduction in serum creatinine levels as compared to the control group. No significant differences were observed between the different preconditioning protocols. For urea levels, only RepISO + RIPC resulted in significantly lower levels as compared to the control group, 14 ± 4 resp. 22 ± 7 mmol/L (p = 0.010). In the preconditioning groups only RepISO showed less histological damage as compared to controls 1.73 ± 1.19 resp. 2.91 ± 1.22 (p = 0.032).

Conclusions: In this study no additional protective effect of repeated ischemic preconditioning was observed as compared to single dose RIPC. Repeated administration of isoflurane provided stronger protection against renal IRI as compared to single dose isoflurane.

Keywords: Anesthetic preconditioning; Animal experiment; Ischemia reperfusion injury; Kidney; Repeated remote ischemic preconditioning.

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Figures

Fig. 1
Fig. 1
Schematic protocol of the animal groups were the line is a non linear timeframe of seven days. The open boxes indicate a period of anesthesia alone, gray boxes a period or RIPC and black boxes a period of renal ischemia. Animals were randomly allocated into six groups: sham, control (IRI), RepISO (daily isoflurane anesthesia), RIPC (single dose isoflurane anesthesia and single dose RIPC), RepISO + RIPC (7-day isoflurane anesthesia and single dose RIPC) and RepISO + RepRIPC (7-day isoflurane anesthesia with 7-day RIPC). RIPC was applied by 3×5 min of cuff inflation on both thighs
Fig. 2
Fig. 2
Serum creatinine; day -10 (baseline), 1 and 2 postoperative (* significantly different from sham, # significantly different from control group)
Fig. 3
Fig. 3
Serum urea; day -10 (baseline), 1 and 2 postoperative (* significantly different from sham, # significantly different from control group)
Fig. 4
Fig. 4
Histology; day 2 postoperative (* significantly different from sham, # significantly different from control group)
See this image and copyright information in PMC

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