Studies on the Change in Renal Functions after an Occlusion of Blood Supply and Perfusion of the Kidney in Dog

Lee, Jin Moo

Abstract

It is generally known that the renal function is significantly decreased immediately after renal transplantation. However, there is no literature concerning the influence of vascular factor such as thrombus formation and narrowing of the vascular lumen due to its anastomosis on the renal functions following kidney transplantation. As an attempt to dissociate the effect of vascular factors from the immediate functional capacity after transplantation. the author studied the various renal function after clamping the renal artery and perfusing the kidney for 45 minutes while avoiding injury to the renal pedicle as much as possible. Then the recovery pattern of renal function was observed for 2 weeks. In every phase of the experiment (immediately, 1,3,7, and 14 days after the clamping and perfusion) various renal functions of the experimental kidney (left kidney) were compared with that of the normal kidney (right kidney). The results are summarized briefly as follows: 1. Hemodynamic changes such as glomerular filtration rate and renal plasma flow were decreased to approximately 65~75% of the control kidney by 7 days after the experiment and then recovered to the values of the normal kidney. 2. Tubular reabsorption of water and electrolytes were reduced in the experimental kidney until the 7th day after the procedures, but these decreases were improved to nearly normal 2 weeks after the renal artery clamping and perfusion. This reduction of tubular reabsorption capacity is considered to be brought by ischemia-induced tubular damage 3. The extraction ratio of PAH was significantly dropped to about 50% of the normal at 3 days after the experiment, then it recovered almost to normal at 14 days after the procedures. In addition total renal plasma flow calculated from C(pah)/E(pah) was almost identical in both kidneys except in the 3 days group which showed a significant increase in the experimental kidney. This finding suggested that postocclusive reactive hyperemia developed. 4. The above mentioned results showed that renal functions after renal artery clamping and perfusion of the kidney with cold (4 degrees C) solution were decreased significantly by the 7th followed with almost normal recovery 2 weeks after the experiment. It was suggested that the period of recovery of renal function was shortened by cold perfusion of the kidney, and day and vascular factors did not influence significantly on the decrease in renal functions after renal transplantation.