Osmotic nephrosis due to the use of anti-adhesive membrane intraperitoneally.
BACKGROUND
A common strategy for the prevention of intra-abdominal adhesions post-operatively has been the application of adhesion barriers into the peritoneal cavity. Side effects of these barriers are infection, abscesses and inadequate wound healing. There is no information about such a side effect of these materials on renal function. The aim of this study was to evaluate the effect of two different, commercially available polysaccharide-based anti-adhesive materials on renal function.


METHODS
In 24 adult Wistar rats, an abdominal midline incision was performed, and an anti-adhesion membrane was placed in the peritoneal cavity so as to cover its whole surface. Four rats were used as the control group. In 12 rats, a membrane of macromolecular polysaccharides, weighing 40 mg/cm2, was placed intra-abdominally and in 8 rats, a hyaluronic acid-hydroacidmethylcellulose membrane weighing 0.4 mg/cm2 was placed. At 24 or 70 h, the rats were sacrificed, and we evaluated changes in serum creatinine, urea, uric acid, K and Na, and histologic examination of the kidney was performed.


RESULTS
The use of the thicker macromolecular membrane was associated with a rise in serum creatinine and urea levels, vacuolization of all the tubular epithelial cells and mild interstitial infiltration. Rats in which the hyaluronic acid-hydroacidmethylcellulose membrane was used did not show any creatinine elevation, and they presented milder histologic lesions.


CONCLUSIONS
Polysaccharide and cellulose anti-adhesive membrane cause renal damage with tubular cell vacuolization. The severity of kidney damage is relative to the quantity of the membrane material used.
Economidou
Dominiki
D
Nephrology Department, Hippokration Hospital, and Physiology Department, Aristotle University, Thessaloniki, Greece. dominiki@otenet.gr
Kapoukranidou
Dorothea
D
Dimitriadis
Chrysostomos
C
Xioufi
Despina
D
Pantzaki
Afroditi
A
Anagnostou
Eleftherios
E
Memmos
Dimitrios
D
D000818:Animals; D001672:Biocompatible Materials / Q000009:adverse effects*; D001706:Biopsy; D004195:Disease Models, Animal; D006820:Hyaluronic Acid / Q000009:adverse effects; D007668:Kidney / Q000473:pathology*; D008567:Membranes, Artificial; D008747:Methylcellulose / Q000009:adverse effects; D009401:Nephrosis / Q000209:etiology* / Q000473:pathology; D010537:Peritoneum; D011134:Polysaccharides / Q000009:adverse effects*; D051381:Rats; D017208:Rats, Wistar; D000267:Tissue Adhesions / Q000517:prevention & control*
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D011134:Polysaccharides; D006820:Hyaluronic Acid; D008747:Methylcellulose