title: Acute kidney injury induced by various pneumoperitoneum pressures in a rabbit model of mild and severe hydronephrosis.
abstract: OBJECTIVE
  Increased pneumoperitoneum pressure during laparoscopic surgery can result in acute kidney injury. We aimed to clarify whether intraabdominal pressure tolerance is modified in various degrees of unilateral kidney hydronephrosis in rabbits.
  
  
  METHODS
  A total 90 rabbits were randomly allocated to three groups (group PN, PM and PS, i.e. rabbits with no, mild and severe hydronephrosis, respectively, subjected to intraabdominal pressures). Rabbits in group PM (n=30) and group PS (n=30) underwent a surgical procedure inducing a mild or severe left hydronephrosis. Rabbits in all groups were then allocated to 5 subgroups. Then, they were subjected to intraabdominal pressures of 0, 6, 9, 12, and 15 mm Hg, respectively. Acute kidney injury was assessed by measuring serum creatinine (Scr), blood urea nitrogen (BUN), tubular cell apoptosis, kidney injury molecule-1 (KIM-1) and cysteine-rich 61 (Cyr-61/CCN1) expression.
  
  
  RESULTS
  Acute kidney injury with increased tubular apoptosis and KIM-1 and Cyr-61 expression occurred when intraabdominal pressure reached 15, 15 and 9 mm Hg in PN, PM and PS groups, respectively. The Scr and BUN levels were similar in all groups.
  
  
  CONCLUSIONS
  In rabbits, kidneys with severe hydronephrosis were more likely to suffer acute injury when they were exposed to pneumoperitoneal pressure.
authors.affiliation: Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Zhixiu
authors.initials: Z
authors.lastname: Cao
authors.forename: Zhongyuan
authors.initials: Z
authors.lastname: Xia
authors.forename: Qingtao
authors.initials: Q
authors.lastname: Meng
authors.forename: Wei-min
authors.initials: WM
authors.lastname: Yu
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Yao
authors.forename: Fan
authors.initials: F
authors.lastname: Cheng
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000209:etiology* / Q000473:pathology; D000818:Animals; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D055515:Cysteine-Rich Protein 61 / Q000378:metabolism; D004195:Disease Models, Animal; D006869:Hydronephrosis / Q000150:complications*; D007668:Kidney / Q000378:metabolism / Q000473:pathology; D008297:Male; D011027:Pneumoperitoneum / Q000150:complications* / Q000503:physiopathology; D011312:Pressure; D011817:Rabbits; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D055515:Cysteine-Rich Protein 61; D003404:Creatinine