title: Glucose supplementation does not interfere with fasting-induced protection against renal ischemia/reperfusion injury in mice.
abstract: BACKGROUND
  Preoperative fasting induces robust protection against renal ischemia/reperfusion (I/R) injury in mice but is considered overcautious and possibly detrimental for postoperative recovery in humans. Furthermore, fasting seems to conflict with reported benefits of preoperative nutritional enhancement with carbohydrate-rich drinks. Here, we investigated whether preoperative ingestion of a glucose solution interferes with fasting-induced protection against renal I/R injury.
  
  
  METHODS
  Mice were randomized into the following groups: fasted for 3 days with access to water (fasted) or a glucose solution (fasted+glc) and fed ad libitum with water (fed) or a glucose solution (fed+glc). After induction of bilateral renal I/R injury, all animals had free access to food and water. Calorie intake, body weight, insulin sensitivity, kidney function, and animal survival were determined.
  
  
  RESULTS
  Fed+glc mice had a comparable daily calorie intake as fed mice, but 50% of those calories were obtained from the glucose solution. Fasted+glc mice had a daily calorie intake of approximately 75% of the intake of both fed groups. This largely prevented the substantial body weight loss seen in fasted animals. Preoperative insulin sensitivity was significantly improved in fasted+glc mice versus fed mice. After I/R injury, kidney function and animal survival were superior in both fasted groups.
  
  
  CONCLUSIONS
  The benefits of fasting and preoperative nutritional enhancement with carbohydrates are not mutually exclusive and may be a clinically feasible regimen to protect against renal I/R injury.
authors.affiliation: Department of Surgery, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
authors.forename: Mariëlle
authors.initials: M
authors.lastname: Verweij
authors.forename: Marieke
authors.initials: M
authors.lastname: van de Ven
authors.forename: James R
authors.initials: JR
authors.lastname: Mitchell
authors.forename: Sandra
authors.initials: S
authors.lastname: van den Engel
authors.forename: Jan H J
authors.initials: JH
authors.lastname: Hoeijmakers
authors.forename: Jan N M
authors.initials: JN
authors.lastname: Ijzermans
authors.forename: Ron W F
authors.initials: RW
authors.lastname: de Bruin
mesh_terms: D000284:Administration, Oral; D000818:Animals; D001835:Body Weight / Q000187:drug effects; D002149:Energy Intake / Q000187:drug effects; D005215:Fasting / Q000502:physiology*; D005947:Glucose / Q000008:administration & dosage / Q000494:pharmacology*; D007333:Insulin Resistance / Q000502:physiology; D007668:Kidney / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology*; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D023421:Models, Animal; D057234:Preoperative Period; D012039:Regional Blood Flow / Q000502:physiology; D015427:Reperfusion Injury / Q000503:physiopathology / Q000517:prevention & control*; D013997:Time Factors
chemical_list: D005947:Glucose