Effect of L-arginine and L-NAME on Kidney Tissue Damage in Rats after 24 h of Bilateral Ureteral Obstruction

Background:

Bilateral ureteral obstruction (BUO) affects renal function adversely. Previous investigations have implied that nitric oxide (NO) improves renal function in obstructive nephropathy. The aim of the current study was to investigate the role of NO precursor, L-arginine, and NO blocker agent, L-NAME on kidney tissue damage in rats after 24 h of BUO.

Methods:

Forty Wistar rats (18 male, 22 female) were divided into four groups as follows; group 1: Sham or negative control group that received saline 3 days prior to the sham operation, group 2: Vehicle or positive control group that received saline 3 days prior to BUO, and groups 3 and 4: L-arginine and L-NAME groups that were treated same as group 2 except L-arginine (300 mg/kg) and L-NAME (4 mg/kg) instead of saline, respectively. Twenty-four hours after obstruction, the serum levels of blood urea nitrogen (BUN), creatinine (Cr), nitrite, and malondialdehyde (MDA) as well as kidney tissue levels of nitrite and MDA were measured and histopathological studies were done on left kidney.

Results:

The serum levels of BUN and Cr and kidney and body weights increased and the tissue levels of MDA and nitrite decreased significantly in all BUO groups (P < 0.05). However, the tissue damage score was significantly lower in the L-arginine treated group in comparison to the vehicle and L-NAME groups (P < 0.05). As expected, the serum level of nitrite significantly increased in the L-arginine group (P < 0.05).

Conclusions:

Endogenous NO donor; L-arginine, may protect the kidney tissue against BUO. However, this renoprotective role of L-arginine did not attenuate the increased kidney function markers (BUN and Cr) induced by obstruction.

Acute kidney injury due to bilateral ureteral obstruction in children

Bilateral ureteral obstruction in children is a rare condition arising from several medical or surgical pictures. It needs to be promptly suspected in order to attempt a quick renal function recovery. In this paper we concentrated on uncommon causes of obstruction, with the aim of giving a summary of such multiple, rare and heterogeneous conditions joint together by the common denominator of sudden bilateral ureteral obstruction, difficult to be suspected at times. Conversely, typical and well-known diseases have been just run over. We considered pediatric cases of ureteral obstruction presenting as bilateral, along with some cases which truly appeared as single-sided, because of their potential bilateral presentation. We performed a review of the literature by a search on PubMed, CrossRef Metadata Search, internet and reference lists of single articles updated to May 2014, with no time limits in the past. Given that we deal with rare conditions, we decided to include also papers in non-English languages, published with an English abstract. For the sake of clearness, we divided our research results into 8 categories: (1) urolithiasis; (2) congenital urinary tract malformations; (3) immuno-rheumatologic causes of ureteral obstruction; (4) ureteral localization of infections; (5) other systemic infective causes of ureteral obstructions; (6) neoplastic intrinsic ureteral obstructions; (7) extrinsic ureteral obstructions; and (8) iatrogenic trigonal obstruction or inflammation. Of course, different pathogenic mechanisms underlay those clinical pictures, partly well-known and partly not completely understood.