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

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 ren...

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Bibliographic Details
Published in:PloS one 2015-04, Vol.10 (4), p.e0124130-e0124130
Main Authors: Yoon, Young Eun, Lee, Kwang Suk, Choi, Kyung Hwa, Kim, Kwang Hyun, Yang, Seung Choul, Han, Woong Kyu
Format: Article
Language:English
Subjects:
Analysis
Animals
Biomarkers
Biomarkers - urine
Clamping
Creatinine
Creatinine - blood
Female
Gelatinase
Injury prevention
Ischemia
Ischemic Preconditioning
Kidney - blood supply
Lipocalin
Nephrectomy
Preconditioning
Renal artery
Reperfusion
Reperfusion injury
Reperfusion Injury - prevention & control
Swine
Windows (intervals)
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Summary: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.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0124130