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Effect of increased renal venous pressure on renal function
J M Doty1, B H Saggi, H J Sugerman
1Department of Surgery, Medical College of Virginia of Virginia Commonwealth University, Richmond, USA.
The Journal of Trauma
|December 23, 1999
Summary
Elevated renal vein pressure (RVP) in swine significantly impaired kidney function, reducing blood flow and filtration. These effects, including hormonal changes and protein leak, were reversible upon pressure reduction, offering insights into acute abdominal compartment syndrome.
Area of Science:
- Nephrology
- Physiology
- Surgical Research
Background:
- Acute renal failure is a complication of acute abdominal compartment syndrome (AACS).
- The role of elevated renal vein pressure (RVP) in renal dysfunction within AACS has not been extensively studied.
- This research investigates the direct impact of increased RVP on renal function.
Purpose of the Study:
- To evaluate the effects of experimentally elevated renal vein pressure (RVP) on renal function in a porcine model.
- To determine if isolated RVP elevation contributes to renal impairment.
- To assess the reversibility of these functional changes.
Main Methods:
- Swine underwent left nephrectomy, with renal artery flow probes and venous catheters placed.
- Renal vein pressure was elevated by 30 mm Hg in the experimental group for 2 hours.
- Glomerular filtration rate (GFR) was measured via inulin clearance; plasma renin activity and aldosterone were also monitored.
Main Results:
- Elevated RVP significantly decreased renal artery blood flow and GFR.
- Experimental animals showed increased plasma renin activity, serum aldosterone, and urinary protein leak.
- These detrimental effects were partially or fully reversible upon returning RVP to baseline.
Conclusions:
- Isolated elevation of renal vein pressure impairs renal function, characterized by reduced blood flow and GFR.
- The observed changes mimic renal pathophysiology in conditions like AACS, morbid obesity, and preeclampsia.
- Reversibility of these changes with RVP reduction highlights potential therapeutic implications for abdominal decompression.