Renal morphological and structural changes versus assessment of renal Doppler flow parameters, at different times of ischemia and types of clamping: experimental study in pigs

• Grant number: 16/20800-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: January 01, 2017
• End date: December 31, 2017
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Nelson Wolosker
• Grantee: Vitória Penido de Paula
• Host Institution: Instituto Israelita de Ensino e Pesquisa Albert Einstein (IIEPAE). Sociedade Beneficente Israelita Brasileira Albert Einstein (SBIBAE). São Paulo , SP, Brazil

Abstract

The occurrence of acute renal failure (ARF) in post-surgical patients represents a great amount of public expends (tests, medications and dialysis). The chance of acute kidney injury installation in the postoperative period is linked directly to surgery time, severity of pathology installed and complexity of the procedure and it is not always possible to prevent such an event. Given the importance of this clinical profile of patients and the financial impact in public health system, this study aims to research the relation between the morphological and structural changes in different warm ischemia times and ecographic findings in Doppler ultrasound during renal intervention, in order to identify from which moment occurs acute renal impairment. Moreover, a comparison between the morphological analysis of biopsied segments with flow parameters identified by intraoperative Doppler Renal series will be performed. The experimental study will be conducted as follows: 12 pigs will be divided into two working groups: Group I; It will be held unilateral clamping of renal artery and vein. Contralateral kidney will be used as control. Group II - only unilateral renal artery clamping, the contralateral kidney is also used as a control. After clamping the vessel, all animals will undergo sequential renal biopsies with 10, 20, 30, 40, 50, 60, 70, 80 and 90 minutes of ischemia. Moreover, ecographic analysis will be performed 30 and 60 minutes after clamp release. The tissues shall be subjected to histopathological analysis by light and electron microscopy, our data will be compared qualitatively with the sonographic parameters found intraoperatively: Resistance Index (RI), pulsatility index (IP), spectral wave pattern, Flux Volume (VF), systolic peak velocity (VPS), final diastolic velocity (VDF) and acceleration time (TA). (AU)