The deep hypothermic circulatory arrest causes more kidney malfunctions based on a novel rabbit model.

Abstract

BACKGROUND AND OBJECTIVESHigh incidences of acute kidney injury after cardiopulmonary bypass (CPB) were observed in previous reports. However, whether deep hypothermic circulatory arrest (DHCA) leads to more severe kidney injury than CPB without DHCA remains controversial. The aim of the study was to investigate the effects of DHCA on renal function in a novel rabbit model of using closed-thoracic DHCA.DESIGN AND SETTINGSExperimental study on New Zealand white rabbits performed in the Department of Cardiac Surgery, the First Affiliated Hospital of China Medical University.METHODSThirty rabbits were randomly divided into 3 groups: the sham-operated group (Group A, N=10), the CPB group (Group B, N=10), and the DHCA group (Group C, N=10). Serum creatinine (Scr), blood urea nitrogen (BUN), serum cystatin C, neutrophil gelatinase-associated lipocalin (NGAL), malondialdehyde (MDA) levels, superoxide dismutase (SOD) activities, histopathologic llesions, and apoptosis were assessed.RESULTSEach single rabbit in Groups B and C died during surgery. Animals received DHCA exhibited more severe kidney impairments than those received CPB and those that were sham operated. Scr and BUN concentrations at 24 and 48 hours after surgery; cystatin C and NGAL concentrations at 12, 24, and 48 hours after surgery; MDA levels, histopathological lesions, and apoptosis score of the kidneys were the highest in Group C, followed by Group B, and were the lowest in Group A (all P<.05). The activities of SOD were the lowest in Group C, followed by Group B, and were the highest in Group A (P<.05).CONCLUSIONOur study established a simple, convenient, economical, and long-term surviving rabbit model for the study of DHCA-induced organic injury. Based on more significant kidney injuries, including elevated levels of serum cystatin C and NGAL at an early time, increased lipid peroxidation, decreased renal antioxidative ability, enhanced histological lesions, and increased tubular epithelial apoptosis from DHCA animals, we concluded that DHCA has more kidney dysfunctions than CPB without DHCA.