Chen Tungchiang, Zhang Zhihua, Lai Caiyong
Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
Department of Pediatric Surgery, Huizhou Central People's Hospital, Huizhou, China.
Ren Fail. 2025 Dec;47(1):2454721. doi: 10.1080/0886022X.2025.2454721. Epub 2025 Mar 17.
The reversible unilateral ureteral obstruction (RUUO) model is pivotal for studying obstructive nephropathy (ON) but has limitations, including procedure complexity and inconsistent recanalization success. We developed a simpler, reliable, and efficient RUUO model, and utilized advanced auxiliary examination methods to assess hydronephrosis and renal function changes, providing evidence for procedural success. Male Sprague-Dawley rats were divided into control and experimental groups. Baseline data on glomerular filtration rate (GFR) and magnetic resonance imaging (MRI) were obtained from the control group. The experimental group was subdivided based on obstruction durations of 3, 7, 10, and 14 days. Unilateral ureteral obstruction models were created followed by obstruction release to establish the RUUO models. Dynamic renal scintigraphy with single-photon emission computed tomography was used to measure left kidney GFR pre-recanalization and on day 7 and 14 post-recanalization. MRI was used to evaluate hydronephrosis resolution. Key surgical modifications included complete removal of ligated ureter segments and wider ureter-bladder anastomosis, improving consistency and 93.35% recanalization success rate. MRI and Tc-DTPA dynamic renal scintigraphy indicated varying degrees of renal functional recovery. The 3-day obstruction group showed near-complete restoration within 1 week of recanalization. Conversely, extended obstruction durations significantly impaired recovery. The 14-day group demonstrated marked functional decline due to progressive renal fibrosis observed at 2 weeks post-recanalization. The optimized model offers simplified surgical techniques, enhanced recanalization success, and high reproducibility. These findings highlight the importance of early recanalization in preserving renal function, and provide a robust framework for future research on ON, including therapeutic strategies.
可逆性单侧输尿管梗阻(RUUO)模型对于研究梗阻性肾病(ON)至关重要,但存在局限性,包括操作复杂和再通成功率不一致。我们开发了一种更简单、可靠且高效的RUUO模型,并利用先进的辅助检查方法评估肾积水和肾功能变化,为手术成功提供证据。雄性Sprague-Dawley大鼠分为对照组和实验组。从对照组获取肾小球滤过率(GFR)和磁共振成像(MRI)的基线数据。实验组根据梗阻持续时间3天、7天、10天和14天进行细分。创建单侧输尿管梗阻模型,随后解除梗阻以建立RUUO模型。使用单光子发射计算机断层扫描动态肾闪烁显像术测量再通前以及再通后第7天和第14天的左肾GFR。使用MRI评估肾积水的消退情况。关键的手术改进包括完全切除结扎的输尿管段和更宽的输尿管膀胱吻合术,提高了一致性和93.35%的再通成功率。MRI和Tc-DTPA动态肾闪烁显像术显示肾功能有不同程度的恢复。3天梗阻组在再通后1周内显示几乎完全恢复。相反,延长梗阻时间显著损害恢复。14天组在再通后2周观察到由于进行性肾纤维化导致明显的功能下降。优化后的模型提供了简化的手术技术、更高的再通成功率和高重复性。这些发现突出了早期再通对保留肾功能的重要性,并为未来关于ON的研究,包括治疗策略,提供了一个有力的框架。