Hydrodynamic Isotonic Fluid Delivery Ameliorates Moderate-to-Severe Ischemia-Reperfusion Injury in Rat Kidneys

• DOI: 10.1681/asn.2016040404
• Publication Date: 2017-01-26T02:00:25Z
• Authors: Jason A. Collett; Peter R. Corridon; Purvi Mehrotra; Alexander L. Kolb; George J. Rhodes; Caroline A. Miller; Bruce A. Molitoris; Janice G. Pennington; Ruben M. Sandoval; Simon J. Atkinson; Silvia B. Campos-...; David P. Basile; Robert L. Bacallao
• Keywords: Peritubular capillaries; Intravital microscopy; Hypervolemia; Parenchyma

Highly aerobic organs like the kidney are innately susceptible to ischemia-reperfusion (I/R) injury, which can originate from sources including myocardial infarction, renal trauma, and transplant. Therapy is mainly supportive depends on cause(s) of damage. In absence hypervolemia, intravenous fluid delivery frequently first course treatment but does not reverse established AKI. Evidence suggests that disrupting leukocyte adhesion may prevent impairment microvascular perfusion heightened inflammatory response exacerbate ischemic injury. We investigated therapeutic potential hydrodynamic isotonic (HIFD) left vein 24 hours after inducing moderate-to-severe unilateral IRI in rats. HIFD significantly increased hydrostatic pressure within vein. When conducted AKI, I/R produced substantial statistically significant decreases serum creatinine levels compared with animals given an equivalent volume saline via peripheral infusion (P<0.05). Intravital confocal microscopy performed immediately showed improved perfusion. Notably, also resulted immediate enhancement parenchymal labeling fluorescent dye Hoechst 33342. associated a reduction accumulation leukocytes, proinflammatory T cells. Additionally, reduced peritubular capillary erythrocyte congestion histologic scores tubular injury 4 days IRI. Taken together, these results indicate establishment AKI rapidly restores small molecule accessibility, improvement overall function.