BJA Advance Access originally published online on September 21, 2006
British Journal of Anaesthesia 2006 97(6):783-791; doi:10.1093/bja/ael245
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Post-conditioning by a short administration of desflurane reduced renal reperfusion injury after differing of ischaemia times in rats
1 Department of Anaesthesiology, Heinrich-Heine University, Duesseldorf Germany
2 Department of Anatomy II, Heinrich-Heine University, Duesseldorf Germany
3 Department of Anaesthesiology, Academical Medical Center University of Amsterdam, The Netherlands
4 Department of Anesthesiology and the Outcomes Research Institute, University of Louisville KY 530 S Jackson S, Louisville 40202, USA.
*Corresponding author. E-mail: d.obal{at}louisville.edu
Background. ‘Anaesthetic post-conditioning’, that is administration of anaesthetics during early reperfusion, is known to have positive effects on several organs. For the kidney, however, the effects of post-conditioning by volatile anaesthetics are not well researched. We examined renal function and morphology after post-conditioning by desflurane.
Methods. Anaesthetized rats were subjected to 30 or 45 min of renal ischaemia 14 days after contralateral nephrectomy. Post-conditioning was achieved by administration of 1 MAC desflurane (6.7 vol%) for 15 min during early reperfusion (all groups n=8). Cystatin C (CyC), creatinine clearance (ClCr) and fractional sodium excretion (FENa) were measured in the awake rats over 3 days. Cell damage was graded from 1 to 4 in histological sections. Functional variables [mean (SD)] were compared statistically by a one-way ANOVA followed by Bonferroni's multiple comparison test and histological scores (median and range) by Kruskal–Wallis test followed by Dunn's multiple comparison test.
Results. Pre-ischaemia function did not differ between the groups, but was markedly reduced after ischaemia. After 30 min ischaemia, the area under the curve (AUC) for ClCr was smaller in the desflurane than in the control group [21.5 (5.0) vs 31.6 (5.1) ml min–1 h, P<0.05]. After 45 min desflurane reduced the AUC compared with the control group for both CyC [15 (4) vs 21 (3) mg litre–1 h] and FENa [1054 (221) vs 1570 (572)% h, both P<0.05). Morphological differences were greater between the 30 min groups [control: 2.75 (2.0–3.5) vs desflurane: 1.5 (1.0–2.5); P<0.05] than between the 45 min groups [control: 3.5 (3.0–4.0) vs desflurane: 3.0 (1.5–4.0)].
Conclusion. Desflurane post-conditioning protects renal function and tissue. This protection was greater after the short episode than after the long episode of ischaemia.