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ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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2/2017
vol. 12
 
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abstract:
Original paper

The effects of prolonged CO2 insufflation on kidney function in a rat pneumoperitoneum model

Dogan Yildirim
,
Turgut Donmez
,
Oguzhan Sunamak
,
Semih Mirapoglu
,
Adnan Hut
,
Nilgun Rukiye Erdogan
,
Zumrut Mine Isık Saglam
,
Huseyin Kilincaslan

Videosurgery Miniinv 2017; 12 (2): 125–134
DOI: https://doi.org/10.5114/wiitm.2017.67210
Online publish date: 2017/04/13
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Introduction: Pneumoperitoneum (PP) is known to cause ischemia in kidneys and other intra-abdominal organs because of decreased splanchnic blood flow.

Aim: We aimed to determine the degree of renal injury that occurs due to a PP and prolonged PP. We measured renal injury biomarkers and made a histopathological evaluation to estimate the degree of injury and assessed the correlation of biomarkers with histopathological findings.

Material and methods: Twenty-one female Sprague Dawley rats were separated randomly into three groups. Group 1 was the control group and was given anesthesia for 3 h. In group 2, a PP was administered under anesthesia for 1 h. A pneumoperitoneum was administered under anesthesia to animals in group 3 for 3 h.

Results: Pathological analysis showed a significant statistical difference between the 3 groups. In particular, neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C (Cys C) levels at the 24th h and preoperative mean urea levels showed a significant difference between the groups. The 24th-hour NGAL level in group 3 was significantly higher than that of group 1. The preoperative Cys C level was higher in group 1 than in either group 2 or 3. Cys C was decreased significantly in group 1 and increased significantly in both groups 2 and 3.

Conclusions: The increase in NGAL and Cys C levels directly correlated with the duration of PP and intra-abdominal pressure, and they are therefore good biomarkers in diagnosing acute renal injury in the early phase. Serum creatinine level is not a good biomarker in the early phase of renal injury.
keywords:

pneumoperitoneum, neutrophil gelatinase-associated lipocalin, cystatin C, acute kidney injury, rats
  
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