Minimal physiologic temperature variations during renal ischemia alter functional and morphologic outcome.

Area of Science:

• Nephrology
• Vascular Surgery
• Physiology

Background:

• Renal ischemia is a common complication during aortic and renal vascular reconstruction.
• Profound hypothermia can preserve renal tissue, but is often impractical in clinical settings.
• Renal ischemia frequently occurs at physiological temperatures, impacting outcomes.

Purpose of the Study:

• To investigate the impact of minimal temperature changes during renal ischemia on kidney function and morphology.
• To determine if maintaining physiological temperatures during renal ischemia affects post-ischemic outcomes.

Main Methods:

• Adult male Sprague-Dawley rats underwent right nephrectomy and 45-minute left renal pedicle ischemia.
• Rats were divided into three groups based on body temperature during ischemia: 35°C, 37°C, and 39°C.
• Creatinine levels and kidney histology were assessed post-ischemia.

Main Results:

• Elevated body temperatures during ischemia led to increased plasma creatinine levels at 24 hours.
• Histological assessment at 30 hours showed better proximal tubular morphology preservation at lower temperatures.
• A significant difference in morphologic outcome was observed between 37°C and 39°C groups (p=0.016).

Conclusions:

• Minimal temperature variations during renal ischemia significantly alter functional and morphologic outcomes.
• Lower body temperatures during renal ischemia are associated with improved renal tissue preservation.
• These findings underscore the importance of temperature management during renal ischemia in vascular reconstruction.