Renal oxidative stress following CO2 pneumoperitoneum-like conditions

Abstract

Background Physiologic renal changes associated with pneumoperitoneum (PNP) have been described and various underlying mechanisms have been suggested. We investigated the possibility that PNP-associated renal damage is pressure dependent, and that oxidative stress is thereby involved. Materials and methods Seventy Wistar rat kidneys (n = 10 per group) were isolated. They were perfused with oxygenated, warm, Krebs-Henseleit solution containing 5% albumin within an isolated environment and subjected to various CO 2 pressures (0 [control], 3,5,8,12,15, and 18 mmHg) for 60 min. Half of each group was additionally perfused for 30 min at 0 mmHg pressure.Results Renal flow decreased proportionately to the applied pressure as did urine output: both decreased (P \ 0.05) after 60 and 90 min when pressure C8 mmHg was applied. Oxygen extraction decreased (P \ 0.05) during PNP in all pressurized groups. Xanthine oxidase (XO) activity and reduced glutathione in the tissues increased (P \ 0.05) proportionately to pressures C8 mmHg. All parameters slightly reversed toward baseline values, upon the release of the intra-chamber pressure, except for the 18 mmHg group's values. Conclusions CO 2 -PNP pressure induces kidney injury, possibly reversible immediately after pressure is annulled. Pressure is associated with oxidative stress, which interferes with cellular metabolism and function, possibly via an ischemic-reperfusion-like mechanism.

Nitric oxide synthase inhibition aggravates the adverse renal effects of high but not low intraabdominal pressure

“…In line with our in vivo protocols, use of a unique ex vivo perfused kidney in a closed chamber [40] demonstrated that increasing CO 2 pressures from 0 mmHg (control), to 3,5,8,12,15, and 18 mmHg for 60 min decreased renal flow and urine output proportionately to the applied pressure. These changes were associated with reduced oxygen extraction in all the pressurized groups.…”

N-acetylcysteine (NAC) Protects Against Acute Kidney Injury (AKI) Following Prolonged Pneumoperitoneum in the Rat

“…Pneumoperitoneum was induced by 10 mmHg CO 2 insufflation by 1 and 3 h [11,12]. After deinsufflation and recovery from the anesthesia, the animals were returned to their original cages and given free access to water and standard rat chow (Nuvilab, Colombo, Brazil).…”

Acute Kidney Injury Induced by Various Pneumoperitoneum Pressures in a Rabbit Model of Mild and Severe Hydronephrosis

“…The effects of intraabdominal pressure during pneumoperitoneum have been reported in rat and pig animal models [9,13,14,15,16]. These reports were based on normal kidneys.…”