Exogenous nitric oxide modulates the systemic inflammatory response and improves kidney function after risk-situation abdominal aortic surgery

Abstract

In our experimental model, prophylactic treatment with the NO donor molsidomine regulates the systemic inflammatory response and minimizes damage at the kidney level. Clinical Relevance The importance of this article resides in the fact that an experimental study that clarifies the effect of the donors of NO under circumstances as similar as possible to those of the human clinic, such as aortic surgery under hypovolemic shock (ruptured aortic aneurysm) have been little studied, most of these studies being performed in rodents without bypass. Using a model with one or two simultaneous insults (aortic clamping with/without previous hemorrhage) that is very similar to the human clinical situation (abdominal aortic rupture), we confirm the findings of previous work related to the beneficial effects of NO donors.

Effects of Sepiapterin Infusion on Renal Oxygenation and Early Acute Renal Injury After Suprarenal Aortic Clamping in Rats

“…First, NO acts as a potent vasodilator, preventing platelet aggregation and leukocyte adhesion at the microcirculatory level, 23,24 thereby contributing to maintaining the microcirculatory flow after ischemia reperfusion. Lozano et al 25 found that infusion of another NO donor, molsidomine, resulted in the decrease of renal damage and prevention of local inflammation including leukocytes infiltration after suprarenal aortic clamping in pigs as found in this study. In a different study, Hosgood et al 26 reported that reperfusion of ischemic kidney with the NO donor sodium nitroprusside resulted in an increase in RBF after warm ischemia in pigs.…”

Protective effect of exogenous nitrite in postoperative ileus

“…Nitrite is unique in that it will be reduced to NO preferentially under hypoxic conditions and might thus provide NO where needed (Raat et al, 2009). This can less systematically be obtained with NO donors which were shown to induce beneficial (Lozano et al, 2005;Li et al, 2009), no (Hoshida et al, 1996;Zhu et al, 1996) or even detrimental (Mori et al, 1998) effects in I/R models.…”

Rickets, vitamin D deficiency, adolescents

“…Kuru et al (15) suggested that increase of renal injury occured with decrease of NO synthesis after chronic NOS inhibition. In another study (16), endogenous NO donor (molsidomine) was shown to improve kidney functions after abdominal aorta surgery. In our study, creatinine and urea levels were compared, and no significant difference was found between IR and IR+SNP groups.…”