Preventive effects of propofol and ketamine on renal injury in unilateral ureteral obstruction.
OBJECTIVE
The aim of the present study was to investigate the preventive effects of propofol and ketamine as anesthetics on renal injury in unilateral ureteral obstruction (UO).


METHODS
Twenty-four male New Zealand white rabbits were randomly assigned to four groups of six rabbits each. Anesthesia was induced and maintained with propofol in groups 1 and 2 and with ketamine in groups 3 and 4. Groups 2 and 4 received complete left ureteral ligation. Groups 1 and 3 (control groups) underwent an identical surgical procedure without ureteral ligation. At 14 days of obstruction, animals were sacrificed and ipsilateral kidneys were removed for determination of tissue nitric oxide (NO) levels and immunohistochemical evaluation of endothelial nitric oxide synthase (eNOS), inducible NOS (iNOS), and apoptosis protease-activating factor 1 (APAF-1).


RESULTS
Between groups 1 and 3, there were no differences in tissue NO levels and eNOS, iNOS, and APAF-1 expressions. iNOS and APAF-1 expressions were at the mild to moderate levels in group 2, but these parameters were markedly increased in group 4 at 14 days of obstruction. Also, elevated expression of iNOS was accompanied by a high NO production in group 4 compared with group 2. Although eNOS expressions were increased in both groups 2 and 4, there were no significant differences between these groups.


CONCLUSIONS
Propofol as an anesthetic agent may attenuate NO-induced renal tubular cell apoptosis by downregulating the expression of iNOS in an animal model of unilateral UO.
Dikmen
Bayazit
B
Clinic of Anesthesiology and Reanimation, The Ministry of Health Ankara Research and Training Hospital, Ankara, Turkey.
Yagmurdur
Hatice
H
Akgul
Turgay
T
Astarci
Muzeyyen
M
Ustun
Huseyin
H
Germiyanoglu
Cankon
C
D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D053477:Apoptotic Protease-Activating Factor 1 / Q000378:metabolism; D015536:Down-Regulation / Q000187:drug effects; D007150:Immunohistochemistry; D007649:Ketamine / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D007684:Kidney Tubules / Q000187:drug effects / Q000378:metabolism / Q000473:pathology; D008297:Male; D009569:Nitric Oxide / Q000378:metabolism; D052247:Nitric Oxide Synthase Type II / Q000378:metabolism; D052250:Nitric Oxide Synthase Type III / Q000378:metabolism; D015742:Propofol / Q000627:therapeutic use*; D011817:Rabbits; D011897:Random Allocation; D014517:Ureteral Obstruction / Q000150:complications*
D018686:Anesthetics, Intravenous; D053477:Apoptotic Protease-Activating Factor 1; D009569:Nitric Oxide; D007649:Ketamine; D052247:Nitric Oxide Synthase Type II; D052250:Nitric Oxide Synthase Type III; D015742:Propofol