Hemodynamics changes with acute carotid baroreceptor field stimulation are age-dependent in normotensive rats

Carotid baroreceptor stimulation can treat resistant hypertension with possible effects on the vasculature beyond the decrease in arterial pressure. This study aims to characterize age-dependency of vascular hemodynamics changes with unilateral field stimulation of carotid baroreceptors in normotensive rats to infer underlying hemodynamic mechanisms. Anesthetized Wistar-Kyoto rats divided into two groups (young: n=10, 13-33 weeks; old: n=6, 52-58 weeks) were instrumented to measure heart rate (HR) and mean arterial pressure (MAP), and flow in the abdominal aorta and renal artery. Measures of aortic and renal artery stiffness and resistance were calculated. Baroreceptor stimulation caused a consistent reduction in MAP, HR, pulse pressure and aortic pulse wave velocity. In young rats reduced MAP (77 ± 10 to 64 ± 13 mmHg, p<;0.001) was concomitant with reduced mean aortic (40 ± 15 to 32 ± 11 ml/min, p<;0.05) and renal flow (3.0 ± 1.6 2.2 ± 1.1 ml/min, p<;0.001). However, in old rats reduced MAP (76 ± 14 to 64 ± 10 mmHg, p<;0.05) occurred with a reduced aortic resistance (1.8 ± 0.9 to 1.6 ± 0.9 mmHg.min/ml, p<;0.05), renal artery resistance (17.4 ± 2.4 to 16.5 ± 2.3 mmHg.min/ml, p<;0.05) and mean renal flow (4.5 ± 1.2 to 4.0 ± 1.1 ml/min, p<;0.05). This was consistent with reduced characteristic impedance in older rats in both the aorta (0.17 ± 0.08 to 0.13 ± 0.08 mmHg.min/ml, p<;0.05) and renal artery (4.97 ± 1.16 to 3.97 ± 1.08 mmHg.min/ml, p<;0.05). Stimulation caused a leftward shift in renal impedance phase frequency spectrum in both age groups indicating changes in wave reflection from the renal bed. Findings show that the reduction in MAP due to carotid barostimulation is associated with different hemodynamic mechanisms that depend on age.

Evaluation of effects of Extracorporeal Shock Wave Lithotripsy on renal vasculature with Doppler ultrasonography

OBJECTIVES

In this prospective study, we aimed to demonstrate the effects of Extracorporeal Shock Wave Lithotripsy (ESWL) on renal blood flow in patients treated for renal/ ureteral stones.

MATERIAL AND METHODS

The study group comprised 41 patients (26 males, 15 females, aged between 18-63 years, mean age 45 years), 23 with renal and 18 with ureteral stones, who underwent ESWL between March 2010 and January 2011. Colour Doppler ultrasonography and pulsed wave spectral analysis was performed before, 1 hour, and 7 days after ESWL to both ipsilateral and contralateral kidneys in order to measure resistive index (RI), pulsatility index (PI) and acceleration time (AT) values.

RESULTS

One hour after ESWL, RI and PI values showed significant increase from pre-ESWL values in both ipsilateral and contralateral kidneys. However, no significant change was found in AT values. Seven days after ESWL, PI in both ipsilateral and contralateral kidneys and RI in contralateral kidney returned to pre-ESWL values. But, 7 days after ESWL, RI in the ipsilateral kidney did not return to pre-ESWL values, although decrease in RI values were observed. CONCLUSİON: Spectral Doppler analysis can provide valuable information as a non-invasive method to assess the hemodynamic changes and renal microcirculation status in cases managed with ESWL.

Differentiated hemodynamic changes controlled by splanchnic nerve

The splanchnic (SPL) nerve is a postganglionic sympathetic nerve involved in the tonic regulation of the cardiovascular system. Electrical stimulation of this nerve produces mesenteric vasoconstriction and it has been assumed that vasodilatory responses are dependent on inhibition of the vasoconstrictor tone. Several different central stimuli have been shown to dilate the hindquarter vascular bed and constrict the mesenteric vascular bed. To determine whether vasodilatory and vasoconstrictor effects in different vascular beds are elicited by activation of different sympathetic nerves, we investigated the hemodynamic changes in hindquarter, mesenteric and renal vascular beds evoked by electrical stimulation of the SPL nerve. Stimulation of the intact or sectioned SPL nerve in chloralose-anesthetized, artificially ventilated rats evoked increases in the hindquarter vascular conductance and simultaneously decreased the mesenteric and renal vascular conductance. Intravenous (i.v.) administration of L-NAME prior to stimulation of the proximal end of the sectioned SPL nerve abolished the increase in hindquarter conductance, suggesting the involvement of nitric oxide in this response. In assessing the hemodynamic effects of tonic activity on the SPL nerves, no significant changes were observed after unilateral section of the SPL nerve, but bilateral section of the SPL nerves decreased hindquarter conductance and did not significantly change the mesenteric conductance simultaneously. No consistent response was observed in the renal vascular bed after unilateral and subsequent contralateral section of the SPL nerves. These findings demonstrate that electrical stimulation of the SPL nerve produces mesenteric vasoconstriction and simultaneous hindquarter vasodilatation, which is mediated by nitric oxide. Moreover, the present data suggest that SPL nerves may provide a tonic vasodilatory tone in the hindquarter vascular bed and simultaneously a vasoconstrictor tone in another, undetermined vascular bed.

[Mitogenic effect and acceleration of stabilization process in the renal glomeruli of hypertrophied kidney after exposure to magnetic field]

Experiments designed to investigate the effects of magnetic fields of different nature, induction, exposure duration and multiplicity, have established a stimulating action of alternating magnetic field of 15 mT applied 2-5 times for 30 min daily on mitotic division of proximal tubule epitheliocytes. The degree of renal glomeruli capillary lumina distention (CLD), defined as the ratio of the total area of glomerular capillaries to glomerular area, was found to be variable, indicating the asynchronism of their filling with blood. Elevated filtration volume in a single kidney left after nephrectomy, was provided by a synchronization of blood filling of renal glomerular capillaries, that was manifested by the shift of their major part to the groups with high CLD and the appearance of glomeruli with extremely dilated capillaries. These changes were more significant and were detected earlier following exposure to alternating magnetic field.

Effects of ionizing radiation on progressive experimental renal disease: a hemodynamic approach

In order to evaluate the progression of renal disease, Munich-Wistar rats were submitted to 5/6 nephrectomy and given whole-body x- or gamma-irradiation with or without remnant kidney protection or were submitted only to remnant kidney irradiation. All groups received a single 6-Gy dose immediately after surgery. Whole-kidney function, glomerular hemodynamics, 24-hour proteinuria and histopathology were assessed 60 days after surgery and irradiation. The irradiated nephrectomized animals presented whole-kidney function parameters comparable to those of normal rats. In addition, they were less hypertensive and had higher hematocrit. They showed glomerular hyperfiltration and hypertension even greater than their respective nephrectomized controls. However, the interrelations among the glomerular filtration determinants were somewhat different in irradiated animals. Their 24-hour proteinuria was significantly lower and the sclerosis index and tubulointerstitial injury score were markedly smaller. Among irradiated animals, the worst sclerosis index was observed in those with a shielded remnant kidney and the best in those without protection of the remnant kidney. This led us to speculate about a possible influence of resident mesangial cells on the early events following renal mass ablation and on the maintenance of subsequent physiopathologic changes. Therefore, radiation undoubtedly provoked a beneficial change in the course of renal disease when the renal mass ablation model was employed. Many factors could have contributed to this favorable feature including lower levels of systemic arterial pressure, less increment in DeltaP, diminished proteinuria, and maintenance of tubulointerstitial space integrity. Our data also suggest that development of glomerulosclerosis seems to be determined by events occurring immediately after injury.

Protective effect of aminophylline on renal perfusion changes induced by high-energy shockwaves identified by Gd-DTPA-enhanced first-pass perfusion MRI

PURPOSE

The purpose of this study was to evaluate regional renal hemodynamics in a noninvasive manner using gadolinium-DPTA magnetic resonance imaging (MRI) before and after extracorporeal shockwave lithotripsy (SWL). In addition, the renoprotective effect of intravenous aminophylline was evaluated on the perfusion on kidneys undergoing SWL.

PATIENTS AND METHODS

Ten randomly selected patients were evaluated for regional renal blood flow in the cortex and medulla with Gd-DTPA MRI studies within 2 weeks before and 4 hours after SWL. Five of these patients were treated with 500 mg of intravenous aminophylline 45 minutes prior to SWL. Renal hemodynamics were assessed utilizing relative perfusion indices (PI) calculated from signal intensity-v-time curves obtained from regions of interest (ROI). The ROI choice was based on the contrast-enhanced MRI images. Relative PIs of pre-SWL and post-SWL studies were compared in the first group of patients. Relative PIs of the treated kidney were compared with those of the contralateral kidney in the second group of patients, who received aminophylline.

RESULTS

In the group not treated with aminophylline, there was no significant difference in cortical perfusion before SWL (average PI -7+/-3%). However, after lithotripsy, there was a reduction of cortical flow (average PI 31+/-12%) in the treated kidney. In the group treated with aminophylline, renal hemodynamics study after SWL revealed no significant difference in relative perfusion (average PI -8+/-6%). Relative PIs of the medulla were small for all patients, but standard errors were large, indicating a wide range of values.

CONCLUSIONS

This study helps to establish reduced cortical flow after SWL and demonstrates that aminophylline attenuated this response in the kidneys subjected to lithotripsy. It appears that aminophylline administration causes no alteration in medullary blood flow.

Abnormal endothelium-dependent responses in early radiation nephropathy

While arterial hypertension and renal dysfunction are well recognized complications of renal irradiation, the mechanisms that trigger the development of these complications are unknown. Recently, it was reported that the endothelium is a major target in radiation injury. Because dysfunction of the endothelial cells may lead or contribute to the development of hypertension and renal dysfunction in radiation nephropathy, we tested the hypothesis that endothelium-dependent vasodilation is impaired in radiated kidneys prior to the onset of hypertension. To test this hypothesis, we used Long-Evans rats that had undergone left nephrectomy (3 weeks earlier) and irradiation (3000 r's) to the right kidney 8 days earlier (mean blood pressures in the irradiated rats were not different than in the controls). We then measured the changes in renal blood flow (RBF) induced by endothelium-dependent (acetylcholine and bradykinin) and -independent (nitroprusside, norepinephrine, and angiotensin II) vasoactive agents. We found that the increases in RBF induced by the endothelium-dependent but not independent vasodilators were markedly impaired in the irradiated kidneys. Blocking nitric oxide synthesis with nitro L-arginine methyl ester in sham rats mimicked the blunted responsiveness of the irradiated rats, whereas indomethacin (an inhibitor of prostaglandin synthesis) had no effect on either sham or irradiated rats. Finally, the RBF responses to the endothelium-independent vasoconstrictors, norepinephrine and angiotensin II, were not altered in the irradiated kidneys. These results suggest that renal irradiation causes endothelial dysfunction (prior to the onset of hypertension) but spares the vascular smooth muscle cells.

Modulation of plasminogen activator inhibitor-1 in vivo: a new mechanism for the anti-fibrotic effect of renin-angiotensin inhibition

We examined the potential of in vivo linkage of plasminogen activator inhibitor-1 (PAI-1) and angiotensin II (Ang II) in the setting of endothelial injury and sclerosis following radiation injury in the rat. PAI-1 is a major physiological inhibitor of the plasminogen activator (PA)/plasmin system, a key regulator of fibrinolysis and extracellular matrix (ECM) turnover. PAI-1 mRNA expression in the kidney was markedly increased (9-fold) at 12 weeks after irradiation (P < 1.001 vs. normal control). In situ hybridization revealed significant association of PAI-1 expression with sites of glomerular injury (signal intensity in injured vs. intact glomeruli, P < 0.001). Angiotensin converting enzyme inhibitors (ACEI, captopril or enalapril) or angiotensin II receptor antagonist (AIIRA, L158,809) markedly reduced glomerular lesions (thrombosis, mesangiolysis, and sclerosis; sclerosis index, 0 to 4+ scale, 0.49 +/- 0.20 in untreated vs. 0.05 +/- 0.02, 0.02 +/- 0.01, 0.04 +/- 0.02 in captopril, enalapril and AIIRA, respectively, all P < 0.01 vs untreated). Further, ACEI and AIIRA markedly attenuated increased PAI-1 mRNA expression in the irradiated kidney (36, 19 and 20% expression, respectively, for captopril, enalapril and AIIRA, compared to untreated irradiated kidney, P < 0.05, < 0.01, < 0.01). This effect was selective in that neither tissue-type nor urokinase-type PA mRNA expression was affected by these interventions. Thus, we speculate that inhibition of the renin-angiotensin system may ameliorate injury following radiation by accelerating fibrinolysis and ECM degradation, at least in part, via suppression of PAI-1 expression. In summary, inhibition of Ang II, in addition to its known effects on vascular sclerosis, may also by its novel effect to inhibit PAI-1, lessen fibrosis following endothelial/thrombotic injury.

Captopril preserves function and ultrastructure in experimental radiation nephropathy

Captopril protects rat lung from radiation-induced pneumonitis and fibrosis and preserves function and survival in experimental radiation nephropathy. This study determined the structural benefit of captopril used preventively in radiation nephropathy. Twenty-eight Wag/RijMCW rats, divided in six groups, received 0 to 17 Gray total body irradiation followed by syngeneic bone marrow transplant. Captopril 0, 62.5, 125, 250, or 500 mg/l was given in the drinking water from the time of irradiation, and the rats were killed at 20 weeks. Using light and electron microscopy, kidneys of irradiated no-drug rats showed glomerular tuft capsular adhesions and hyalinization, focal tubular necrosis, severe interstitial fibrosis, and marked thickening and hyaline degeneration of the wall of interlobular arteries and arterioles, with intimal proliferation and periadventitial edema and inflammation. Lumens of the smaller arteries were often occluded. Significant collagen deposition was present in glomeruli, interstitium, and adventitia of interlobular arteries. Marked reduction of glomerular, tubular, vascular, and interstitial damage was seen in irradiated, captopril-treated animals, with only mild focal tubular interstitial injury and fibrosis seen. alpha smooth muscle actin-positive cells, probably myofibroblasts, were enhanced in the irradiated kidneys, and this expression was reduced in a dose-related fashion by captopril. There was also reduction in the arteriolar wall thickening, luminal occlusion, and collagen deposition in captopril-treated animals. The presence of elastin was not affected by radiation or drug treatment. Blood pressure and azotemia were lower and survival was higher in irradiated drug-treated rats compared with irradiated no-drug rats. We conclude that captopril exerts significant functional and structural protection against renal radiation injury. There was notable reduction in radiation-induced fibrosis in captopril-treated animals in this model, as in experimental lung radiation injury.

Radiation response of the monkey kidney following contralateral nephrectomy

PURPOSE

The long-term functional and morphologic responses of the hypertrophied monkey kidney after unilateral nephrectomy to fractionated irradiation were assessed.

METHODS AND MATERIALS

The right kidney of 13 adult female rhesus monkeys was removed. Twelve weeks after unilateral nephrectomy (UN) the remaining kidney received fractionated doses of gamma-rays ranging from 35.2 Gy/16 fractions (F) up to 44 Gy/20 F. Glomerular filtration rate, effective renal plasma flow, blood urea nitrogen, serum creatinine, and hematocrit values were measured up to 107 weeks postirradiation (PI). The monkeys were killed and the remaining kidneys were removed 107 weeks PI or earlier when end-stage renal failure was exhibited. Glomeruli were scored for the presence/absence of several pathologic features including increased intercapillary eosinophilic material (ICE), ectatic capillaries, and thrombi. The relative proportion of renal cortex occupied by glomeruli, interstitium, normal tubules or abnormal tubules was determined using a Chalkley point grid. These quantal dose response data were analyzed using a logistic regression model.

RESULTS

Irradiation of the remaining kidney in UN monkeys resulted in a dose-dependent reduction in renal function and anemia. Glomerular dysfunction preceded tubular dysfunction. Animals receiving 44 Gy all manifested progressive clinical renal failure. Conversely, those receiving < or = 39.6 Gy showed stable, albeit impaired, renal function for the duration of the observation period of 107 weeks. Morphologically, the incidence of ICE, ectatic glomerular capillaries, thrombi, and periglomerular fibrosis was significantly dose-related (p < 0.005). A significant (p < 0.001) dose-related increase in the relative proportion of renal cortex occupied by abnormal tubules was indicative of tubular injury. A highly significant (p < 0.001) dose-dependent increase in the proportion of abnormal to normal tubules was also seen.

CONCLUSION

The pathogenesis of radiation nephropathy is difficult to fully understand because of the complex and dynamic interactions among all components of the nephron that make discrimination between primary radiation effects and secondary pathophysiological consequences very difficult. Notwithstanding, the current experiment shows that the functional and morphological expressions of radiation injury in the kidney are dose dependent. Renal failure occurs when both the glomeruli and tubules are dysfunctional. In monkeys following UN, a total dose of 44 Gy to the remaining kidney damages all components of the nephron and causes renal failure in less than 45 weeks. With lower doses, changes to the glomeruli predominate and the animals survive. Kidney doses of up to 39.6 Gy/18 fractions of 2.2 Gy are compatible with survival for at least 2 years in primates.

Sequential evaluation of radiation-induced glomerular ultrastructural changes in the pig kidney

Both kidneys of 12 mature female pigs received either a single dose of 9.8 Gy 60Co gamma rays or sham irradiation. At intervals of 1-4 weeks serial renal biopsies were obtained, followed by sacrifice at 24 weeks after irradiation. Individual kidney glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and the hematocrit (Hct) were measured routinely. Renal irradiation resulted in a progressive decline in GFR, ERPF, and Hct, with minimal values being observed within 12 weeks of irradiation. No change in any of these parameters was noted in the sham-irradiated pigs. The initial morphological change in irradiated glomeruli was leukocyte attachment to capillary endothelial cells 3-6 weeks after irradiation followed by activation and swelling of the endothelial cells. This was followed by pronounced increases in capillary permeability with fluid and erythrocyte, leukocyte, and platelet exudation into the subendothelial/mesangial space. This resulted in compression of glomerular capillary lumina, which occurred concomitantly with the reduction in GFR. By 12 to 15 weeks after irradiation the changes in endothelial cells were less evident. However, mesangial cells exhibited evidence of activation and proliferation accompanied by progressive mesangial expansion and sclerosis. Thus the glomerular capillary endothelial and mesangial cells appear particularly important in the pathogenesis of radiation nephropathy.

Resistance and pulsatility Doppler indices: how accurately do they reflect changes in renal vascular resistance

Doppler indices such as the resistance (RI) and pulsatility indices (PI) are generally thought to indicate the resistance of the vascular bed supplied by the artery under investigation. However, this association remains uncertain; some studies have demonstrated an excellent correlation between alterations in vascular resistance and changes in Doppler indices, while others have shown no consistent change. In order to assess the validity of these two indices in estimating alterations in renal vascular resistance, 12 female Large White pigs, 45 weeks old, were entered into a double blind study. In nine of the pigs both kidneys received a single dose of 9.8 Gy 60Co gamma-rays; the remaining three served as sham-irradiated controls. Renal haemodynamics were measured using 131I-hippuran renography and Duplex Doppler prior to and at 8, and 12 weeks after kidney (sham-)irradiation. The sham-irradiated animals exhibited no significant changes in any of the parameters. In contrast, the animals in which both kidneys were irradiated exhibited a significant decrease (p < 0.001) in renal blood flow (RBF) 8 and 12 weeks after irradiation. In addition, both PI and RI were increased following kidney irradiation; however, this increase was not significant until 12 weeks after irradiation (p < 0.01). This suggests that the reduction in RBF was not simply a reflection of an increased vascular resistance and/or that PI and RI do not truly represent alterations in vascular resistance. Further studies are required to confirm the applicability of PI and RI in the assessment of renal haemodynamics.

Functional changes in the pig kidney following irradiation with fractionated doses of fast neutrons (42 MeVd-->Be)

The right kidney of female Large White pigs, approximately 14 weeks old, was irradiated with fractionated doses of fast neutrons (42 MeVd-->Be). The total doses used were 6.6-9.2 Gy. Changes in kidney function, assessed as the functional index (FI, where FI = irradiated kidney function/unirradiated kidney function) or as individual kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), were serially determined up to 104 weeks after irradiation using 99Tcm-DTPA and 131I-hippuran renography. The animals were then euthanized, the kidneys removed and weighed. A dose-dependent reduction in FI was seen within 13 weeks of irradiation. Measuring individual kidney function revealed a hyperaemic response in both irradiated and unirradiated kidney 4 weeks after irradiation. This was followed by a dose-dependent reduction in irradiated kidney GFR and particularly ERPF. The ED50 value for the impairment in ERPF, assessed as the percentage of irradiated kidneys exhibiting a > or = 50% reduction in ERPF, was significantly lower than that for GFR, i.e. 7.20 +/- 0.10 Gy compared with 8.44 +/- 0.07 Gy (p < 0.001). A dose-related reduction in irradiated kidney weight was also observed. These fast neutron-induced changes in renal function and weight are qualitatively similar to those observed following photon irradiation of the pig kidney.

Positron emission tomography in the study of acute radiation effects on renal blood flow in dogs

Renal blood flow measurements have been carried out by means of positron emission tomography (PET) to facilitate the detection of radiation-induced injuries. The advantages of the method employed in animal experiments are described.

Residual radiation-induced damage to the kidney of the pig as assayed by retreatment

The effect of re-irradiation on the previously irradiated kidney was studied in the Large White female pig. Both kidneys of 14-week-old pigs were initially irradiated with a single dose of 3-7 Gy of 250 kV X-rays. The individual kidney glomerular filtration rate (GFR), effective renal plasma flow (ERPF), and the haematocrit (Hct) were serially measured up to 24 weeks after X-irradiation. Doses of 3 and 5 Gy of X-rays had little effect on the GFR. However, 7 Gy of X-rays caused a marked decline in the GFR up to 12 weeks after irradiation; the GFR then began to recover. A similar pattern of response was seen in the ERPF. In contrast, the Hct was reduced in all pigs 4 weeks after X-irradiation. The extent of the decline and subsequent recovery 24 weeks after irradiation appeared to be related to dose. Twenty-four weeks after X-irradiation both kidneys were re-irradiated with a single dose of 7.9 Gy of 60Co gamma-rays; both kidneys of four age-matched control pigs which had not previously received X-irradiation were similarly treated. Individual kidney GFR, ERPF and Hct were again serially measured up to 24 weeks after gamma-irradiation. Re-irradiation resulted in a significantly greater reduction in the GFR, ERPF and Hct compared with that seen after gamma-irradiation alone. Moreover, the severity of the reduction in the GFR and Hct observed after gamma-irradiation was related, in a dose-dependent manner, to the initial X-ray doses employed. These results indicate that the kidney fails to exhibit complete long-term recovery in function following irradiation. Re-irradiation of the kidney in patients should thus be viewed with extreme caution.

The effect of unilateral nephrectomy on the subsequent radiation response of the pig kidney

The left kidney of 14 Large White female pigs, approximately 14 weeks of age, was surgically removed. Thirty weeks after unilateral nephrectomy (UN) the remaining kidney was irradiated with a single dose of between 11.9 and 15.6 Gy of 60Co gamma-rays; three pigs received sham irradiation. Following irradiation glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and haematocrit (Hct) were determined for up to 48 weeks after irradiation. Irradiation resulted in a dose-dependent decline in GFR, evident 8 weeks after irradiation. This was followed by a gradual improvement in GFR, although after doses of 14.0 Gy GFR remained below control values throughout the study. A similar pattern of response was seen in terms of ERPF, but this was not dose-related. Doses of greater than or equal to 14.0 Gy also caused a significant reduction (p less than 0.001) in Hct within 4-8 weeks. Minimal levels were evident 16 weeks after irradiation; Hct then increased, but remained below preirradiation values. Dose-effect curves were obtained by determining the percentage of irradiated kidneys which showed a greater than or equal to 50% reduction in GFR and ERPF, fitted by probit analysis, and ED50 values (+/- SE) were calculated for each parameter. The ED50 values for GFR and ERPF were 14.49 +/- 0.27 Gy and 12.56 +/- 0.98 Gy, respectively. These values were not significantly different from those obtained from intact age-matched pigs in which the right kidney alone was irradiated; UN did not compromise or alter the radiation response of the kidney to irradiation. However, the ED50 values obtained for the UN pigs were significantly greater (p less than 0.001) than the values of 9.76 +/- 0.17 Gy and 6.19 +/- 0.93 Gy, seen for GFR and ERPF in intact age-matched pigs in which both kidneys were irradiated. Thus although both experimental situations involved irradiating the entire renal tissue, the relative radiosensitivity of the kidneys varied considerably. These findings show that the radiosensitivity of the pig kidney can vary markedly, depending on the physiological status of the kidney at the time of irradiation.

The effect of age and the proportion of renal tissue irradiated on the apparent radiosensitivity of the pig kidney

In 14-week-old (immature) and 45-week-old (mature) pigs either the right kidney (unilateral irradiation, UI) or both kidneys (bilateral irradiation, BI) were irradiated. The kidneys of immature pigs received single doses of 7.0-12.6 Gy of 250 kV X-rays; mature pigs received single doses of 7.8-14.0 Gy of 60Co gamma-rays. These were assumed to be approximately equivalent to the X-ray doses using a RBE of 0.9 gamma-rays/X-rays. The glomerular filtration rates (GFR) and effective renal plasma flows (ERPF), were determined for up to 24 weeks after irradiation. From these data dose-effect curves were obtained by determining, at each dose level, the percentage of irradiated kidneys which exhibited a greater than or equal to 50 per cent reduction in GFR and ERPF. 60Co gamma-ray doses were normalised to approximately equivalent X-ray doses. The dose-effect curves were fitted by probit analysis, and ED50 values (+/- SE) calculated for both GFR and ERPF. Similar conclusions could be drawn from the results obtained following the determination of both GFR and ERPF. However, the ED50 values obtained for ERPF were significantly lower than those for GFR (p less than 0.05). In 14-week-old animals the kidney of UI animals was significantly more radiosensitive than that of BI animals, i.e. the ED50 values, in terms of GFR, were 8.74 +/- 0.31 Gy and 10.97 +/- 0.23 Gy, respectively (p less than 0.001). In 45-week-old pigs the reverse was true; the ED50 values were 12.67 +/- 0.34 Gy and 8.78 +/- 0.15 Gy (p less than 0.001) for unilateral- or bilateral-irradiated animals, respectively. The kidney of BI mature animals appeared to be as radiosensitive as the UI immature pigs. Thus the renal response to radiation was markedly influenced by the age of the animals and by the proportion of the renal tissue irradiated.

Radiation nephropathy in mature pigs following the irradiation of both kidneys

Both kidneys in mature female Large White pigs, ca. 45 weeks old were irradiated with single doses of 7.8-14.0 Gy of 60Co gamma-rays. Radiation-induced changes in renal function were assessed on the basis of sequential individual measurements of kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) for up to 24 weeks after irradiation. At the same time intervals blood samples were taken to determine plasma renin levels and the haematological status of each animal. Two weeks after irradiation the ERPF and in particular the GFR was increased. This was followed by a pronounced, dose-dependent, decline in renal haemodynamics. Minimal functional levels were observed 8-12 weeks after irradiation. Function then somewhat recovered. There was a significant (r greater than or equal to 0.98; p less than 0.001) inverse relationship between the mean values of GFR and ERPF, determined at 4-24 weeks after irradiation, and the radiation dose. After a dose of 7.8 Gy the reduction in ERPF was greater than that for GFR. However, at higher doses both parameters were reduced to an equal extent. The resulting slope of the dose-effect curve for impaired renal function versus dose was significantly steeper for GFR than that for ERPF (p less than 0.001). There was a significant reduction (p less than 0.002) in the erythrocyte count, the haematocrit and haemoglobin levels within 6-8 weeks of irradiation; this anaemia was characterized as a normochromic normocytic anaemia. There were no marked changes in plasma renin levels as a result of renal irradiation. The pathogenesis of late radiation-induced damage to the kidney is discussed in the light of these findings.

Nephropathy in the mature pig after the irradiation of a single kidney: a comparison with the immature pig

The right kidney of 11 mature 10-month-old Large White female pigs was irradiated with single doses of 9.8-14.0 Gy of 60Co gamma rays. Individual kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured using 99mTc-DTPA and 131I-hippuran renography for periods up to 24 weeks after irradiation. Renal function was assessed either as a functional index, FI (FI = irradiated/unirradiated kidney function), or as the individual kidney GFR and ERPF. The radiation-induced changes after the irradiation of a single kidney (unilaterally irradiated--UI) of mature pigs were compared with those previously observed in 14-week-old immature pigs. Irradiation resulted in a dose-dependent reduction in the FI for both GFR and ERPF. However, these reductions were significantly less than those previously seen in immature pigs. Within 2 weeks of irradiation GFR increased in both the irradiated and the unirradiated kidneys in each animal, compared with unirradiated age-matched control kidneys. No marked changes in renal hemodynamics were seen in mature animals after a single dose of 9.8 Gy. This was in marked contrast to the pronounced reduction in the GFR and ERPF in the irradiated kidney previously observed in immature animals irradiated with an equivalent single dose of X rays. After higher doses, the irradiated kidney in mature pigs showed a dose-dependent reduction in GFR and ERPF. However, the extent of this reduction was significantly less than that seen in immature animals. There was no apparent difference in the response of the unirradiated kidneys in mature or immature pigs. The ED50 values, based on a probit fit to the data for the proportion of functional tests in which the irradiated kidney showed a greater than or equal to 50% reduction in GFR or ERPF, were higher in the mature animals; for example for ERPF the ED50 values were 11.76 +/- 0.28 Gy and 7.67 +/- 0.34 Gy for mature and immature animals, respectively. Thus, the UI kidney in mature pigs appears to be less radiosensitive than the UI kidney in immature animals.

Effects of single doses of X-rays on renal function in the pig after the irradiation of both kidneys

Irradiation of a single kidney in the pig with relatively low doses of X-rays, in the order of 8 Gy, produces a pronounced reduction in both glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). This apparent high radiosensitivity may be due, in part, to the compensatory hypertrophy displayed by the contralateral unirradiated kidney. This could suppress any potential for recovery by the irradiated kidney. To test this hypothesis, both kidneys of 14-week-old Large White pigs were sequentially irradiated with single doses of 250 kV X-rays, in the range 8.8 to 12.6 Gy. Sequential measurements of individual kidney GFR and ERPF were made for periods up to 24 weeks after irradiation. Time-related changes in haematocrit (Hct) were also studied. Two weeks after irradiation, GFR and ERPF increased markedly in all irradiated kidneys; levels then declined in a dose-dependent manner. Following a dose of 8.8 Gy renal haemodynamics returned to control values within 4 weeks of irradiation and remained essentially constant throughout the study. After higher doses, GFR and ERPF decreased markedly and remained below control values up to 24 weeks after irradiation. Associated with these changes in renal haemodynamics was a fall in Hct within 3 weeks of irradiation, with minimal levels being found approximately 8 weeks after irradiation. Although there was some recovery between weeks 12 and 24, Hct values remained below those of age-matched controls. At all doses the mean functional status of irradiated kidneys in animals in which both kidneys were irradiated (BI) was significantly greater than that previously observed in the irradiated kidney of pigs in which only one kidney was irradiated (UI). Moreover, in BI pigs there appeared to be a marked imbalance between the contribution each kidney makes to the total renal function. In terms of ERPF, the functional status of the right kidney, relative to that of the left kidney, showed a dose-related decline. These findings support the hypothesis that the compensatory response exhibited by the contralateral unirradiated kidney in UI pigs suppresses the potential for functional recovery by the irradiated kidney. The findings also indicate that individual kidneys in the same animal may differ in their response to a similar nephrotoxic insult.

The response of the pig kidney to the combined effects of cisplatin and unilateral renal irradiation

Seven mature Large White female pigs, approximately 10 months of age received a single dose of cis-dichlorodiammineplatinum(II), c-DDP (2.5 mg/kg body weight). Prior to, and 4 weeks after c-DDP administration, individual kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were measured by [99mTc]DTPA and [131I]hippuran renography. Of the 5 pigs surviving the c-DDP treatment most exhibited a reduction in both GFR and ERPF; the mean reduction in GFR (36.2 +/- 18.9%) was more pronounced than that for ERPF (12.6 +/- 19.4%). However, the difference in the severity of the impairment in these two parameters was not significant (p greater than 0.55). Haematocrit, haemoglobin and red blood cell counts were markedly reduced 14 days after c-DDP infusion, and despite some recovery evident 21 days after treatment, all three haematological parameters were still reduced 28 days after c-DDP administration. The right kidneys of these 5 animals, plus 5 pigs which did not receive c-DDP, were irradiated with a single dose of 11.9 Gy of 60Co gamma-rays. Individual kidney GFR and ERPF was routinely measured up to 24 weeks after irradiation. Pigs in which only the right kidney was irradiated showed a marked increase in both GFR and ERPF values 2 weeks after irradiation. This was followed by a decline in function with a reduction of 50% in terms of ERPF 16 weeks after irradiation. Values then showed some evidence of a recovery in function. There was a concomitant compensatory response by the contralateral unirradiated kidney.(ABSTRACT TRUNCATED AT 250 WORDS)

Interaction of cis-diamminedichloroplatinum and renal irradiation on renal function in the young and adult rat

The interaction between single low doses of cis-diamminedichloroplatinum(II) (c-DDP) and renal irradiation (7.5, 10, 12.5 Gy) on renal function and systolic blood pressure (SBP) was investigated in young (3-4 weeks old, BW 45-65 g) and adult rats (over 12 weeks old, BW 230-290 g). The glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), plasma creatinine, urea and SBP were measured over 24 weeks. Changes in ERPF, plasma creatinine and urea concentrations paralleled GFR changes, but tended to be less pronounced. In young rats, BW and GFR were 10-20% below control values after c-DDP administration (5 mg/kg BW). Irradiation caused a dose-dependent drop in GFR, starting 4 weeks after irradiation in young rats. When c-DDP was given immediately after irradiation to the young rats, the loss of renal function was more pronounced than after either treatment modality alone. Dose-effect curves for a greater than 25% reduction of the GFR relative to controls (ml/min) after 24 weeks gave an ED50 of 9.8 Gy for irradiation alone and 4.6 Gy for irradiation followed by c-DDP. After correction for the drug effect, dose-effect curves were similar for renal irradiation given alone or followed by c-DDP administration in young rats. In adult rats, c-DDP (2.5 mg/kg BW) or irradiation alone did not significantly alter renal function during the follow-up period. Only 12.5 Gy in combination with c-DDP, caused a significant reduction in GFR after 16 weeks in adult rats. In adult rats data were too limited for probit analysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Functional recovery in the irradiated kidney following removal of the contralateral unirradiated kidney

The right kidneys of seven Large White female pigs, approximately 14 weeks of age, were irradiated with single doses of 7-12.6 Gy of 250 kV X-rays. Sequential measurements of individual kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were carried out using 99mTc-DTPA and [131I]hippuran renography for time periods up to 24 weeks after irradiation. From this data, kidneys receiving a dose of 7 Gy were found to be functioning (F), while kidneys which received greater than or equal to 8.8 Gy were assessed as having no significant function (NF). When the pigs were approximately 10 months of age the contralateral unirradiated kidney was removed; the left kidney of three age-matched unirradiated pigs was also removed. The response of the right kidney to unilateral nephrectomy (UN) in these animals was assessed in terms of changes in haemodynamics (i.e. GFR and ERPF) for periods up to 24 weeks after UN. At post-mortem, the length and weight of the remaining kidney was measured. A marked increase in renal length was observed in irradiated kidneys following UN. In addition, the weights of irradiated kidneys following UN were greater than those of irradiated kidneys in age-matched pigs where the unirradiated kidney had not been removed. Four weeks after UN there was a pronounced increase in GFR and, in particular, ERPF in previously NF irradiated kidneys. The mean increase in these parameters, measured at the end of the follow-up period, when compared with the pre-surgery values, was 350.1 +/- 84.3 and 781.8 +/- 151.0% respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of single doses of X-rays on renal function in unilaterally irradiated pigs

The right kidney of 13 Large White female pigs was irradiated with single doses of 250 kV X-rays in the range 7-12.6 Gy. Sequential measurements of individual kidney glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) were carried out by means of 99mTc-DTPA and 131I-hippuran renography for periods up to 24 weeks after irradiation. GFR levels increased in irradiated and unirradiated contralateral kidneys 2 weeks after treatment compared with age-matched controls. ERPF values exhibited a small increase in a proportion of animals. Renal function then declined in irradiated kidneys in a dose-dependent manner. A dose of 7 Gy resulted in a decline followed by subsequent recovery. After doses of greater than or equal to 8.8 Gy GFR and ERPF declined rapidly, reaching minimal levels by 6-12 weeks, the time depending on the dose. The reduction in ERPF was quantitatively greater than that for GFR. In animals receiving greater than 8.8 Gy the irradiated kidney contributed in the order of only 10% of the total ERPF. The reduction in GFR resulted in a prompt functional compensatory response in GFR in the unirradiated contralateral kidney. In terms of ERPF, a compensatory response was not evident until weeks 20-24. The results indicated that the radiation tolerance dose of the pig kidney following unilateral irradiation with single doses of X-rays was approximately 8 Gy.