虚血腎機能障害に対するエリスロポエチンの腎保護作用についての検討 (第58回日本泌尿器科学会中部総会(金沢))

Abstract

We reexamined the conditions of tissue disorders resulting from temporary ischemia of the organs as well as changes in tissue function and the effects on the preservation of renal function over time by using rat models in order to clinically utilize erythropoietin, which has inhibitory effects on ischemia-reperfusion disorders. In 8- to 9-week-old Wister male rats, after the right kidney had been resected under general anesthesia, the left renal artery was clamped to inhibit the blood flow for 45 minutes. At 30 minutes before inhibiting the blood flow and after releasing the inhibited blood flow, 100 U/kg of recombinant human erythropoietin (rhEPO) was administered via the inferior vena cava and the abdominal cavity, and then the tissues and blood samples were extracted at 6 hours and 24 hours after the release. The renal tissue specimens were evaluated for apoptosis and renal function using hematoxylin eosin staining and TUNEL staining. Changes in the emergence of active oxygen were investigated by using blood samples. The degree of renal dysfunction was evaluated by measuring neutrophil gelatinase-associated lipocalin (NGAL) in the spot urine samples. The changes in the serum creatinine level, showed that the renal function was preserved with a significant difference in the rhEPO administration group. The liver deviation enzymes clearly decreased in the rhEPO administration group. Active oxygen did not change before and after the ischemia-reperfusion nor was it changed by rhEPO administration. Apoptosis was inhibited by rhEPO administration. No direct effects of rhEPO administration on the emergence of active oxygen were observed. The administration of rhEPO, was suggested to help preserve the renal function in marginal donors with a longer agonal stageby effectively.