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Renal oxygenation in acute renal ischemia-reperfusion injury

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Renal Physiology

Published online on

Abstract

Tissue hypoxia has been demonstrated, in both the renal cortex and medulla, during the acute phase of reperfusion after ischemia induced by occlusion of the aorta upstream from the kidney. But there are also recent clinical observations indicating relatively well preserved oxygenation in the non-functional transplanted kidney. To test whether severe acute kidney injury can occur in the absence of widespread renal tissue hypoxia, we measured cortical and inner medullary tissue PO2, and total renal oxygen delivery (DO2) and consumption (VO2) during the first 2 h of reperfusion after 60 min of occlusion of the renal artery in anesthetized rats. To perform this experiment, we employed a new method for measuring kidney DO2 and VO2 that relies on implantation of fluorescence optodes in the femoral artery and renal vein. We were unable to detect reductions in renal cortical or inner medullary tissue tissue oxygen tension (PO2) during reperfusion after ischemia localized to the kidney. This is likely explained by the observation that VO2 (-57%) was reduced by at least as much as DO2 (-45%), due to a large reduction in glomerular filtration (-94%). However, localised tissue hypoxia, as evidence by pimonidazole adduct immunohistochemistry, was detected in kidneys subjected to ischemia and reperfusion, particularly in, but not exclusive to, the outer medulla. Thus, cellular hypoxia, particularly in the outer medulla, may still be present during reperfusion even when reductions in tissue PO2 are not detected in the cortex or inner medulla.