title: Repeated remote ischemic preconditioning and isoflurane anesthesia in an experimental model of renal ischemia-reperfusion injury.
abstract: BACKGROUND
  In animal studies, remote ischemic preconditioning (RIPC) and anesthetic preconditioning are successful in reducing renal ischemia reperfusion injury (IRI), however the protective effect of RIPC may be improved by repeating the RIPC stimulus.
  
  
  METHODS
  Sprague-Dawley rats underwent unilateral nephrectomy followed by 30 min of renal pedicle clamping. Animals were allocated into six groups: sham, control (IRI), RepISO (daily isoflurane anesthesia), RIPC (single dose isoflurane anesthesia and single dose RIPC), RepISO + RIPC (7-day isoflurane anesthesia and single dose RIPC) and RepISO + RepRIPC (7-day isoflurane anesthesia with 7-day RIPC). RIPC was applied by 3×5 min of cuff inflation on both thighs. Serum creatinine and urea levels were measured and histology was obtained at day two.
  
  
  RESULTS
  RepISO diminished renal IRI, as reflected by a significant reduction in serum creatinine levels as compared to the control group, 170 ± 74 resp. 107 ± 29 μmol/L. The other preconditioning protocols showed similar reduction in serum creatinine levels as compared to the control group. No significant differences were observed between the different preconditioning protocols. For urea levels, only RepISO + RIPC resulted in significantly lower levels as compared to the control group, 14 ± 4 resp. 22 ± 7 mmol/L (p = 0.010). In the preconditioning groups only RepISO showed less histological damage as compared to controls 1.73 ± 1.19 resp. 2.91 ± 1.22 (p = 0.032).
  
  
  CONCLUSIONS
  In this study no additional protective effect of repeated ischemic preconditioning was observed as compared to single dose RIPC. Repeated administration of isoflurane provided stronger protection against renal IRI as compared to single dose isoflurane.
authors.affiliation: Department of Surgery, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands. Theo.menting@radboudumc.nl.
authors.forename: Theo P
authors.initials: TP
authors.lastname: Menting
authors.affiliation: Department of Surgery, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergun
authors.affiliation: Department of Surgery, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Moira H D
authors.initials: MH
authors.lastname: Bruintjes
authors.affiliation: Systematic Review Centre for Laboratory animal Experimentation, SYRCLE, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Kimberley E
authors.initials: KE
authors.lastname: Wever
authors.affiliation: Department of Surgery, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Roger M L M
authors.initials: RM
authors.lastname: Lomme
authors.affiliation: Department of Surgery, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Harry
authors.initials: H
authors.lastname: van Goor
authors.affiliation: Department of Surgery, Radboud University Medical Center, Geert Grooteplein-zuid 10, 6525 GA, Nijmegen, The Netherlands.
authors.forename: Michiel C
authors.initials: MC
authors.lastname: Warlé
mesh_terms: D000818:Animals; D003404:Creatinine / Q000097:blood; D004195:Disease Models, Animal; D019194:Ischemic Preconditioning / Q000379:methods*; D007530:Isoflurane / Q000494:pharmacology*; D007668:Kidney / Q000473:pathology; D008297:Male; D065840:Protective Factors; D051381:Rats; D015427:Reperfusion Injury / Q000097:blood / Q000473:pathology / Q000517:prevention & control*; D014508:Urea / Q000097:blood
chemical_list: D014508:Urea; D003404:Creatinine; D007530:Isoflurane
keywords: Anesthetic preconditioning; Animal experiment; Ischemia reperfusion injury; Kidney; Repeated remote ischemic preconditioning