Improvements of postburn renal function by early enteral feeding and their possible mechanisms in rats.

Abstract

To investigate the protective effects of early enteral feeding (EEF) on postburn impairments of renal function and their possible mechanisms. Wistar rats with 30 % of total body surface area (TBSA) full-thickness burn were adopted as the experimental model. The effects of EEF on the postburn changes of gastric intramucosal pH (pHi), endotoxin levels in portal vein, water contents of renal tissue, and blood concentrations of tumor necrosis factor (TNF-alpha), urea nitrogen (BUN), creatinine (Cr), as well as the changes of clearance of creatinine (CCr) were dynamically observed within 48 h postburn. EEF could significantly improve gastric mucosal acidosis, reduce portal vein endotoxin levels and water contents of renal tissue, as well as blood concentrations of TNF-alpha after severe burns (P<0.01). The postburn elevations of BUN and BCr were not found to be recovered by EEF. However, the CCr in EEF group was greatly increased by 4.67-fold compared with that of the non-feeding burned control (16.43+/-2.90 vs. 3.52+/-0.79, P<0.01). EEF has beneficial effects on the improvement of renal function in severely burned rats, which may be related to its increase of splanchnic blood flow, decrease of the translocation of gut-origin endotoxin and the release of inflammatory mediators.