The Renal Protective Effect of Erythropoietin on Acute Ischemic Injury in Kidney Transplantation

Abstract

During kidney transplantation, renal ischemia, and reperfusion injury (IRI) is associated with reduced microvasculature blood flow and loss of glycocalyx integrity, thereby leading to a reduction in glomerular filtration rate, afferent arteriolar vasoconstriction, and transtubular back leak of ultrafiltrate [ 1 Snoeijs M.G. van Heurn L.E. Buurman W.A. Biological modulation of renal ischemia-reperfusion injury. Current Opinion in Organ Transplantation. 2010; 15: 190 Crossref PubMed Scopus (49) Google Scholar , 2 Snoeijs M.G. Vink H. Voesten N. et al. Acute ischemic injury to the renal microvasculature in human kidney transplantation. Am J Physiol Renal Physiol. 2010; 299: F1134 Crossref PubMed Scopus (86) Google Scholar ]. Moreover, IRI propagates inflammation by up-regulating genes involved with toll-like receptors, components of the complement pathway, chemokines, and adhesion molecules, and promotes graft rejection by up-regulating genes involved with oxidative stress and apoptosis [ 1 Snoeijs M.G. van Heurn L.E. Buurman W.A. Biological modulation of renal ischemia-reperfusion injury. Current Opinion in Organ Transplantation. 2010; 15: 190 Crossref PubMed Scopus (49) Google Scholar , 2 Snoeijs M.G. Vink H. Voesten N. et al. Acute ischemic injury to the renal microvasculature in human kidney transplantation. Am J Physiol Renal Physiol. 2010; 299: F1134 Crossref PubMed Scopus (86) Google Scholar , 3 Furuichi K. Kaneko S. Wada T. Chemokine/chemokine receptor-mediated inflammation regulates pathologic changes from acute kidney injury to chronic kidney disease. Clin Exp Nephrol. 2009; 13: 9 Crossref PubMed Scopus (71) Google Scholar ]. Collectively, these processes are responsible for a high rate of graft rejection, morbidity, and mortality following kidney transplantation. Therefore, it is clinically relevant and important to determine renal protective mechanisms to modulate this acute ischemic injury [ 4 Toledo-Pereyra LH. Leukocyte depletion, ischemic injury, and organ preservation. J Surg Res (in press, corrected proof). Google Scholar ]. Erythropoietin Ameliorates Renal Ischemia and Reperfusion Injury via Inhibiting Tubulointerstitial InflammationJournal of Surgical ResearchVol. 176Issue 1PreviewTubulointerstitial inflammation is the characteristics of renal ischemia reperfusion injury (IRI) that is inevitable in kidney transplantation. Erythropoietin (EPO) has recently been shown to have protective effects on renal IRI by anti-apoptosis and anti-oxidation. Here, the effect and mechanism of EPO on renal IRI were further investigated, with a focus on tubulointerstitial inflammation. Full-Text PDF