Is there a renal protective role for gelsolin treatment in crush syndrome? An experimental study.

BACKGROUND

This study aims to investigate the impact of combining crush fluid resuscitation with gelsolin treatment on renal function in a rat model of crush syndrome.

METHODS

Twenty-four adult female Wistar albino rats were randomly assigned to one of three groups for crush syndrome treat-ment: Control (C) group, gelsolin + crush fluid (gel) group, and crush fluid only (CF) group, each containing eight rats. Sedated rats underwent unilateral hind limb compression of 2 kg using a compression device, maintained for five hours. The control group received no treatment post-compression. After removing the tourniquet, rats in the gelsolin group received an intravenous administration of recombinant human gelsolin at a dose of 2 mg/kg in 0.1 ml sterile saline, along with crush fluid. The CF group received only the crush solution.

RESULTS

At 24 hours, creatine kinase (CK) levels in the CF group were lower compared to those in the control and gelsolin + CF groups (132 IU vs. 630 IU [p=0.004] and 519.5 IU [p=0.014], respectively). By 48 hours, CK levels in both CF and gelsolin + CF groups were lower than in the control group (p<0.001 and p=0.014, respectively), with no significant difference between the CF and gelsolin + CF groups (p=0.773). At 72 hours, CK levels in the gelsolin + CF group were lower than in the control group (p=0.023) but comparable to the CF group (p>0.05). Blood urea nitrogen (BUN) levels at 24 and 72 hours were similar in the control and gelsolin + CF groups (p>0.05). At 48 hours, BUN levels in both CF and gelsolin + CF groups were lower than in the control group (p=0.001 and p=0.003, respectively), with no significant difference between the CF and Gelsolin + CF groups (p>0.05). At 24 hours, creatinine levels in the gelsolin + CF group were lower than in the control group (p=0.017), while levels in the CF and gelsolin + CF groups were similar (p>0.05). By 48 and 72 hours, creatinine levels in both CF and gelsolin + CF groups were similar but lower than in the control group (p<0.05). Changes in creatinine levels were comparable across all groups (p>0.05).

CONCLUSION

This study marks the first instance in literature where it has been demonstrated that administering gelsolin along with crush solution does not yield superior results compared to crush solution alone in treating crush syndrome. Nonetheless, further research utilizing varying doses of gelsolin is warranted.