Role of combined L-arginine and prostaglandin E1 in renal ischemia-reperfusion injury.
BACKGROUND
L-Arginine (L-arg) and Prostaglandin E(1) (PGE(1)) have been used effectively as single agents to ameliorate renal ischemia-reperfusion injury. We hypothesized that combined treatment with L-arg and PGE(1 )would be more effective.


METHODS
The left renal artery of male Sprague-Dawley rats was clamped for 45 min and the right kidney was removed. Fifty six rats were randomly allocated into 5 groups each consisted of 12 rats except sham group (n = 8). (1) sham, underwent right nephrectomy only; (2) control, untreated ischemic rats; (3) L-arg group, L-arg-treated ischemic rats; (4) PGE(1) group, PGE(1)-treated ischemic rats; (5) L-arg+PGE(1) group, ischemic rats treated with both L-arg and PGE(1). Renal function and histology were assessed on days 2 and 7 postoperatively.


RESULTS
All rats, except control ones, showed a significant improvement of renal function towards normal on postoperative day 7. Serum creatinine and creatinine clearance were significantly better in L-arg+PGE(1) group compared to all other groups on day 7. With the exception of sham-operated and L-arg+PGE(1)-treated animals, all other groups showed significant increases in fractional excretion of sodium (FE(Na)) in response to renal ischemia-reperfusion. The severest tubular damage was determined in the kidneys of control rats. Rats treated with L-arg+PGE(1) had the least severe tubular damage.


CONCLUSIONS
The administration of either L-arg or PGE(1) attenuates both functional and structural consequences of renal warm ischemia. A near total protection might be achieved when both agents are administered concomitantly.
Mahmoud
Ihab M
IM
Urology and Nephrology Center, Mansoura University, Mansoura, Egypt. uronef@hotmail.com
Hussein
Abd El-Aziz M
Ael-A
Sarhan
Mohammed E
ME
Awad
Ali A
AA
El Desoky
Ibrahim
I
D000527:Alprostadil / Q000494:pharmacology*; D000818:Animals; D001120:Arginine / Q000494:pharmacology*; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D004359:Drug Therapy, Combination; D007668:Kidney / Q000187:drug effects / Q000473:pathology / Q000502:physiology; D007674:Kidney Diseases / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D015427:Reperfusion Injury / Q000188:drug therapy* / Q000473:pathology; D012964:Sodium / Q000652:urine; D016019:Survival Analysis; D014556:Urine; D014665:Vasodilator Agents / Q000494:pharmacology*
D014665:Vasodilator Agents; D001120:Arginine; D012964:Sodium; D003404:Creatinine; D000527:Alprostadil