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2015 ; 10
(12
): e0144516
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Ulinastatin Protects against Acute Kidney Injury in Infant Piglets Model
Undergoing Surgery on Hypothermic Low-Flow Cardiopulmonary Bypass
#MMPMID26656098
Wang X
; Xue Q
; Yan F
; Liu J
; Li S
; Hu S
PLoS One
2015[]; 10
(12
): e0144516
PMID26656098
show ga
OBJECTIVE: Infants are more vulnerable to kidney injuries induced by inflammatory
response syndrome and ischemia-reperfusion injury following cardiopulmonary
bypass especially with prolonged hypothermic low-flow (HLF). This study aims to
evaluate the protective role of ulinastatin, an anti-inflammatory agent, against
acute kidney injuries in infant piglets model undergoing surgery on HLF
cardiopulmonary bypass. METHODS: Eighteen general-type infant piglets were
randomly separated into the ulinastatin group (Group U, n = 6), the control group
(Group C, n = 6), and the sham operation group (Group S, n = 6), and
anaesthetized. The groups U and C received following experimental procedure:
median thoracotomy, routine CPB and HLF, and finally weaned from CPB. The group S
only underwent sham median thoracotomy. Ulinastatin at a dose of 5,000 units/kg
body weight and a certain volume of saline were administrated to animals of the
groups U and C at the beginning of CPB and at aortic declamping, respectively.
Venous blood samples were collected at 3 different time points: after anesthesia
induction in all experimental groups, 5 minutes, and 120 minutes after CPB in the
Groups U and C. Markers for inflammation and acute kidney injury were tested in
the collected plasma. N-acetyl-?-D-glucosaminidase (NAG) from urine, markers of
oxidative stress injury and TUNEL-positive cells in kidney tissues were also
detected. RESULTS: The expressions of plasma inflammatory markers and acute
kidney injury markers increased both in Group U and Group C at 5 min and 120 min
after CPB. Also, numbers of TUNEL-positive cells and oxidative stress markers in
kidney rose in both groups. At the time point of 120-min after CPB, compared with
the Group C, some plasma inflammatory and acute kidney injury markers as well as
TUNEL-positive cells and oxidative stress markers in kidney were significantly
reduced in the Group U. Histologic analyses showed that HLF promoted acute
tubular necrosis and dilatation. CONCLUSIONS: HLF cardiopulmonary bypass surgery
could intensify systemic inflammatory responses and oxidative stress on infant
piglets, thus causing acute kidney injury. Ulinastatin might reduce such
inflammatory response and oxidative stress and the extent of kidney injury.
|Acetylglucosaminidase/urine
[MESH]
|Acute Kidney Injury/drug therapy/*prevention & control
[MESH]