de Carvalho Ana Lygia R, Vital Roberto B, Kakuda Cláudio M, Braz José R C, Castiglia Yara M M, Braz Leandro G, Módolo Marília P, Ribeiro Odilon R G, Domingues Maria A, Módolo Norma S P
Department of Anesthesiology, Botucatu Medical School, UNESP, Univ Estadual Paulista , SP , Brazil.
Ren Fail. 2015 Apr;37(3):526-30. doi: 10.3109/0886022X.2015.1006118. Epub 2015 Jan 23.
Ischemic acute kidney injury is a common occurrence in the perioperative period and in critical patients admitted to intensive care units. The reestablishment of blood supply may worsen injury through the ischemia-reperfusion (I/R) mechanism. We investigated the effect of dexmedetomidine on the kidneys of rats subjected to an experimental I/R model.
34 rats anesthetized with isoflurane was undergone right nephrectomy and randomly assigned to four groups: Control C (saline solution); Dexmedetomidine D (dexmedetomidine); Sham S (saline solution); Sham with Dexmedetomidine SD (dexmedetomidine). The serum levels of neutrophil gelatinase-associated lipocalin (NGAL) were measured at time-points T1 (following stabilization), T2 (ischemia), T3 (reperfusion), T4 (12 h after of I/R). The kidneys were subjected to histological examination.
The NGAL levels were significantly higher at T4 compared with T1. Upon histological examination, the left kidneys in groups C and D exhibited a similar extent of cell injury.
The levels of NGAL did not indicate either protection against or worsening of kidney injury. Histological examination for acute tubular necrosis showed that dexmedetomidine did not protect the kidneys from I/R.
缺血性急性肾损伤在围手术期以及入住重症监护病房的危重症患者中很常见。恢复血液供应可能通过缺血再灌注（I/R）机制使损伤加重。我们研究了右美托咪定对实验性I/R模型大鼠肾脏的影响。
34只使用异氟烷麻醉的大鼠接受右肾切除术，并随机分为四组：对照组C（生理盐水）；右美托咪定组D（右美托咪定）；假手术组S（生理盐水）；假手术加右美托咪定组SD（右美托咪定）。在时间点T1（稳定后）、T2（缺血）、T3（再灌注）、T4（I/R后12小时）测量中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的血清水平。对肾脏进行组织学检查。
与T1相比，T4时NGAL水平显著更高。组织学检查显示，C组和D组左肾的细胞损伤程度相似。
NGAL水平既未表明对肾损伤有保护作用，也未表明肾损伤加重。急性肾小管坏死的组织学检查表明，右美托咪定不能保护肾脏免受I/R损伤。
