title: Ineffectiveness of remote ischemic renal preconditioning in a porcine solitary-kidney model.
abstract: OBJECTIVE
  Our study sought to demonstrate the effects of remote ischemic preconditioning (R-IPC) on renal function in a large animal (porcine) solitary-kidney model.
  
  
  METHODS
  Twelve pigs were assigned to two groups: Each underwent a right nephrectomy followed by a week of recovery. Group 1 (No-IPC) underwent left renal hilar clamping for 90 minutes. Group 2 underwent right and left iliac artery clamping for 10 minutes each (R-IPC), followed by left hilar clamping for 90 minutes. Serum creatinine was drawn for both groups before ischemia (preoperative), then at 6 hours, 24 hours, 3 days, and 7 days after. Kidneys were harvested at 24 hours or 7 days for histologic analysis, and the degree of acute tubular necrosis (ATN) or lymphocyte invasion was quantified.
  
  
  RESULTS
  Paired serum creatinine values were analyzed between time points. For Group 1, paired differences existed at 24 hours (P=0.008) but not at 3 days or 7 days. For Group 2, paired differences existed at 24 hours (P=0.006) but not at 3 days or 7 days. The mean preoperative serum creatinine level was similar between groups (P>0.05). The change in serum creatinine level was not significantly different between groups at any time point. Histologic analysis revealed rare evidence of ATN at 24 hours in Group 2, but not in Group 1. At 7 days, neither group showed ATN, and both showed 1-2+evidence of lymphocytic infiltrates.
  
  
  CONCLUSIONS
  R-IPC in a solitary-kidney porcine model does not confer renal protection from warm ischemia either as evidenced by renal function measures or on histologic analysis.
authors: Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors: Selhattin
authors: S
authors: Bedir
authors: Yunbo
authors: Y
authors: Ma
authors: Jodi
authors: J
authors: Antonelli
authors: Jeffrey A
authors: JA
authors: Cadeddu
authors: Jeffrey C
authors: JC
authors: Gahan
mesh_terms: D000818:Animals; D003250:Constriction; D007511:Ischemia / Q000473:pathology; D019194:Ischemic Preconditioning / Q000379:methods*; D007668:Kidney / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D007677:Kidney Function Tests; D008214:Lymphocytes; D008953:Models, Anatomic; D009392:Nephrectomy / Q000379:methods*; D034421:Sus scrofa; D013552:Swine; D052096:Warm Ischemia / Q000379:methods*