Post-conditioning by a short administration of desflurane reduced renal reperfusion injury after differing of ischaemia times in rats.
BACKGROUND
'Anaesthetic post-conditioning', that is administration of anaesthetics during early reperfusion, is known to have positive effects on several organs. For the kidney, however, the effects of post-conditioning by volatile anaesthetics are not well researched. We examined renal function and morphology after post-conditioning by desflurane.


METHODS
Anaesthetized rats were subjected to 30 or 45 min of renal ischaemia 14 days after contralateral nephrectomy. Post-conditioning was achieved by administration of 1 MAC desflurane (6.7 vol%) for 15 min during early reperfusion (all groups n=8). Cystatin C (CyC), creatinine clearance (Cl(Cr)) and fractional sodium excretion (FE(Na)) were measured in the awake rats over 3 days. Cell damage was graded from 1 to 4 in histological sections. Functional variables [mean (SD)] were compared statistically by a one-way anova followed by Bonferroni's multiple comparison test and histological scores (median and range) by Kruskal-Wallis test followed by Dunn's multiple comparison test.


RESULTS
Pre-ischaemia function did not differ between the groups, but was markedly reduced after ischaemia. After 30 min ischaemia, the area under the curve (AUC) for Cl(Cr) was smaller in the desflurane than in the control group [21.5 (5.0) vs 31.6 (5.1) ml min(-1) h, P<0.05]. After 45 min desflurane reduced the AUC compared with the control group for both CyC [15 (4) vs 21 (3) mg litre(-1) h] and FE(Na) [1054 (221) vs 1570 (572)% h, both P<0.05). Morphological differences were greater between the 30 min groups [control: 2.75 (2.0-3.5) vs desflurane: 1.5 (1.0-2.5); P<0.05] than between the 45 min groups [control: 3.5 (3.0-4.0) vs desflurane: 3.0 (1.5-4.0)].


CONCLUSIONS
Desflurane post-conditioning protects renal function and tissue. This protection was greater after the short episode than after the long episode of ischaemia.
Obal
D
D
Department of Anaesthesiology, Heinrich-Heine University, Duesseldorf, Germany. d.obal@louisville.edu
Rascher
K
K
Favoccia
C
C
Dettwiler
S
S
Schlack
W
W
D018685:Anesthetics, Inhalation / Q000627:therapeutic use*; D000818:Animals; D003404:Creatinine / Q000652:urine; D055316:Cystatin C; D015891:Cystatins / Q000097:blood; D000077335:Desflurane; D053331:Ectodysplasins / Q000378:metabolism; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000627:therapeutic use; D007668:Kidney / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D009318:Natriuresis; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors
D018685:Anesthetics, Inhalation; C525032:Cst3 protein, rat; D055316:Cystatin C; D015891:Cystatins; D053331:Ectodysplasins; D003404:Creatinine; D000077335:Desflurane; D007530:Isoflurane