Emergency Center, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, 430071, Hubei, China.
Emergency Department, Xiangyang No.1 People's Hospital, Hubei University of Medicine, 15 Jiefang Road, Xiangyang, 441000, Hubei, China.
Scand J Trauma Resusc Emerg Med. 2019 Jul 18;27(1):68. doi: 10.1186/s13049-019-0644-0.
In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dialysis (PPD) is useful for renal protection in CI.
Animals received hindlimb compressions for 6 h to induce CI. Then, animals were untreated or treated with PPD and/or massive fluid resuscitation (MFR) for 8 h since the onset of compression release. Blood and renal tissue samples were collected at various time points for biological and morphological analysis.
PPD attenuated lactic acidosis and reduced serum K and myoglobin levels in CI animals. In addition, PPD was effective in removing blood urea nitrogen (BUN) and creatinine, and reduced renal expressions of neutrophil gelatinase-associated lipocalin (NGAL). The combination of PPD and MFR furtherly attenuated AKI with significantly decreased histological scores (p = 0.037) and reduced NGAL expressions (p = 0.0002) as compared with the MFR group. Moreover, MFR + PPD group had a significantly higher survival rate than that in the MFR and the PPD groups (p < 0.05, respectively).
The use of PPD at the onset of compression release is beneficial for renal protection and survival outcome in a rabbit model of CI.
在挤压伤（CI）患者中，住院期间肾脏替代治疗（RRT）被广泛用于急性肾损伤（AKI）的治疗。本研究旨在探讨预防性腹膜透析（PPD）是否对 CI 中的肾脏保护有用。
动物接受后肢压迫 6 小时以诱导 CI。然后，在压迫释放开始后，动物未接受治疗或接受 PPD 和/或大量液体复苏（MFR）治疗 8 小时。在不同时间点采集血液和肾组织样本进行生物学和形态学分析。
PPD 减轻了 CI 动物的酸中毒并降低了血清 K 和肌红蛋白水平。此外，PPD 有效去除了血尿素氮（BUN）和肌酐，并降低了肾中性粒细胞明胶酶相关脂质运载蛋白（NGAL）的表达。与 MFR 组相比，PPD 和 MFR 的联合进一步减轻了 AKI，组织学评分明显降低（p=0.037），NGAL 表达降低（p=0.0002）。此外，与 MFR 组和 PPD 组相比，MFR+PPD 组的存活率明显更高（p<0.05，分别）。
在压迫释放开始时使用 PPD 有利于 CI 兔模型的肾脏保护和生存结果。
