INTRODUCTION: The immediate (1-5 hours) response to percutaneous renal access (PERC) in pigs is vasoconstriction in the treated kidney. The present study determined the longer-term (72 hours) consequences of this surgical procedure. MATERIALS AND METHODS: Adult female pigs were anesthetized, and bilateral glomerular filtration rate (GFR), effective renal plasma flow (ERPF), urine flow rate, and sodium excretion rate were measured before and 1 hour after sham PERC or unilateral, single-tract PERC using a balloon dilator system. Animals were allowed to regain consciousness and were then anesthetized 72 hours later for final measurements of bilateral renal hemodynamic and excretory function together with renal para-aminohippuric acid (PAH) extraction (a measure of tubular organic anion transport efficiency). RESULTS: Bilateral renal hemodynamics were unchanged in the sham-PERC-treated pigs over the 72-hour observation period. In contrast, both GFR and ERPF were reduced by approximately 55% in the PERC-treated kidney within 1 hour of access, and returned to pre-PERC levels within 72 hours. Renal hemodynamics were not significantly altered in the opposite, untreated kidney of the PERC-treated pigs. Renal PAH extraction was decreased in PERC-treated kidneys at 72 hours post-PERC. Both sham-PERC-treated and PERC-treated animals showed similar falls in urine flow rate and sodium excretion rate immediately after treatment and at 72 hours after PERC. CONCLUSIONS: Renal vasoconstriction characterized the acute response of the treated kidney to unilateral PERC, whereas impaired tubular function (reduced PAH extraction) with near-normal GFR and ERPF characterizes the later (72 hours) response to PERC.
INTRODUCTION: The immediate (1-5 hours) response to percutaneous renal access (PERC) in pigs is vasoconstriction in the treated kidney. The present study determined the longer-term (72 hours) consequences of this surgical procedure. MATERIALS AND METHODS: Adult female pigs were anesthetized, and bilateral glomerular filtration rate (GFR), effective renal plasma flow (ERPF), urine flow rate, and sodium excretion rate were measured before and 1 hour after sham PERC or unilateral, single-tract PERC using a balloon dilator system. Animals were allowed to regain consciousness and were then anesthetized 72 hours later for final measurements of bilateral renal hemodynamic and excretory function together with renal para-aminohippuric acid (PAH) extraction (a measure of tubular organic anion transport efficiency). RESULTS: Bilateral renal hemodynamics were unchanged in the sham-PERC-treated pigs over the 72-hour observation period. In contrast, both GFR and ERPF were reduced by approximately 55% in the PERC-treated kidney within 1 hour of access, and returned to pre-PERC levels within 72 hours. Renal hemodynamics were not significantly altered in the opposite, untreated kidney of the PERC-treated pigs. Renal PAH extraction was decreased in PERC-treated kidneys at 72 hours post-PERC. Both sham-PERC-treated and PERC-treated animals showed similar falls in urine flow rate and sodium excretion rate immediately after treatment and at 72 hours after PERC. CONCLUSIONS: Renal vasoconstriction characterized the acute response of the treated kidney to unilateral PERC, whereas impaired tubular function (reduced PAH extraction) with near-normal GFR and ERPF characterizes the later (72 hours) response to PERC.
Authors: Kara L Watts; Abhishek Srivastava; Wilson Lin; Daniel Schoenfeld; Matthew Abramowitz; Joshua M Stern Journal: Urolithiasis Date: 2019-02-12 Impact factor: 3.436
Authors: Rajash K Handa; Cynthia D Johnson; Bret A Connors; Andrew P Evan; James E Lingeman; Ziyue Liu Journal: J Endourol Date: 2015-10-26 Impact factor: 2.942