Abstract
ABSTRACTObjective:The objective of the present study was to evaluate the effectiveness of HBO therapy on biochemical parameters, renal morphology and renal scintigraphy in rats undergoing chronic unilateral partial ureteral obstruction (UPUO).Material and methods:Thirty-five rats were divided into five equal groups: Control group; Sham group; HBO group; UPUO group and UPUO/HBO group. The effects of HBO therapy were examined using biochemical parameters and histopathological changes. After calculating the score for each histopathological change, the total histopathological score was obtained by adding all the scores. In addition, dynamic renal scintigraphy findings were evaluated.Results:Serum parameters indicating inflammation, serum tumor necrosis factor- alpha, ischemia modified-albumin, IMA/albumin ratio and Pentraxin-3 levels, were observed to be high in the UPUO group and low in the UPUO/HBO treatment group. Similarly, in the treatment group, the reduction in malondialdehyde, total oxidant status and oxidative stress index levels and increase in total antioxidant capacity values were observed to be statistically significant compared to the UPUO group (p<0.001, p=0.007, p<0.001, p=0.001, respectively). The total score and apoptosis index significantly decreased after administration of HBO treatment. Dynamic 99mTc-MAG3 renal scintigraphy also showed convincing evidence regarding the protective nature of HBO against kidney injury. In the UPUO/HBO therapy group, the percentage contribution of each operated kidney increased significantly compared to the UPUO group (41.73% versus 32.72%).Conclusion:The findings of this study indicate that HBO therapy had a reno-protective effect by reducing inflammation and oxidative stress, and preserving renal function after renal tissue damage due to induction of UPUO.
Highlights
Obstructive uropathy is one of the leading causes of end-stage renal disease in children and adults and is associated with increased intraluminal pressure in the ureter and renal tubules that can cause renal parenchymal damage [1]
There was no significant difference between Hyperbaric oxygen (HBO) and sham groups in terms of plasma biochemical parameters
In the unilateral partial ureteral obstruction (UPUO)/HBO treated group, the plasma TNF-α, Ischemia-modified albumin (IMA), IMA/ albumin ratio (IMAR) and PTX3 values were low compared to the UPUO group (p=0.032, p=0.042, p=0.011, p=0.023, respectively)
Summary
Obstructive uropathy is one of the leading causes of end-stage renal disease in children and adults and is associated with increased intraluminal pressure in the ureter and renal tubules that can cause renal parenchymal damage [1]. Known factors in the pathophysiology of the partially obstructed kidney are characterized by renal blood flow impairment, intrapelvic pressure elevation, vasoactive and inflammatory mediators [3]. Increased lipid peroxidation and oxidative stress in UPUO have been proposed as possible causes that lead to tubule-interstitial lesions and renal fibrosis. Despite advances in supportive precautions and preventive strategies, presently there is no specific medication in clinical use for UPUO-induced renal damage. Because inflammation, oxidative stress and apoptosis combine in the pathophysiology of UPUO, the optimal therapeutic or preventive approach should target these pathways
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