Mannitol reduces nephron loss after warm renal ischemia in a porcine model
Mannitol reduces nephron loss after warm renal ischemia in a porcine model
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DOI：
10.1186/s12894-018-0328-5
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发表时间：
2018-03-06
期刊：
影响因子：
2
通讯作者：
De Souza, Diogo B.
中科院分区：
文献类型：
--
作者：
Damasceno-Ferreira, Jose A.;Abreu, Leonardo A. S.;De Souza, Diogo B.
背景资料：甘露醇已被用于改善肾部分切除术中的肾热缺血损伤，然而，支持在肾部分切除术中使用甘露醇的科学证据有限。本研究的目的是调查肾小球数量肾热缺血后，有和没有使用甘露醇在猪Model.Methods：24只雄性猪被分为三组。将8只动物分配至假手术组，对左肾门进行腹腔镜解剖，无肾缺血。缺血组8只，腹腔镜下夹闭左肾门30 min。8只动物在肾门闭塞30分钟前接受甘露醇（250 mg/kg）。在术后21天对猪实施安乐死后收集肾脏。右肾用作每只动物的自身对照。测量血清肌酐、尿素水平、肾脏重量和体积。通过体视学方法定量肾小球体积密度、体积加权肾小球体积和皮质体积，并用于确定每个肾脏的肾单位数量。结果：缺血组左肾肾小球数目较右肾减少24.6%（290，000个肾小球），缺血组左肾肾小球数目较右肾减少24.6%（290，000个肾小球）。与假手术组和甘露醇组相比，缺血肾脏的重量和体积也有所减少。在假手术组和甘露醇组的左肾和右肾之间没有观察到差异。此外，血清肌酐和尿素之间的组之间没有区别observed.Conclusion：甘露醇的使用显着减少肾单位的损失在猪热缺血。
Background: Mannitol has been employed to ameliorate renal warm ischemia damage during partial nephrectomy, however, there is limited scientific evidence to support the use of mannitol during partial nephrectomy. The objective of the present study was to investigate the glomerular number after renal warm ischemia, with and without the use of mannitol in a Pig Model.Methods: Twenty-four male pigs were assigned into three groups. Eight animals were allocated to the sham group that was subjected to laparoscopic dissection of the left renal hilum, without renal ischemia. Eight animals were allocated to the ischemia group that had the left renal hilum clamped for 30 min through laparoscopic access. Eight animals received mannitol (250 mg/kg) before the occlusion of renal hilum for 30 min. The kidneys were collected after the euthanasia of the pigs 21 days post surgery. The right kidney was utilized as a self-control for each animal. Serum creatinine, urea levels, the weight and volume of the kidneys were measured. Glomerular volumetric density, volume-weighted glomerular volume, and cortical volume were quantified through stereological methods and employed to determine the number of nephrons per kidney. Student's t test and ANOVA were used for statistical analysis.Results: In the ischemia group, the left kidney recorded a reduction of 24.6% (290, 000 glomeruli) in the number of glomeruli in comparison to the right kidney. Kidneys subjected to ischemia also displayed decreased weight and volume in comparison to the sham and mannitol groups. No difference was observed between the left and right kidneys from the sham and mannitol groups. Further, no distinction in serum creatinine and urea among the groups was observed.Conclusion: The use of mannitol significantly reduces nephron loss during warm ischemia in pigs.