Is Solitary Kidney Really More Resistant To Ischemia? An Experimental Canine Study

Abstract

Purpose

To date, there is no evidence-based medicine data critically judging the vulnerability of solitary kidney to warm ischemia (WI) compared to paired kidneys

Materials & Methods

Ten dogs were exposed to open right nephrectomy to perform a solitary kidney model (Group I). Ten dogs with both kidneys were considered as group II. All dogs were subjected to WI by open occlusion of left renal artery for 90 minutes. Dogs were sacrificed after different time intervals from 3 days and up to 4 weeks. All dogs were re-evaluated by renogram prior to sacrifice as well as histopathology of the investigated kidney. Pro-inflammatory markers CD95 and TNF were assessed using real time PCR.

Results

In group I, there was reduction of clearance by 20% at 1 week that regained its basal function starting from the 2nd week. In group II, the reduction of clearance was more than 90% up to the 2nd week. Recoverability started at the 3rd week and at 4 weeks there was 23% reduction of the clearance. On histopathologic examination in group I, there was significant tubular necrosis (60%) at 3 days with starting regeneration at 1 week. In group II, there was more pronounced tubular necrosis (90%) with starting regeneration at 2 weeks. Expressions of Pro-inflammatory markers were up regulated in both groups with higher and more sustained expression observed in group II.

Conclusion

Solitary kidney in a canine model is more resistant to ischemia compared to paired kidney based on radiologic, pathologic and genetic evidence.

http://www.jurology.com/article/S0022-5347(13)03689-6/abstract