Insulin maintains plasma antioxidant capacity at an early phase of kidney transplantation

Area of Science:

• Nephrology
• Transplantation Immunology
• Oxidative Stress Research

Background:

• Ischaemia-reperfusion and hyperglycaemia are key contributors to oxidative stress in transplant recipients.
• This oxidative stress plays a significant role in the pathophysiology of tissue injury following transplantation.

Purpose of the Study:

• To investigate if controlling hyperglycaemia with insulin during the early hours post-kidney transplantation can enhance antioxidant defenses.
• To determine if improved antioxidant defenses can mitigate ischaemia-reperfusion-induced injury.

Main Methods:

• A prospective randomized study involving non-diabetic patients receiving their first cadaveric renal allograft.
• Patients were assigned to either a control group (glucose infusion) or an insulin group (glucose infusion with insulin to maintain blood glucose <10 mmol/l).
• Antioxidant capacity was assessed using the plasma total radical-trapping antioxidant parameter (TRAP).

Main Results:

• TRAP values remained stable in the insulin group, unlike the control group where they decreased and then tended to recover.
• Significantly higher TRAP values were observed in the insulin group compared to the control group at days 1 and 4 post-transplantation.
• No significant differences were found in urinary malondialdehyde, markers of oxidative damage, graft function, or patient outcomes between the groups.

Conclusions:

• This study is the first clinical trial to demonstrate that insulin administration improves antioxidant defenses in the early stages of kidney transplantation.
• Further extensive research is needed to ascertain the long-term benefits of this strategy on graft outcomes.