a Department of Critical Care Medicine , Second Affiliated Hospital of Guangxi Medical University , Nanning , P.R. China.
Ren Fail. 2019 Nov;41(1):278-283. doi: 10.1080/0886022X.2019.1596819.
In the current study, we investigated the incidence of acute kidney injury (AKI) induced by cardiac arrest (CA) and cardiopulmonary resuscitation (CPR) and whether such an AKI can recover spontaneously in rats.
We used transesophageal alternating current stimulation to establish 7 min of CA rat model followed by conventional CPR. The experimental rats were randomly divided into three groups (n = 20 per group) according to the different time points after restoration spontaneous circulation (ROSC): the ROSC 24 h, ROSC 48 h, and ROSC 72 h group. The diagnosis of rat AKI refers to the 2012 KDIGO adult AKI diagnostic criteria. The severity of AKI quantified by the serum creatinine (SCR), blood urea nitrogen (BUN) levels and histological features of renal tissue.
The incidence rates of AKI in ROSC 24 h, ROSC 48 h, and ROSC 72 h group were 65%, 45%, and 42.9%. Moreover, the values of SCR and BUN were highest at ROSC 24 h, and then gradually decreased with the time of ROSC. The histological changes of the renal tissues such as glomerular collapse, renal tubular cell swelling, and inflammatory cell infiltration had also observed.
The incidence of AKI in rats was high after suffering from CA and CPR, but renal function improved with the prolongation of ROSC time, indicating the ability of the kidney to self-repair.
在本研究中,我们调查了心脏骤停(CA)和心肺复苏(CPR)引起的急性肾损伤(AKI)的发生率,以及这种 AKI 是否可以在大鼠中自发恢复。
我们使用经食管交流电刺激建立 7 分钟的 CA 大鼠模型,然后进行常规 CPR。实验大鼠根据恢复自主循环(ROSC)后不同时间点随机分为三组(每组 n=20):ROSC 24 小时、ROSC 48 小时和 ROSC 72 小时组。大鼠 AKI 的诊断参照 2012 年 KDIGO 成人 AKI 诊断标准。通过血清肌酐(SCR)、血尿素氮(BUN)水平和肾组织的组织学特征来量化 AKI 的严重程度。
ROSC 24 小时、ROSC 48 小时和 ROSC 72 小时组 AKI 的发生率分别为 65%、45%和 42.9%。此外,SCR 和 BUN 的值在 ROSC 24 小时时最高,然后随着 ROSC 时间的延长而逐渐降低。肾组织的组织学变化,如肾小球塌陷、肾小管细胞肿胀和炎症细胞浸润也观察到了。
大鼠在遭受 CA 和 CPR 后 AKI 的发生率较高,但肾功能随着 ROSC 时间的延长而改善,表明肾脏具有自我修复的能力。