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Enhanced ketogenesis in the kidney during hepatic inflow occlusion with the administration of Ringer's acetate
T Nakatani1, Y Sakamoto, H Ando
1Trauma and Critical Care Center, Teikyo University School of Medicine, Tokyo, Japan.
Background:
The blood levels of ketone bodies, which are synthesized principally in the liver, were maintained even during hepatic inflow occlusion if Ringer's acetate solution (AR) was administered, resulting in an improvement of hepatic energy level in the reperfusion phase, as reported in our previous experimental study. The current study was designed to prove that the kidneys are the organs that contribute to synthesize ketone bodies during hepatic inflow occlusion if AR is administered.
Methods:
The arterial, central venous, renal venous, and renal tissue ketone body concentrations were determined in rabbits administered AR or Ringer's lactate solution (LR) at 20 minutes of hepatic ischemia and at 30 minutes of reperfusion. The concentrations were also compared in rabbits under AR infusion with or without hepatic ischemia for 20 minutes. Statistical analyses were performed by means of ANOVA:
Results:
With AR the renal venous ketone body concentration not only was higher than that with LR (p < 0.001) but also was higher than the arterial concentration (p = 0.05). The renal tissue ketone body concentration was higher than in those with LR (p < 0.001) and also than in those without occlusion (p < 0.001).
Conclusions:
Ketogenesis is enhanced in the kidney and may compensate for hepatic loss of ketogenic function during hepatic inflow occlusion under AR administration.