title: Tolerance of the human kidney to isolated controlled ischemia.
abstract: Tolerance of the human kidney to ischemia is controversial. Here, we prospectively studied the renal response to clamp ischemia and reperfusion in humans, including changes in putative biomarkers of AKI. We performed renal biopsies before, during, and after surgically induced renal clamp ischemia in 40 patients undergoing partial nephrectomy. Ischemia duration was >30 minutes in 82.5% of patients. There was a mild, transient increase in serum creatinine, but serum cystatin C remained stable. Renal functional changes did not correlate with ischemia duration. Renal structural changes were much less severe than observed in animal models that used similar durations of ischemia. Other biomarkers were only mildly elevated and did not correlate with renal function or ischemia duration. In summary, these data suggest that human kidneys can safely tolerate 30-60 minutes of controlled clamp ischemia with only mild structural changes and no acute functional loss.
authors: Department of Urology, University of Texas Health Science Center San Antonio, San Antonio, Texas, USA. parekhd@med.miami.edu
authors: Dipen J
authors: DJ
authors: Parekh
authors: Joel M
authors: JM
authors: Weinberg
authors: Barbara
authors: B
authors: Ercole
authors: Kathleen C
authors: KC
authors: Torkko
authors: William
authors: W
authors: Hilton
authors: Michael
authors: M
authors: Bennett
authors: Prasad
authors: P
authors: Devarajan
authors: Manjeri A
authors: MA
authors: Venkatachalam
mesh_terms: D058186:Acute Kidney Injury / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D005260:Female; D006801:Humans; D007511:Ischemia / Q000473:pathology / Q000503:physiopathology*; D007668:Kidney / Q000098:blood supply* / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D011446:Prospective Studies; D015427:Reperfusion Injury / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D013997:Time Factors
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D003404:Creatinine