The Effects of Iloprost and Vitamin C on Kidney as a Remote Organ After Ischemia/Reperfusion of Lower Extremities

Ozcan, Ali V.; Sacar, Mustafa; Aybek, Hülya; Bir, Ferda; Demir, Süleyman; Onem, Gokhan; Goksin, Ibrahim; Baltalarli, Ahmet; Colakoglu, Nagihan

doi:10.1016/j.jss.2006.04.031

« Previous Next »Journal of Surgical Research
Volume 140, Issue 1 , Pages 20-26, 1 June 2007

The Effects of Iloprost and Vitamin C on Kidney as a Remote Organ After Ischemia/Reperfusion of Lower Extremities

Presented meeting name: The 40^th congress of the European Society for Surgical Research, May 25–28, 2005, Konya, Turkey.

Ali V. Ozcan, M.D.
- Department of Cardiovascular Surgery, Denizli, Turkey
- To whom correspondence and reprint requests should be addressed at Department of Cardiovascular Surgery, Pamukkale University, Siteler Mah. Barbaros Cad. 6248S. C-Blok. No: 3, Denizli, Kinikli 20070 Turkey.
Mustafa Sacar, M.D.
- Department of Cardiovascular Surgery, Denizli, Turkey
Hülya Aybek, M.D.
- Department of Biochemistry, Denizli, Turkey
Ferda Bir, M.D.
- Department of Pathology, Denizli, Turkey
Süleyman Demir, M.D.
- Department of Biochemistry, Denizli, Turkey
Gokhan Onem, M.D.
- Department of Cardiovascular Surgery, Denizli, Turkey
Ibrahim Goksin, M.D.
- Department of Cardiovascular Surgery, Denizli, Turkey
Ahmet Baltalarli, M.D.
- Department of Cardiovascular Surgery, Denizli, Turkey
Nagihan Colakoglu, M.D.
- Department of Pathology, Denizli, Turkey

Received 22 October 2005 published online 02 April 2007.

Background

Abdominal aortic surgery can cause ischemic/reperfusion (I/R) injury in not only the lower extremities, but also in the remote organs and tissues such as lungs, kidneys, heart, and liver during abdominal aortic surgery. It can result in mortality and morbidity because of the remote organ injury in early postoperative period. In this study, we investigate the effects of iloprost and vitamin C on the kidney remote organ damage after I/R following abdominal aortic surgery.

Material and methods

Thirty-four adult male Wistar rats were used and divided into five groups. I/R was studied infrarenally in the abdominal aorta following a median laparotomy. The left kidney was excised immediately following the laparotomy in group I (n = 6, normal group). Group II (n = 6) was the sham group. Group III (n = 6, control group) was subjected to 3 h of ischemia followed by an hour of reperfusion. Group IV (n = 8) was given iloprost 20 ng/kg/min during I/R period before aortic-clamping. Group V (n = 8) was given vitamin C 100 mg/kg during I/R period before aortic-clamping. Arterial blood samples were obtained to determine the levels of blood pH, pO₂ (mmHg), pCO2 (mmHg), HCO₃ (mmol/L), and plasma malondialdehyde (MDA, nmol/mL) at the end of reperfusion period in all groups. The left kidneys were used for remote measurements of tissue MDA (nmol/g.w.t) and scored by histopathological examination for acute inflammation.

Results

While the arterial blood pO₂ and HCO₃ levels significantly increased, the plasma and renal parenchymal MDA levels significantly decreased in both group IV and group V when compared to group III (P < 0.05). Histopathological and acute inflammation scores statistically decreased in both group IV and V compared with group III (P < 0.05). Although MDA levels, histopathologic and acute inflammation scores in group V were lower than group IV, the differences were not statistically significant (P > 0.05).

Conclusion

Both iloprost and vitamin C decreased remote organ damage on the kidney after I/R of lower extremities in the rat model. However, vitamin C is more effective than iloprost in preventing postoperative renal dysfunction.

Key Words: ischemia/reperfusion, remote organ damage, kidney injury, iloprost, vitamin C