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Effects of glucose in protected ischemic kidneys
M Kallerhoff1, M Blech, G Kehrer
1Zentrum Physiologie und Pathophysiologie, Universität Göttingen, FRG.
Urological Research
|January 1, 1987
Summary
Glucose in organ preservation solutions negatively impacts kidney health during ischemia. High glucose levels increase lactate production and reduce intrarenal pH, leading to structural damage. Mannitol may be a better alternative for kidney protection.
Area of Science:
- Nephrology
- Transplantation
- Biochemistry
Background:
- Renal tissue has lower energy reserves (Total Adenine Nucleotides - TAN) and anaerobic substrates (glucose, glycogen) compared to myocardial tissue.
- Euro-Collins solution is high in glucose (approx. 200 mmol/l), while HTK solution contains no glucose.
Purpose of the Study:
- To analyze the influence of glucose on kidney lactate production, energy reserves (TAN), intrarenal pH, and morphology during ischemic protection.
- To compare the efficacy of Euro-Collins solution, a modified Euro-Collins solution (mannitol instead of glucose), and HTK solution (with varying glucose concentrations) for kidney preservation.
Main Methods:
- Kidneys were perfused with different preservation solutions: Euro-Collins, modified Euro-Collins (mannitol), and HTK (0, 5, 10, 20 mmol/l glucose).
- Parameters measured included intrarenal pH, lactate production, TAN levels, and morphological integrity after 420 minutes of ischemia at 25°C.
Main Results:
- Euro-Collins solution led to a significant decrease in intrarenal pH (7.1 to 5.1) and increased glucose levels during perfusion.
- HTK solution without glucose provided the best structural protection, despite lower TAN levels compared to Euro-Collins.
- Increasing glucose concentrations in HTK solutions correlated with decreased intrarenal pH.
Conclusions:
- Glucose in preservation solutions stimulates lactate production, lowers kidney interstitial pH, and may increase membrane permeability, causing structural deterioration.
- Mannitol appears more suitable than glucose for kidney preservation, though other substrates may offer improved energy supply and structural protection.