Tolerance of the human kidney to isolated controlled ischemia

Dipen J. Parekh, Joel M. Weinberg, Barbara Ercole, Kathleen C. Torkko, William Hilton, Michael Bennett, Prasad Devarajan, Manjeri A. Venkatachalam

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Abstract

Tolerance of the human kidney to ischemia is controversial. Here, we prospectively studied the renal response to clamp ischemia and reperfusion in humans, including changes in putative biomarkers of AKI. We performed renal biopsies before, during, and after surgically induced renal clamp ischemia in 40 patients undergoing partial nephrectomy. Ischemia duration was >30minutes in 82.5% of patients. There was a mild, transient increase in serum creatinine, but serum cystatin C remained stable. Renal functional changes did not correlate with ischemia duration. Renal structural changes were much less severe than observed in animal models that used similar durations of ischemia. Other biomarkers were only mildly elevated and did not correlate with renal function or ischemia duration. In summary, these data suggest that human kidneys can safely tolerate 30-60 minutes of controlled clamp ischemia with only mild structural changes and no acute functional loss.

Original languageEnglish (US)
Pages (from-to)506-517
Number of pages12
JournalJournal of the American Society of Nephrology
Volume24
Issue number3
DOIs
StatePublished - Feb 28 2013

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ASJC Scopus subject areas

  • Nephrology

Cite this

Parekh, D. J., Weinberg, J. M., Ercole, B., Torkko, K. C., Hilton, W., Bennett, M., Devarajan, P., & Venkatachalam, M. A. (2013). Tolerance of the human kidney to isolated controlled ischemia. Journal of the American Society of Nephrology, 24(3), 506-517. https://doi.org/10.1681/ASN.2012080786