Influence of experimental acute blood loss complicated by ischemia-reperfusion of the extremity on the size of diuresis and the glomerular filtration rate
DOI:
https://doi.org/10.11603/2414-4533.2019.4.10710Keywords:
blood loss, ischemia-reperfusion of the limb, kidney, diuresis, glomerular filtration rateAbstract
The aim of the work: to find out the effect of acute blood loss complicated by limb ischemia-reperfusion on diuresis and glomerular filtration rate and to evaluate the effectiveness of carbacetam in correcting the revealed violations.
Materials and Methods. The experiments were performed on 96 non-linear male rats weighing 160–180 g. All animals were divided into five groups: control and four experimental (6 rats per group). The first experimental group included animals, which under thiopental-sodium anesthesia simulated a two-hour limb ischemia followed by reperfusion. In the second experimental group, in conditions of animal anesthesia, acute blood loss was simulated in the amount of 20–22 % of the circulating blood volume by crossing the femoral vein. In the third experimental group, these injuries were combined. In the fourth experimental group of animals with acute blood loss complicated by limb ischemia-reperfusion, carbacetam (Institute of Physico-Organic Chemistry and Coal Chemistry of the National Academy of Sciences of Ukraine, Donetsk) was administered intraperitoneally in a dose of 5 mg per kilogram of animal weight. In the control group, animals were injected into anesthesia using an equivalent dose of thiopental sodium, a tourniquet was applied for 2 hours without stopping the blood flow, and subsequently taken for studies after 1 hour.
After 1 and 2 hours, as well as after 1, 7 and 14 days in the experimental animals, the functional state of the kidneys was determined by the method of water loading. Urine was collected over 2 hours and diuresis was determined. After urine sampling in thiopental sodium anesthesia, rats were removed from the experiment by total bloodletting from the heart. In urine and blood serum, creatinine concentration was determined. Glomerular filtration rate (GFR) was evaluated by the clearance of endogenous creatinine.
Results and Discussion. It was established that reperfusion after two hours of ischemia is accompanied by a significant impairment of the functional state of the kidneys, which is manifested by a decrease in urine output and GFR, the value of which reaches a minimum level by 1 day, but normalizes by 14 days. Against the background of acute blood loss, the studied parameters decreased even more. At all observation times, diuresis and GFR were statistically significantly less than in animals with limb ischemia-reperfusion. Under the conditions of modeling acute blood loss and limb ischemia-reperfusion during all periods of the reperfusion period, the amount of diuresis was significantly less than with blood loss itself. In turn, GFR under these conditions statistically significantly decreased after 2 hours and 7 days of the reperfusion period. A study of the effect of carbacetam showed that its use in the reperfusion period after 7 days led to a statistically significant increase in diuresis and GFR in animals with acute blood loss complicated by ischemia-reperfusion of the limb. The effect became even greater after 14 days. Thus, carbacetam eliminates the pathogenic manifestations of acute blood loss and limb ischemia-reperfusion and reduces the manifestations of renal dysfunction, which indicates its promise as a means of systemic correction.
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