Renographic evaluation of kidney preservation with chlorpromazine

Abstract

The effect of chlorpromazine pretreatment of kidneys then damaged by warm ischemia was investigated. The ischemia was inflicted on rabbit kidneys by renal arterial occlusion of 1 1/2 and 3 hours' duration after contralateral nephrectomy. Pretreatment with chlorpromazine, 3.5 mg/kg, was given intravenously before arterial clamping. I-125 Hippuran renography was performed before clamping, immediately after clamp release, and at 2, 4, 6, and 14 days later. Serum creatinine and survival rate were followed. Comparison with untreated control groups was made. The effect on tubular function was investigated by measuring I-125 Hippuran uptake in pretreated slices of renal cortex (compared with untreated contralateral kidney) 48 hr after circulation was restored to the ischemic kidney. Chlorpromazine pretreatment improved recovery from ischemic damage: the renograms showed improved Hippuran uptake after clamp removal, and return to normal was faster. Survival rate after 3 hr of ischemia increased from 1/10 to 6/10 in the pretreated group, and serum creatinine recovered earlier. Hippuran uptake in slices of cortex showed no significant improvement because of pretreatment. It is concluded that the beneficial effect of chlorpromazine pretreatment must be because of decreased vascular resistance, leading to long-lasting increased postischemic renal blood flow.