Costa Felipe Lobato da Silva, Yamaki Vitor Nagai, Teixeira Renan Kleber Costa, Feijó Daniel Haber, Valente André Lopes, Carvalho Luan Teles Ferreira de, Yasojima Edson Yuzur, Brito Marcus Vinicius Henriques
MD, Department of Experimental Surgery, School of Medicine, Universidade do Estado do Pará (UEPA), Belem-PA, Brazil. Conception, design, intellectual and scientific content of the study; interpretation of data; manuscript writing.
MD, School of Medicine, UEPA, Belem-PA, Brazil. Acquisition and interpretation of data, statistical analysis.
Acta Cir Bras. 2017 Aug;32(8):599-606. doi: 10.1590/s0102-865020170080000001.
: To evaluate if combination of perconditioning and postconditioning provides improved renal protection compared to perconditioning alone in a model of renal reperfusion injury.
: Thirty rats were assigned into 6 groups: normality; sham; ischemia and reperfusion; postconditioning; perconditioning; perconditioning + postconditioning. Animals were subjected to right nephrectomy and left renal ischemia for 30 minutes. Postconditioning consisted of 3 cycles of 5 min renal perfusion followed by 5 min of renal ischemia after major ischemic period. Perconditioning consisted of 3 cycles of 5 min hindlimb ischemia followed by 5 min of hindlimb perfusion contemporaneously to renal major ischemic period. After 24 hours, kidney was harvested and blood collected to measure urea and creatinine.
: Perconditioning obtained better values for creatinine and urea level than only postconditioning (p<0.01); performing both techniques contemporaneously had no increased results (p>0.05). Regarding tissue structure, perconditioning was the only technique to protect the glomerulus and tubules (p<0.05), while postconditioning protected only the glomerulus (p<0.05). Combination of both techniques shows no effect on glomerulus or tubules (p>0.05).
: Perconditioning had promising results on ischemia and reperfusion induced kidney injury, enhanced kidney function and protected glomerulus and tubules. There was no additive protection when postconditioning and perconditioning were combined.
在肾再灌注损伤模型中，评估预处理和后处理相结合与单独进行预处理相比，是否能提供更好的肾脏保护。
将30只大鼠分为6组：正常组；假手术组；缺血再灌注组；后处理组；预处理组；预处理+后处理组。动物接受右肾切除术，左肾缺血30分钟。后处理包括在主要缺血期后进行3个循环，每个循环为5分钟肾灌注，随后5分钟肾缺血。预处理包括在肾主要缺血期同时进行3个循环，每个循环为5分钟后肢缺血，随后5分钟后肢灌注。24小时后，采集肾脏并收集血液以测量尿素和肌酐。
预处理在肌酐和尿素水平方面比仅后处理取得了更好的值（p<0.01）；同时进行两种技术并没有增加效果（p>0.05）。关于组织结构，预处理是唯一能保护肾小球和肾小管的技术（p<0.05），而后处理仅能保护肾小球（p<0.05）。两种技术相结合对肾小球或肾小管没有影响（p>0.05）。
预处理在缺血再灌注诱导的肾损伤方面有良好结果，可增强肾功能并保护肾小球和肾小管。后处理和预处理联合使用时没有额外的保护作用。
