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Nitric oxide synthase inhibition aggravates the adverse renal effects of high but not low intraabdominal pressure

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Abstract

Background

Previously, the authors demonstrated that an intraabdominal pressure (IAP) of 14 mmHg in normal rats reduced kidney function/hemodynamics. These adverse effects are related to interference with the nitric oxide (NO) system. This study was designed to compare the effects of NO synthase (NOS) inhibition on kidney function/hemodynamics during increases in IAP from 0 mmHg to 7, 10, and 14 mmHg.

Methods

The rats were divided into six groups. After an IAP of 0 (baseline), the first three groups were subjected to increasing IAPs as follows: 7 mmHg (group 1), 10 mmHg (group 2), and 14 mmHg (group 3). Each pressure was applied for 1 h, followed by a deflation period of 60 min (recovery). An additional three groups were pretreated with nitro-l-arginine methyl ester (l-NAME), an NOS inhibitor, before pressures of 7 mmHg (group 4), 10 mmHg (group 5) and 14 mmHg (group 6) were applied for 1 h. Urine flow rate (V), Na+ excretion (UNaV), glomerular filtration rate (GFR), and renal plasma flow (RPF), were determined throughout the experiments.

Results

There were no significant changes in V, UNaV, GFR, or RPF during 7-mmHg insufflation. However, significant reductions in these parameters were observed during 10 and 14 mmHg, with V decreasing from 9.95 ± 1.34 μl/min to 6.8 ± 1.1 and 6.1 ± 0.5 μl/min (p < 0.05) and UNaV decreasing from 1.29 ± 0.28 to 0.43 ± 0.32 μEq/min (p < 0.05), and 0.39 ± 0.09 μEq/min (p < 0.05). These alterations in excretory functions were associated with considerable declines in GFR, from 1.98 ± 0.2 to 1.05 ± 0.18 ml/min (p < 0.05) and 0.95 ± 0.06 ml/min (p < 0.05) and RPF from 8.66 ± 0.62 to 3.94 ± 0.88 ml/min (p < 0.05) and 3.08 ± 0.71 ml/min (p < 0.05), respectively. When the animals were pretreated with l-NAME, the adverse renal effects of an IAP of 14 mmHg, but not 10 mmHg, were substantially aggravated.

Conclusion

Decreased renal function/perfusion is induced by IAP pressures of 10 and 14 mmHg but not 7 mmHg. Inhibition of NOS aggravates the adverse renal effects of high (14 mmHg) but not low (7 or 10 mmHg) IAP, indicating that NO deficiency may contribute to the renal dysfunction during high IAP.

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Acknowledgment

The authors are grateful to Aviva Kaballa for her expert technical assistance.

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Authors and Affiliations

  1. Department of General Surgery “A”, Rambam–Human Health Care Campus and Faculty of Medicine, Technion–Israel Institute of Technology, P.O. Box 9649, Haifa, 31096, Israel

    Bishara Bishara

  2. Department of Nephrology, Rambam–Human Health Care Campus and Faculty of Medicine, Technion–Israel Institute of Technology, P.O. Box 9649, Haifa, 31096, Israel

    Rawi Ramadan

  3. Department of Vascular Surgery and Kidney Transplantation, Rambam–Human Health Care Campus and Faculty of Medicine, Technion–Israel Institute of Technology, P.O. Box 9649, Haifa, 31096, Israel

    Tony Karram

  4. Department of Physiology and Biophysics, Faculty of Medicine, Technion–Israel Institute of Technology, P.O. Box 9649, Haifa, 31096, Israel

    Hoda Awad, Niroz Abu-Saleh, Joseph Winaver & Zaid Abassi

  5. Department of Urology, Rambam–Human Health Care Campus, P.O. Box 9649, Haifa, 31096, Israel

    Akram Assadi

  6. Research Unit, Rambam–Human Health Care Campus, Haifa, Technion–Israel Institute of Technology, P.O. Box 9649, Haifa, 31096, Israel

    Zaid Abassi

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  1. Bishara Bishara
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Correspondence to Zaid Abassi.

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Bishara, B., Ramadan, R., Karram, T. et al. Nitric oxide synthase inhibition aggravates the adverse renal effects of high but not low intraabdominal pressure. Surg Endosc 24, 826–833 (2010). https://doi.org/10.1007/s00464-009-0672-3

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  • DOI: https://doi.org/10.1007/s00464-009-0672-3

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