Abstract
ObjectiveWe aimed to study whether tolerance to irrigation pressure could be modified by evaluating the oxidative damage of obstructed kidneys based on rabbit models experiencing different degrees of hydronephrosis.MethodsA total of 66 rabbits were randomly divided into two experimental groups and a control group. In the experimental groups, the rabbits underwent a surgical procedure inducing mild (group M, n=24) or severe (group S, n=24) hydronephrosis. In each experimental group, the rabbits were then randomly divided into 4 subgroups (M0-M3 and S0-S3) consisting of 6 rabbits each. Group 0 received no perfusion. Groups 1 through 3 were perfused with 20, 60 and 100 mmHg fluid, respectively. For the control group, after a sham operation was performed, the rabbits were divided into 4 subgroups and were perfused with fluid at 0, 20, 60 or 100 mmHg of pressure. Kidney injuries was evaluated by neutrophil gelatinase associated lipocalin (NGAL). Oxidative damage was assessed by analyzing superoxide dismutase (Mn-SOD) activity, malondialdehyde (MDA) levels, glutathione reductase (GR), catalase (CAT) and peroxide (H2O2) levels, mitochondrial injuries was assessed by mitochondrial membrane potential (MMP), the mitochondrial ultrastructure and tubular cell apoptosis.ResultsIn the experimental groups, all results were similar for groups 0 and 1. In group 2, abnormalities were observed in the S group only, and the kidneys of rabbits in group 3 suffered oxidative damage and mitochondrial injuries with increased NGAL, decreased Mn-SOD, GR and CAT,increased MDA and H2O2, lower levels of MMP, mitochondrial vacuolization and an increased apoptotic index.ConclusionIn rabbits, severely obstructed kidneys were more susceptible to oxidative damage and mitochondrial injury than mildly obstructed kidneys when subjected to higher degrees of kidney perfusion pressure.
Highlights
Flexible ureterorenoscopy and percutaneous nephrolithotomy are widely used for the treatment of kidney stones and present several advantages over open procedures including reduced post-operational pain, minimal scar tissue and shorter hospitalization time [1,2]
Severely obstructed kidneys were more susceptible to oxidative damage and mitochondrial injury than mildly obstructed kidneys when subjected to higher degrees of kidney perfusion pressure
Mn-Superoxide dismutase (SOD), glutathione reductase (GR), CAT, MDA and H2O2 levels were comparable in Ctrl 1, Ctrl 2 and Ctrl 3, and we combined these groups for our analysis
Summary
Flexible ureterorenoscopy and percutaneous nephrolithotomy are widely used for the treatment of kidney stones and present several advantages over open procedures including reduced post-operational pain, minimal scar tissue and shorter hospitalization time [1,2]. These endourological procedures require effective fluid perfusion pressure to obtain a clear operational visual field and to flush out kidney stone fragments. We investigated whether tolerance to irrigation pressure differs based on the degree of hydronephrosis by evaluating oxidative damage indicators in rabbit kidneys that were obstructed to different extents
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