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Repetitive Brief Ischemia: Intermittent Reperfusion During Ischemia Ameliorates the Extent of Injury in the Perfused Kidney 

Authors: Desley A. Willgoss a;  Bing Zhang a;  Glenda C. Gobeacute b;  Mehri Kadkhodaee c; Zoltan H. Endre a
Affiliations:   a Departments of Medicine, Royal Brisbane Hospital, University of Queensland, Brisbane, Australia
b Departments of Molecular and Cellular Pathology, School of Medicine, Royal Brisbane Hospital, University of Queensland, Brisbane, Australia
c Department of Physiology and Pharmacology, University of Tehran School of Medicine, Tehran, Iran
DOI: 10.1081/JDI-120021164
Publication Frequency: 10 issues per year
Published in: journal Renal Failure, Volume 25, Issue 3 January 2005 , pages 379 - 395
Subject: Dialysis;
Formats available: HTML (English) : PDF (English)
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Abstract

Acute renal failure commonly follows reduced renal perfusion or ischemia. Reperfusion is essential for recovery but can itself cause functional and structural injury to the kidney. The separate contributions of ischemia and of reperfusion were examined in the isolated perfused rat kidney. Three groups were studied: brief (5 min) ischemia, 20 min ischemia, and repetitive brief ischemia (4 periods of 5 min) with repetitive intervening reperfusion of 5 min. A control group had no intervention, the three ischemia groups were given a baseline perfusion of 30 min before intervention and all groups were perfused for a total of 80 min. In addition, the effects of exogenous ·NO from sodium nitroprusside and xanthine oxidase inhibition by allopurinol were assessed in the repetitive brief ischemia-reperfusion model. Brief ischemia produced minimal morphological injury with near normal functional recovery. Repetitive brief ischemia-reperfusion caused less functional and morphological injury than an equivalent single period of ischemia (20 min) suggesting that intermittent reperfusion is less injurious than ischemia alone over the time course of study. Pretreatment with allopurinol improved renal function after repetitive brief ischemia-reperfusion co pared with the allopurinol-untreated repetitive brief ischemia-reperfusion group. Similarly, sodium nitroprusside reduced renal vascular resistance but did not improve the glomerular filtration rate or sodium reabsorption in the repetitive brief ischemia-reperfusion model. Thus, these studies show that the duration of uninterrupted ischemia is more critical than reperfusion in determining the extent of renal ischemia- reperfusion injury and that allopurinol, in particular, counteracts the oxidative stress of reperfusion.
Keywords: Repetitive ischemia; Acute renal failure; Oxygen-derived free radicals; Allopurinol; Nitric oxide
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