Laboratory Investigation

Kidney International (1990) 37, 1240–1247; doi:10.1038/ki.1990.107

Red cell trapping after ischemia and long-term kidney damage. Influence of hematocrit

P Olof A Hellberg1, Alfred Bayati1, Örjan Källskog1 and Mats Wolgast1

1Department of Physiology, University of Uppsala, Biomedical Center, Uppsala, Sweden

Correspondence: Dr Olof Hellberg, Department of Physiology and Medical Biophysics, University of Uppsala, Biomedical Center, Box 572, S-757 23 Uppsala, Sweden.

Received 21 February 1989; Revised 4 December 1989; Accepted 18 December 1989.

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Abstract

Red cell trapping after ischemia and long-term kidney damage. Influence of hematocrit. The influence of the hematocrit (Hct) on the trapping of red blood cells (RBC) in the renal microvasculature and its effect on the long-term outcome following unilateral ischemia were investigated in the rat. The results showed that an increase in the duration of ischemia increased the RBC trapping, as measured by 51Cr-labeled erythrocytes, in a dose-dependent manner. At normal Hct (46%) the period of ischemia producing half-maximum RBC trapping was 45 minutes, whereas after hemodilution (Hct = 31%) or hemoconcentration (Hct = 60%) the corresponding periods were 80 and 25 minutes, respectively. Regarding the long-term outcome, 45 minutes of ischemia with a normal Hct was associated with a marked decrease in kidney weight, GFR and urine osmolarity after four weeks of recovery, which could be prevented to a large extent by hemodilution. Conversely, with hemoconcentration there was severe damage after only 25 minutes of ischemia. It is suggested that these long-term effects are attributable to RBC trapping in the microvasculature of the outer medulla, which may cause added ischemia in this area of the kidney. It is also suggested that cortical atrophy is secondary to the medullary injury, and is brought about to avoid extensive water and salt losses.

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References

  1. Hostetter TH, Brenner BM: Renal circulation and nephron function in experimental acute renal failure, in Acute Renal Failure, edited by Brenner BM, Lazarus JM, New York, Churchill Livingstone, 1988, pp. 67–90
  2. Norlen BJ, Engberg A, Källskog Ö, Wolgast M: Nephron function in the transplanted rat kidney. Kidney Int 14:10–20, 1978 | PubMed | ISI | ChemPort |
  3. Karlberg L, Källskog Ö, Norlen B-J, Wolgast M: Nephron function in postischemic renal failure. Scand J Urol Nephrol 16:167–172, 1982 | PubMed | ISI | ChemPort |
  4. Mason J, Thorhost J, Welsch J: Role of the medullary perfusion deficit in the pathogenesis of ischemic renal failure. Kidney Int 26:283–293, 1984 | PubMed | ISI | ChemPort |
  5. Mason J, Welsch J, Thorhorst J: The contribution of vascular obstruction to the functional defect that follows renal ischemia. Kidney int 31:65–71, 1987 | PubMed | ISI | ChemPort |
  6. Brezis M, Rosen S, Silva P, Epstein F: Renal ischemia: A new perspective. Kidney Int 26:375–383, 1984 | PubMed | ISI | ChemPort |
  7. Norlen B-J, Engberg A, Källskog Ö, Wolgast M: Intrarenal hemodynamics in the transplanted rat kidney. Kidney Int 14:1–9, 1978 | PubMed | ISI | ChemPort |
  8. Karlberg L, Norlen B-J, Öjteg G, Wolgast M: Impaired medullary circulation in postischemic acute renal failure. Acta Physiol Scand 118:11–17, 1983
  9. Vetterlein F, Pethhö A, Schmidt G: Distribution of capillary blood flow in the rat kidney during post-ischemic renal failure. Am J Physiol 251:H510–H519, 1986 | PubMed |
  10. Karlberg L, Källskog Ö, Nygren K, Wolgast M: Erythrocyte and albumin distribution in the kidney following warm ischemia. Scand J Urol Nephrol 16:173–177, 1983
  11. Hellberg O, Wolgast M: Renal blood flow after ischemia. Differences between the outer and inner medulla. Acta Physiol Scand (submitted for publication)
  12. Bayati A, Hellberg O, Odlind B, Wolgast M: Prevention of acute renal failure with superoxide dismutase and sucrose. Acta Physiol Scand 130:367–372, 1987
  13. Nygren A, Hellberg O, Hansell P, Fasching A: Hyperosmolar mannitol administered after the ischaemic event may enhance kidney damage in the rat. (abstract) Acta Physiol et Pharmacol Bulgaria 14:65, 1988
  14. Öjteg G, Bayati A, Källskog Ö, Wolgast M: Renal capillary permeability and intravascular red cell aggregation after ischemia. I. Effects of xanthine oxidase activity. Acta Physiol Scand 129:295–304, 1987
  15. Andesson G, Jennische E: Lack of relationship between medullary blood congestion and tubular necrosis in postischemic kidney damage. Acta Physiol Scand 130:429–432, 1987
  16. Hellberg O, Källskog Ö, Wolgast M, Öjteg G: Peritubular capillary permeability and intravascular red cell aggregation after ischemia. Effects of neutrophils. Am J Physiol (in press)
  17. Lowry O, Rosenbrough N, Farr A, Randall R: Protein measurement with the folic phenol reagent. J Biol Chem 193:265–275, 1951 | PubMed | ISI | ChemPort |
  18. Pfaller W, Rittinger M: Quantitative morphology of the rat kidney. Int T Biochem 12:17–22, 1980
  19. Källskog Ö, Hellström I, Rissler K, Wolgast M: Long-term recovery from superficial and deep glomeruli after acute renal failure evoked by warm ischemia. Renal Physiol 8:328–337, 1985
  20. Weibel ER: Stereological Methods, London, Academic Press, p. 1079
  21. Rassmusen SN: Intrarenal red cell and plasma volumes in the non-diuretic rat. Pflügers Arch 342:61–72, 1973
  22. Knepper M, Danielsson R, Saidel G, Post R: Quantitative analysis of renal medullary anatomy in rats and rabbit. Kidney Int 12:313–323, 1977
  23. Parks DA, Granger DN: Ischemia-induced vascular changes: Role of xanthine oxidase and hydroxyl radicals. Am J Physiol 245:G167–G289, 1983
  24. Del Maestro RF, Björk J, Arfors K-E: Increase in microvascular permeability induced by enzymatically generated free radicals. II Role of superoxide anion radical, hydrogen peroxide and hydroxyl radical. Microvasc Res 22:255–270, 1982
  25. Grgaard B, Parks DA, Granger DN, McCord JM, Forsberg JO: Effects of ischemia and oxygen radicals on mucosal albumin clearance in intestine. Am J Physiol 242:G448–G454, 1982
  26. Wolgast M: Renal medullary red cell and plasma flow as studied with labelled indicators and intrarenal detection. Acta Physiol Scand 88:212–225, 1973
  27. Merrill EW: Rheology of blood. Physiol Rev 49:863–888, 1969 | PubMed |
  28. Kritz W: Structural organisation of the renal medullary circulation. Nephron 31:290–295, 1982
  29. Yagil Y, Miyamoto M, Jamison RL: Inner medullary blood flow in postischemic acute renal failure in the rat. Am J Physiol 256:F456–F461, 1989 | PubMed | ChemPort |
  30. Karlberg L, Källskog Ö, Norlen B-J, Wolgast M: Postisch emic renal failure. Intrarenal blood flow and functional character istics in the recovery phase. Acta Physiol Scand 115:1–10, 1982
  31. Finn WF, Chevalier RL: Recovery from post-ischemic acute renal failure in the rat. Kidney Int 16:113–123, 1979 | PubMed | ISI | ChemPort |
  32. Conger JD, Robinette JB, Kelleher SD: Nephron heterogeneity in ischemic acute renal failure. Kidney Int 26:422–429, 1984
  33. Mason J, Welsch J, Takabatake T: Disparity between surface and deep nephron function early after ischemia. Kidney Int 24:27–36, 1983 | PubMed | ISI | ChemPort |

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