Abstract
About 50 % of indications for dialysis in acute renal failure are related to problems originated during the perioperative period. Intraoperative hemodynamic changes lead to renal vasoconstriction and hypoperfusion. Previous studies have not defined the dexmedetomidine renal role in hemorrhage situations. This study evaluated the effect of dexmedetomidine on renal function and histology after acute hemorrhage in rats. Covered study with 20 Wistars rats, anesthetized with sodium pentobarbital, 50 mg.kg(-1), intraperitoneal, randomized into 2 groups submitted to 30% volemia bleeding: DG - iv dexmedetomidine, 3 microg.kg(-1) (10 min) and continuous infusion - 3 microg.kg(-1).h(-1); CG - pentobarbital. For renal clearance estimative, sodium p-aminohippurate and iothalamate were administered. Studied attributes: heart rate, mean arterial pressure, rectal temperature, hematocrit, iothalamate and p-aminohippurate clearance, filtration fraction, renal blood flow, renal vascular resistance, and histological evaluations of the kidneys. DG showed smaller values of heart rate, mean arterial pressure, and renal vascular resistance, but iothalamate clearance and filtration fraction values were higher. There was similarity in p-aminohippurate clearance and renal blood flow. Both groups had histological changes ischemia-like, but dexmedetomidine determined higher tubular dilatation scores. In rats, after acute hemorrhage, dexmedetomidine determined better renal function, but higher tubular dilation scores.
Highlights
In cases of acute renal failure, about 50% of indications for dialysis are related to failures originated during the perioperative period in which high mortality rates still prevail, in spite of better care to the patients
This study evaluated the effect of dexmedetomidine on renal function and histology after acute hemorrhage in rats
Two groups of 10 rats each were randomly divided and studied after anesthesia induction and jugular vein cannulation: 1) the dexmedetomidine group (DG), 10 rats submitted to arterial hemorrhage – 30% of volemia – and to dexmedetomidine - 1μg per mL of 0.9% NaCl with dexmedetomidine velocity infusion of 3 μg. kg-1 over 10 minutes, followed by continuous infusion of 3 μg. kg-1. h-1, i.v.; 2) the control group (CG) 10 rats submitted to the same hemorrhage procedure of DG and the administration of the same volume of 0.9% NaCL utilized for dexmedetomidine infusion
Summary
In cases of acute renal failure, about 50% of indications for dialysis are related to failures originated during the perioperative period in which high mortality rates still prevail, in spite of better care to the patients. Acute renal failure during the perioperative period is the result of the exposure of a seriously affected patient to a high risk procedure with nephrotoxic agents infusion, e.g., antibiotics, anesthetics, non-steroidal anti-inflammatory drugs, contrast agents, etc[2]. Other agents responsible for kidney complications are intraoperative hemodynamic changes which lead to renal arteriolar vasoconstriction and parenchyma ischemia by blood flow redistribution. Α2-adrenergic agonists determine urinary alterations consequent to hemodynamic changes they determine. They reduce the antidiuretic hormone release[6], or inhibit its action on the distal tubule[7], inhibit renin release and increase the release of atrial natriuretic peptide[8]. Would dexmedetomidine have a beneficial effect on renal hypoperfusion due to acute hemorrhage? The aim of this study was to evaluate, in rats, the dexmedetomidine action over the renal function and histology after acute hemorrhage
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