Keywords: blood loss, limb ischemia-reperfusion, kidney, proximal and distal sodium transport


Introduction. The most effective way to stop massive external bleeding is the application of a tourniquet. Complete bleeding of the limb within 2 hours can cause damage to nerves and blood vessels under the tourniquet, myonecrosis, rhabdomyolysis, deep vein thrombosis. However, the role of limb ischemia-reperfusion in the pathogenesis of impaired renal function in acute blood loss has not been adequately studied. There is no data on the effectiveness of their correction with carbacetam.

The aim of the study – to find out the features of the renal transport of sodium ions in the early period after applying a skeletal injury of varying severity, complicated by blood loss and the effectiveness of the correction of the revealed violations with carbacetam.

Research Methods. The experiments were performed on 108 non-linear male rats weighing 160–180 g. In the research group 1, two-hour limb ischemia was simulated followed by reperfusion, in group 2 – acute blood loss in the amount of 20–22 % of the circulating blood volume, in group 3 – these injuries were combined, in group 4 – animals with acute blood loss and limb ischemia-reperfusion was administered intraperitoneally at a dose of 5 mg/kg. After 1 and 2 hours, as well as after 1, 7 and 14 days in rats of the research groups, the functional state of the kidneys was determined by the method of water loading. The animals of the control group were injected with anesthesia and taken for research after 1 hours. The urine output and concentration of sodium ions in urine and blood serum were determined. The proximal and distal sodium transport was calculated.

Results and Discussion. Reperfusion after two-hour limb ischemia in white rats was accompanied by a significant decrease in proximal and distal sodium transport with a maximum of disturbances after 1 day and normalization after 14 days. Acute blood loss significantly exacerbated the violation of the proximal and distal sodium transport processes. The combination of acute blood loss and limb ischemia-reperfusion was accompanied by a large decrease of indicators. The use of carbacetam led to an improvement in the studied parameters after 7 and 14 days of use, which did not reach the level of the control group.

Conclusions. The complication of acute blood loss by two-hour ischemia and reperfusion of the limb causes a greater decrease in the proximal and distal sodium transport compared to other research groups. The use of carbacetam under these conditions is accompanied by a nephroprotective effect.


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How to Cite
Shatsky, V. V. (2020). FEATURES OF PROXIMAL AND DISTAL TRANSPORT OF SODIUM IN ACUTE BLOOD LOSS, COMPLICATED BY ISCHEMIA-REPERFUSION OF EXTREMITY, AND THEIR CORRECTION IN THE EXPERIMENT. Medical and Clinical Chemistry, (4), 127-133. https://doi.org/10.11603/mcch.2410-681X.2019.v.i4.10849