Miriam Aparecida Moreira1, Maria Claudia Irigoyen2, Karen Ruggeri Saad3, Paulo Fernandes Saad3, Marcia Kiyomi Koike4, Edna Frasson de Souza Montero5, José Luiz Martins1. 1. Department of Surgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil. 2. Hypertension Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil. 3. Medical School, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil. 4. Department of Internal Medicine, Emergency Medicine Laboratory (LIM-51), University of São Paulo Medical School, São Paulo, São Paulo, Brazil. 5. Department of Surgery, Laboratory of Surgical Physiopathology (LIM-62), University of São Paulo Medical School, São Paulo, São Paulo, Brazil. Electronic address: edna.montero@gmail.com.
Abstract
BACKGROUND: Renal ischemia/reperfusion injury induced by hemorrhagic shock (HS) and subsequent fluid resuscitation is a common cause of acute renal failure. The objective of this study was to evaluate the effect of combining N-acetylcysteine (NAC) with fluid resuscitation on renal injury in rats that underwent HS. MATERIALS AND METHODS: Two groups of male Wistar rats were induced to controlled HS at 35 mm Hg mean arterial pressure for 60 min. After this period, the HS and fluid resuscitation (HS/R) group was resuscitated with lactate containing 50% of the blood that was withdrawn. The HS/R + NAC group was resuscitated with Ringer's lactate combined with 150 mg/kg of NAC and blood. The sham group animals were catheterized but were not subjected to shock. All animals were kept under anesthesia and euthanized after 120 min of fluid resuscitation or observation. RESULTS: Animals treated with NAC presented attenuation of histologic lesions, reduced oxidative stress, and apoptosis markers when compared with animals from the HS/R group. The serum creatinine was similar in all the groups. CONCLUSIONS: NAC is a promising drug for combining with fluid resuscitation to attenuate the kidney injury associated with HS.
BACKGROUND:Renal ischemia/reperfusion injury induced by hemorrhagic shock (HS) and subsequent fluid resuscitation is a common cause of acute renal failure. The objective of this study was to evaluate the effect of combining N-acetylcysteine (NAC) with fluid resuscitation on renal injury in rats that underwent HS. MATERIALS AND METHODS: Two groups of male Wistar rats were induced to controlled HS at 35 mm Hg mean arterial pressure for 60 min. After this period, the HS and fluid resuscitation (HS/R) group was resuscitated with lactate containing 50% of the blood that was withdrawn. The HS/R + NAC group was resuscitated with Ringer's lactate combined with 150 mg/kg of NAC and blood. The sham group animals were catheterized but were not subjected to shock. All animals were kept under anesthesia and euthanized after 120 min of fluid resuscitation or observation. RESULTS: Animals treated with NAC presented attenuation of histologic lesions, reduced oxidative stress, and apoptosis markers when compared with animals from the HS/R group. The serum creatinine was similar in all the groups. CONCLUSIONS:NAC is a promising drug for combining with fluid resuscitation to attenuate the kidney injury associated with HS.