Aysel TAKTAK, Umut Selda BAYRAKÇI, Esra KARAKUŞ, Banu ACAR, Adem Yasin KÖKSOY, Murat ALIŞIK, Salim NEŞELİOĞLU, Özcan EREL

Akut Kısa Süreli Selenyum Tedavisi: Akut Böbrek Hasarında Kurtarıcı Bir Tedavi Olabilir mi?

Amaç: İskemi/Reperfüzyon (İR) hasarı nativ ve nakil böbrekte akut böbrek hasarının önemli bir nedenidir. Bu durum oksitadif bir ortam oluşturarak doku hasarına neden olur. Bu çalışmanın amacı kısa süreli akut selenyum (Se) tedavisinin oksidatif durum ve akut böbrek hasarına etkilerini değerlendirmektir. Gereç ve Yöntemler: Bu çalışmada 18 yetişkin Long Evans cinsi rat rastgele 3 gruba ayrıldı. Genel anestezi altında steril koşullarda batın insize edildi, bilateral böbrek damar yapıları ayrıldı. Sol renal arter klemplendi, sağ nefrektomi yapıldı, 45 dakika iskemi uygulanmasını takiben sol renal arter klempi açıldı ve 4 saat reperfüzyon uygulandı. İR ve Se tedavisi grubuna, cerrahi işlemden 4 saat önce ve reperfüzyon periyodunun bitiminden 4 saat sonra 0.625 mg/kg Se oral verildi. İR grubuna benzer protokol ile 1 cc steril salin oral uygulandı. Sham grubu dışında tüm ratlar ikinci ilaç uygulamasından 4 saat sonra sakrifiye edildi. Kan ve doku örnekleri alınarak histopatolojik değerlendirme ve kan kreatinin, total thiol, nativ thiol, disülfid düzey ve dinamik thiol/disülfid oran ölçümleri yapıldı. Bulgular: Selenyum tedavisi alan grupta İR hasarı öncesi ve sonrası thiol düzeylerinde anlamlı azalma görülmezken İR grubunda thiol düzeyinde anlamlı düşme gözlendi (p=0.345, p=0.028). Selenyum tedavisi alan ve almayan gruplar böbrek fonksiyonları ve histopatolojik açıdan karşılaştırıldığında Se tedavisi alan ratlarda anlamlı iyileşme saptanmadı (p=0.053). Sonuç: Kısa süreli akut Se tedavisi hücrenin oksidatif durumunu düzeltmekle birlikte bu durum histopatolojik ve biyokimyasal iyileşme için yetersizdir. Ayrıca halihazırda hasarlı böbrekte Se tedavisinin mevcut durumu kötüleştirdiği düşünülmektedir.

Anahtar Kelimeler:

İskemi/Reperfüzyon hasarı, Selenyum, Oksidatif stres, Akut böbrek hasarı, Kurtarıcı tedavi

Acute Short-Term Selenium Treatment: Could It Be a Salvage Therapy in Acute Kidney Injury?

Objective: Ischemia/Reperfusion (IR) injury is an important cause of acute kidney injury (AKI) in native and transplanted kidneys. This condition aggravates tissue damage by initiating an oxidative status. This study evaluates the effect of acute short-term selenium (Se) treatment on oxidative status and acute kidney injury.Material and Methods: A total of 18 adult male Long Evans rats were randomly allocated into three groups. Under general anaesthesia and sterile conditions, the anterior abdominal wall was incised, and bilateral renal vessels were separated. Left renal artery was clamped, right nephrectomy was performed after 45 min of ischemia, left renal artery was de-clamped, and 4 hours reperfusion was performed. In IR and Se treated group, 0.625 mg/kg Se was administered orally 4 hours before the surgical procedure and 4 hours after the reperfusion period. In the IR group, one cc sterile saline was given orally with a similar protocol. All rats except the sham group were sacrificed after 4 hours following the second dose of saline and Se administration. Blood samples and kidney saved for histopathological investigation and creatinine, total thiol, native thiol, disulfides levels and dynamic thiol/disulfide ratio determinations. Results: While there was no significant decrease in thiol levels before and after IR injury in the Se treated group, a significant decrease was observed in the IR group (p=0.345, p=0.028). There was no statistically significant improvement when the groups were compared in terms of renal functions and histopathological evaluation (p=0.053). Conclusion: Our study revealed that acute short-term Se treatment improves the kidney redox status. However, histopathological changes in kidney and plasma creatinine levels remain unaffected. Moreover, Se administration increases the existing kidney damage after the injury has occurred.

Keywords:

Ischemia-reperfusion injury, Selenium, Oxidative stress, Acute kidney injury, Salvage therapy,

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