title: Amelioration of nephrotoxicity associated with synthetic oxygen transport media.
abstract: Use of synthetic oxygen transport media offers the potential advantages of reducing requirements for coadministration of blood products and oxygen at the scene of mass casualty situations. Previous studies have shown perfusions of isolated kidneys with stroma-free hemoglobin (SFH) to be physiological while those with Fluosol-DA (20% FDA) have been associated with low glomerular filtration rate, urinary flow rate, and fractional reabsorption of sodium and potassium (FrNa+ and FrK+). In the present studies, perfusions with SFH/FDA mixtures showed normal glomerular filtration rate, a 50% lower urinary flow rate, and FrNa+ values 3% to 5% higher than SFH controls. Compared with 20% FDA perfusions, nephrotoxic effects of SFH/FDA combinations were moderate. Compared with SFH/FDA mixtures, perfusion with 20% FDA showed lower urinary flow and glomerular filtration rates. Ultrastructural assessment of glomerular filter revealed that FDA emulsion particles were adherent to epithelial podocytes. We conclude that resuscitation with a mixture of SFH and FDA may ameliorate the previously reported nephrotoxicity associated with the use of FDA alone.
authors.affiliation: Department of Physiology & Biophysics, Howard University, Washington, DC 20059.
authors.forename: R M
authors.initials: RM
authors.lastname: Millis
authors.forename: J D
authors.initials: JD
authors.lastname: Barber
authors.forename: W A
authors.initials: WA
authors.lastname: Anderson
authors.forename: R M
authors.initials: RM
authors.lastname: Toussaint
authors.forename: F W
authors.initials: FW
authors.lastname: Baker
authors.forename: B E
authors.initials: BE
authors.lastname: Hackley
mesh_terms: D000818:Animals; D001802:Blood Substitutes / Q000633:toxicity*; D005466:Fluorocarbons / Q000633:toxicity*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006454:Hemoglobins / Q000633:toxicity*; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D010477:Perfusion; D010952:Plasma Substitutes / Q000633:toxicity*; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D001802:Blood Substitutes; D005466:Fluorocarbons; D006454:Hemoglobins; D010952:Plasma Substitutes; C016484:hemoglobin, stroma free; C050455:fluosol