Mohammed ELSHIEKH, Behjat SEIFI, Mehri KADKHODAEE, Mina RANJBARAN

Additional effects of erythropoietin pretreatment, ischemic preconditioning, and N-acetylcysteine posttreatment in rat kidney reperfusion injury

Background/aim: Since the nature of ischemia/reperfusion (IR)-induced tissue damage is multifactorial and complex, in the currentstudy, the effects of multiple treatment strategies via concomitant administration of erythropoietin (EPO) and N-acetylcysteine (NAC)with an ischemic preconditioning (IPC) regimen on renal IR injury were examined.Materials and methods: Thirty male Wistar rats were subjected to bilateral occlusion of the renal pedicles for 50 min followed byreperfusion. EPO (1000 IU/kg) was administered for 3 days, as well as IPC before the IR and NAC (150 mg/kg) administration for 4 daysafter IR. The animals were randomly allocated into 6 groups (n = 5): sham, IR, EPO+IR, IPC+IR, NAC+IR, and EPO+IPC+NAC+IR.Kidney tissues and blood samples were obtained for oxidative stress, proinflammatory cytokines, and renal functional evaluations.Results: IR caused significant inflammatory response, oxidative stress, and reduced renal function. Treatment with EPO, IPC, and NACor a combination of two of them attenuated renal dysfunction and reduced the oxidative stress and inflammatory markers. Rats treatedwith the combination of EPO, IPC, and NAC showed a higher degree of protection compared to the other groups.Conclusion: These results showed that concomitant administration of EPO and IPC along with posttreatment NAC may have additivebeneficial effects on kidney IR injury during IR-induced acute renal failure.

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