Early peritoneal dialysis reduces lung inflammation in mice with ischemic acute kidney injury.
Although dialysis has been used in the care of patients with acute kidney injury (AKI) for over 50 years, very little is known about the potential benefits of uremic control on systemic complications of AKI. Since the mortality of AKI requiring renal replacement therapy (RRT) is greater than half in the intensive care unit, a better understanding of the potential of RRT to improve outcomes is urgently needed. Therefore, we sought to develop a technically feasible and reproducible model of RRT in a mouse model of AKI. Models of low- and high-dose peritoneal dialysis (PD) were developed and their effect on AKI, systemic inflammation, and lung injury after ischemic AKI was examined. High-dose PD had no effect on AKI, but effectively cleared serum IL-6, and dramatically reduced lung inflammation, while low-dose PD had no effect on any of these three outcomes. Both models of RRT using PD in AKI in mice reliably lowered urea in a dose-dependent fashion. Thus, use of these models of PD in mice with AKI has great potential to unravel the mechanisms by which RRT may improve the systemic complications that have led to increased mortality in AKI. In light of recent data demonstrating reduced serum IL-6 and improved outcomes with prophylactic PD in children, we believe that our results are highly clinically relevant.
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Chris
C
Altmann
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Nilesh
N
Ahuja
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Carol M
CM
Kiekhaefer
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Ana
A
Andres Hernando
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Kayo
K
Okamura
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Rhea
R
Bhargava
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Jane
J
Duplantis
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Lara A
LA
Kirkbride-Romeo
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Jill
J
Huckles
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Benjamin M
BM
Fox
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Kashfi
K
Kahn
Department of Pediatrics and Bioengineering, University of Colorado Denver, Aurora, Colorado, USA.
Danielle
D
Soranno
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA; Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Republic of Korea.
Hyo-Wook
HW
Gil
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA.
Isaac
I
Teitelbaum
University of Colorado Denver, Internal Medicine, Renal, Aurora, Colorado, USA. Electronic address: sarah.faubel@ucdenver.edu.
Sarah
S
Faubel
D058186:Acute Kidney Injury / Q000097:blood / Q000150:complications / Q000628:therapy*; D000818:Animals; D015850:Interleukin-6 / Q000097:blood; D055370:Lung Injury / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D051379:Mice; D023421:Models, Animal; D010530:Peritoneal Dialysis / Q000295:instrumentation / Q000379:methods*
D015850:Interleukin-6; C577686:interleukin-6, mouse
acute kidney injury; cytokines; dialysis; uremia