title: The hemodynamic effects of CO2-induced pressure on the kidney in an isolated perfused rat kidney model.
abstract: BACKGROUND
  Variable mechanisms were suggested to mediate the changes in renal hemodynamics during pneumoperitoneum. To assess whether it can be pressure dependent only, we conduct a study in an isolated, pressurized, and perfused organ model.
  
  
  METHODS
  Seventy Wistar rat kidneys were perfused with oxygenated, 3% albumin-contained Krebs-Henseleit solution. Experiments took place within Plexiglass chamber that provided conditions for perfusion of organs, humidity, and maintenance of intracameral CO2 pressures [0 (control), 3, 5, 8, 12, 15, and 18 mm Hg]. All kidneys (10/group) were perfused for 60 minutes. One-half of the groups were perfused for an additional 30 minutes, during which the perfusion pressures were reduced to 0 mm Hg. pH of the perfusate was measured as well.
  
  
  RESULTS
  The perfusion pressure increased and the kidney flow decreased slightly, in proportion with the intrachamber pressure. Urine output decreased to a minimum of 40% in >or=8 mm Hg pressure conditions, compared with the control group. The pH values were below normal, during experimental pneumoperitoneum.
  
  
  CONCLUSIONS
  Pneumoperitoneal conditions are a direct cause of changes in renal urinary output. The increase in pCO2 pressure and consequently low intraorgan pH may contribute to a mild transient renal damage during pneumoperitoneum.
authors.affiliation: Division of General Surgery B, Tel Aviv Sourasky Medical Center, The Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. we_khoury@yahoo.com
authors.forename: Wisam
authors.initials: W
authors.lastname: Khoury
authors.forename: Amir
authors.initials: A
authors.lastname: Szold
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Klausner
authors.forename: Avi A
authors.initials: AA
authors.lastname: Weinbroum
mesh_terms: D000222:Adaptation, Physiological / Q000187:drug effects; D000818:Animals; D002245:Carbon Dioxide / Q000494:pharmacology*; D004195:Disease Models, Animal; D006439:Hemodynamics / Q000187:drug effects*; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D066298:In Vitro Techniques; D007668:Kidney / Q000187:drug effects / Q000502:physiology*; D008297:Male; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D011312:Pressure; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012079:Renal Circulation / Q000187:drug effects*; D051437:Renal Insufficiency / Q000209:etiology / Q000503:physiopathology
chemical_list: D002245:Carbon Dioxide