The hemodynamic effects of CO2-induced pressure on the kidney in an isolated perfused rat kidney model

Wisam Khoury, Amir Szold, Joseph M. Klausner, Avi A. Weinbroum

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Variable mechanisms were suggested to mediate the changes in renal hemodynamics during pneumoperitoneum. To assess whether it can be pressure dependent only, we conduct a study in an isolated, pressurized, and perfused organ model. METHODS: Seventy Wistar rat kidneys were perfused with oxygenated, 3% albumin-contained Krebs-Henseleit solution. Experiments took place within Plexiglass chamber that provided conditions for perfusion of organs, humidity, and maintenance of intracameral CO2 pressures [0 (control), 3, 5, 8, 12, 15, and 18ĝ€‰mm Hg]. All kidneys (10/group) were perfused for 60 minutes. One-half of the groups were perfused for an additional 30 minutes, during which the perfusion pressures were reduced to 0ĝ€‰mm Hg. pH of the perfusate was measured as well. RESULTS: The perfusion pressure increased and the kidney flow decreased slightly, in proportion with the intrachamber pressure. Urine output decreased to a minimum of 40% in ĝ‰¥8ĝ€‰mm Hg pressure conditions, compared with the control group. The pH values were below normal, during experimental pneumoperitoneum. CONCLUSIONS: Pneumoperitoneal conditions are a direct cause of changes in renal urinary output. The increase in pCO2 pressure and consequently low intraorgan pH may contribute to a mild transient renal damage during pneumoperitoneum.

Original languageEnglish
Pages (from-to)573-578
Number of pages6
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume18
Issue number6
DOIs
StatePublished - Dec 2008
Externally publishedYes

Keywords

  • Kidney
  • Perfusion
  • Pneumoperitoneum
  • Urine

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