Nephrology Dialysis Transplantation, Vol 12, Issue 3 449-455, Copyright © 1997 by Oxford University Press
SG Ramella-Virieux, JP Steghens, A Barbieux, P Zech, N Pozet and A Hadj-Aissa
BACKGROUND: Extracellular types (high-Na) of cold-storage solution (CSS)
have been shown to be more effective in preserving kidneys than
intracellular CSS (high-K). On the other hand, calcium entry blockers (CEB)
have been demonstrated to improve graft function when administered after
and/or prior to transplantation. The ischaemia reperfusion syndrome
involves, in part, an alteration in intracellular calcium metabolism that
induces an increase in renal vascular resistances (RVR) and other cellular
dysfunction, and high-K CSS per se are vasoconstrictive. Since CEB act via
a modification in intracellular calcium metabolism on vascular smooth
muscle, glomerular, and tubular cells, we evaluated the actual benefit on
CEB on kidneys preserved in Belzer's CSS (K-UW) and a high-Na version of
Belzer's CSS (Na-UW). METHOD: The isolated perfused rat kidney (IPK) was
used, first as a vascular bed to test the effects of CSS on RVR, and the
influence of nifedipine. Second, the recovery function of the IPK was
assessed by GFR and tubular Na reabsorption, after 24 h preservation in
K-UW and Na- UW, with or without nifedipine. Results were compared with a
control group in which renal function was measured without prior
cold-storage. RESULTS: K-UW but not Na-UW induced an increase in RVR when
flushed into the kidney. This vasoconstriction is prevented by nifedipine.
K-UW CSS was more deleterious to renal function than Na-UW. Addition of
nifedipine to the flush, the CSS for 24 h, and to the normothermic
reperfusate further improved recovery function of the IPK cold stored in
Na-UW but not in K-UW, without any modification of RVR. CONCLUSION:
Nifedipine may be of potential effect in attenuating ischaemic injury by a
mechanism which does not involve its vasodilatory properties.
ORIGINAL ARTICLES
Nifedipine improves recovery function of kidneys preserved in a high- sodium, low-potassium cold-storage solution: study with the isolated perfused rat kidney technique
Department of Renal Functional Exploration, Edouard Herriot Hospital, Lyon, France.
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