Additional effects of erythropoietin pretreatment, ischemic preconditioning, and N-acetylcysteine posttreatment in rat kidney reperfusion injury

Turk J Med Sci. 2019 Aug 8;49(4):1249-1255. doi: 10.3906/sag-1812-228.

Abstract

Background/aim: Since the nature of ischemia/reperfusion (IR)-induced tissue damage is multifactorial and complex, in the current study, the effects of multiple treatment strategies via concomitant administration of erythropoietin (EPO) and N-acetylcysteine (NAC) with an ischemic preconditioning (IPC) regimen on renal IR injury were examined.

Materials and methods: Thirty male Wistar rats were subjected to bilateral occlusion of the renal pedicles for 50 min followed by reperfusion. EPO (1000 IU/kg) was administered for 3 days, as well as IPC before the IR and NAC (150 mg/kg) administration for 4 days after IR. The animals were randomly allocated into 6 groups (n = 5): sham, IR, EPO+IR, IPC+IR, NAC+IR, and EPO+IPC+NAC+IR. Kidney tissues and blood samples were obtained for oxidative stress, proinflammatory cytokines, and renal functional evaluations.

Results: IR caused significant inflammatory response, oxidative stress, and reduced renal function. Treatment with EPO, IPC, and NAC or a combination of two of them attenuated renal dysfunction and reduced the oxidative stress and inflammatory markers. Rats treated with the combination of EPO, IPC, and NAC showed a higher degree of protection compared to the other groups.

Conclusion: These results showed that concomitant administration of EPO and IPC along with posttreatment NAC may have additive beneficial effects on kidney IR injury during IR-induced acute renal failure.

Keywords: Ischemia; reperfusion; erythropoietin; ischemic preconditioning; N-acetylcysteine; oxidative stress.

MeSH terms

  • Acetylcysteine / pharmacology*
  • Animals
  • Blood Urea Nitrogen
  • Creatinine / blood
  • Cytokines / blood
  • Disease Models, Animal
  • Erythropoietin / pharmacology*
  • Ischemic Preconditioning / methods*
  • Kidney Diseases / metabolism
  • Kidney Diseases / physiopathology
  • Kidney* / drug effects
  • Kidney* / injuries
  • Kidney* / physiopathology
  • Male
  • Oxidative Stress / drug effects
  • Rats
  • Rats, Wistar
  • Reperfusion Injury* / metabolism
  • Reperfusion Injury* / physiopathology

Substances

  • Cytokines
  • Erythropoietin
  • Creatinine
  • Acetylcysteine