Fluid resuscitation with preventive peritoneal dialysis attenuates crush injury-related acute kidney injury and improves survival outcome.

Abstract

BACKGROUND:

In-hospital renal replacement therapy (RRT) is widely used for the treatments of acute kidney injury (AKI) in crush injury (CI) victims. This study was designed to investigate whether preventive peritoneal dialysis (PPD) is useful for renal protection in CI.

METHODS:

Animals received hindlimb compressions for 6 h to induce CI. Then, animals were untreated or treated with PPD and/or massive fluid resuscitation (MFR) for 8 h since the onset of compression release. Blood and renal tissue samples were collected at various time points for biological and morphological analysis.

RESULTS:

PPD attenuated lactic acidosis and reduced serum K+ and myoglobin levels in CI animals. In addition, PPD was effective in removing blood urea nitrogen (BUN) and creatinine, and reduced renal expressions of neutrophil gelatinase-associated lipocalin (NGAL). The combination of PPD and MFR furtherly attenuated AKI with significantly decreased histological scores (p = 0.037) and reduced NGAL expressions (p = 0.0002) as compared with the MFR group. Moreover, MFR + PPD group had a significantly higher survival rate than that in the MFR and the PPD groups (p < 0.05, respectively).

CONCLUSION:

The use of PPD at the onset of compression release is beneficial for renal protection and survival outcome in a rabbit model of CI.

• Authors: Xian-Long Zhou, Shao-Zhou Ni, Dan Xiong, Xue-Qi Cheng, Peng Xu, Yan Zhao
• Journal: Scandinavian journal of trauma, resuscitation and emergency medicine (Scand J Trauma Resusc Emerg Med) Vol. 27 Issue 1 Pg. 68 (Jul 18 2019) ISSN: 1757-7241 [Electronic] England
• PMID: 31319855 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Creatinine

Topics

• Acute Kidney Injury (etiology, mortality, therapy)
• Animals
• Biomarkers (blood)
• Blood Urea Nitrogen
• Creatinine (blood)
• Crush Injuries (complications)
• Disease Models, Animal
• Fluid Therapy (methods)
• Male
• Rabbits
• Renal Replacement Therapy (methods)
• Resuscitation (methods)