BACKGROUND: An exceptional susceptibility to unilateral renal ischemia/reperfusion (I/R) injury resulting in inflammation, fibrosis, atrophy of the kidney, and end-stage renal disease (ESRD) has been demonstrated in the diabetic rat. The aim of this study was to examine whether insulin treatment would reduce I/R injury in diabetic kidneys. METHODS: Diabetes mellitus (DM) was induced in male Wistar rats by streptozotocin. I/R was achieved by clamping the left renal artery for 30 minutes. Treatment with long acting insulin was started 7 to 14 days before or one day after I/R. Short acting insulin was administrated 2 to 6 hours before the injury. Apoptosis was evaluated six hours after ischemia with the TUNEL-method. Four weeks after the clamping inulin clearance was measured and kidneys were removed for histopathological evaluation. RESULTS: In DM animals renal I/R caused massive induction of apoptosis in the renal medulla after six hours as well as inflammation, fibrosis, renal atrophy and anuria within four weeks. Treatment with long acting insulin before I/R resulted in decreased cell death and an almost complete protection of both renal function and histomorphology. Treatment with short acting insulin before I/R also decreased the loss of renal function. In contrast, insulin treatment after I/R did not protect the kidney from damage. CONCLUSIONS: This study shows that insulin treatment with a subsequent improved metabolic control before renal I/R protected kidneys from ESRD.
BACKGROUND: An exceptional susceptibility to unilateral renal ischemia/reperfusion (I/R) injury resulting in inflammation, fibrosis, atrophy of the kidney, and end-stage renal disease (ESRD) has been demonstrated in the diabeticrat. The aim of this study was to examine whether insulin treatment would reduce I/R injury in diabetic kidneys. METHODS:Diabetes mellitus (DM) was induced in male Wistar rats by streptozotocin. I/R was achieved by clamping the left renal artery for 30 minutes. Treatment with long acting insulin was started 7 to 14 days before or one day after I/R. Short acting insulin was administrated 2 to 6 hours before the injury. Apoptosis was evaluated six hours after ischemia with the TUNEL-method. Four weeks after the clamping inulin clearance was measured and kidneys were removed for histopathological evaluation. RESULTS: In DM animals renal I/R caused massive induction of apoptosis in the renal medulla after six hours as well as inflammation, fibrosis, renal atrophy and anuria within four weeks. Treatment with long acting insulin before I/R resulted in decreased cell death and an almost complete protection of both renal function and histomorphology. Treatment with short acting insulin before I/R also decreased the loss of renal function. In contrast, insulin treatment after I/R did not protect the kidney from damage. CONCLUSIONS: This study shows that insulin treatment with a subsequent improved metabolic control before renal I/R protected kidneys from ESRD.
Authors: Fionnuala B Hickey; James B Corcoran; Neil G Docherty; Brenda Griffin; Una Bhreathnach; Fiona Furlong; Finian Martin; Catherine Godson; Madeline Murphy Journal: J Am Soc Nephrol Date: 2011-07-22 Impact factor: 10.121
Authors: Guofeng Gao; Binzhi Zhang; Ganesan Ramesh; Daniel Betterly; Raghu K Tadagavadi; Weiwei Wang; W Brian Reeves Journal: Am J Physiol Renal Physiol Date: 2013-01-02
Authors: Richard Engbersen; Niels P Riksen; Marc J Mol; Bert Bravenboer; Otto C Boerman; Patrick Meijer; Wim J G Oyen; Cees Tack; Gerard A Rongen; Paul Smits Journal: Cardiovasc Diabetol Date: 2012-10-10 Impact factor: 9.951
Authors: Özge Kuzgun; Sevda Özkardeşler; Şule Özbilgin; Mert Akan; Bekir Uğur Ergür; Gonca Kamacı; Mehmet Ensari Güneli; Nazire Ateş; Ali Rıza Şişman; Reci Meseri Dalak Journal: Turk J Anaesthesiol Reanim Date: 2018-09-06