"Experimental Studies on Cross Circulation between Normal Dogs with Disturbed Kidney Function: Part III. Influence of Cross Circulation on Non-protein Nitrogen, Urea Nitrogen and Creatinine Blood Levels of Dogs with Renal Arteries Clamped Bilaterally.
- Author:
Hyo Joong MOON
1
;
Hak Song LEE
Author Information
1. Department of Urology, College of Medicine, Seoul National University, Seoul, Korea.
- Publication Type:Original Article
- MeSH:
Anesthesia;
Animals;
Anuria;
Arrhythmias, Cardiac;
Arteries;
Constriction;
Creatinine*;
Cross Circulation*;
Diuresis;
Dogs*;
Kidney*;
Korea;
Nitrogen*;
Penicillins;
Renal Artery*;
Renal Insufficiency;
Respiratory Rate;
Rivers;
Rubber;
Streptomycin;
Survival Rate;
Thiopental;
Urea*;
Ureter;
Wounds and Injuries
- From:Korean Journal of Urology
1961;2(1):81-98
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
In Part II, the authors have reported that cross circulation between normal dogs and bilaterally nephrectomized dogs resulted in decreased blood concentrations of non-protein nitrogen, urea nitrogen and creatinine in the bilaterally nephrectomized dogs and improvement of the dogs' general condition for a short time. In this study the renal arteries of normal dogs were occluded by clamping for varied periods of time to cause reversible renal insufficiency. After renal insufficiency developed cross criculation with untreated normal dogs was instituted to investigate the effects of cross circulation on blood concentrations of NPN, urea nitrogen and creatinine, urinary out-put and in the general condition of the dogs.As a control experiment, renal arteries of dogs were clamped bilaterally for 1, 2, 3, 4, 5 and 6 hours and blood concentrations of NPN, urea nitrogen and creatinine, general condition and urinary out-put of these dogs were studied.In the oliguric phase caused by bilateral clamping of the renal arteries of dogs for 3, 4, 5, and 6 hours, cross circulation between these dogs and normal dogs was performed. One to three cross circulations were done on each dog and one cross circulation lasted for 2 to 4 hours. Changes in the blood concentration of NPN, urea nitrogen and creatinine, the general condition of the dogs and urinary out-put were studied.In the control and cross circulation studies 5 dogs were studied in each of the groups designated by the time interval of clamping renal arteries except one dog was used for the 1 and 2 hour groups. Using normal Korea mongrels weighing 12kg. or more, the kidneys were exposed through a flank incision under pentothal anesthesia. Perirenal fat tissue was freed and vessels supplying the renal capsule were severed and ligated. The upper ureters were freed of abarrent vessels. The right kidney was first exposed and then the left. Clamping of both renal arteries was instituted at the same time. The renal arteries were lightly clamped using a rubber shod clamp to interrrupt the blood stream but bot to damage the arterial wall. Clamping of both renal arteries were released simultaneously and the operative wounds were closed. Direct cross circulation as described previously was used in this study and all procedures were done under aseptic technic. Prophylactic penicillin and streptomycin were also given pre- and postoperatively. All observation and determination of experimental items were done before clamping the arteries and at 12 hours after clamping. Daily determinaton for 5 days followed thereafter. Hourly determinatons were performed during the cross circulation. The results of the experiment are summarized as follows: When bilateral renal arteries of normal dogs were clamped for 1, 2, 3, 4, 5 and 6 hours, oliuria or anuria was observed immediately after clamping. Blood levels of NPN, urea nitrogen and creatinine were increased at 12 hours after clamping. A poor general condition was observed in most dogs one to two days post-experimentally in these and there was gradual exacerbation in the induced kidney insufficiency during oliguric phase. Most experimental animals died except a few did recover after regaining enough renal unction to produce diuresis. During cross circulation, urinary out-put was not altered and the general condition of the dogs was remarkedly improved. A decrease in the blood concentrations of NPN, urea nitrogen and creatinine was observed in all the dogs. For one to seven days after the circulation the condition of these dogs became slightly worse but a diuretic phase soon developed and most dogs in these experimental groups survived except for the few which died during or after the cross circulaton.In each of the six control groups in which the renal arteries were clamped for 1 to 6 hours as described above, 1, 1, 2, 2, 0 and 0 dogs survived. With cross circulation, experimental groups in which the renal arteries were clamped for 3, 4, 5 and 6 hours, had a survival of 4, 3, 3 and 2 dogs, respectively. Of 20 dogs, 12 survived and 8 died.Cross circulation increased the survival rate of dogs with induced renal insufficieney, but it is unlikely that pathological changes and function in these kidneys were changed during the curculation. It, however, is clear that the toxic state of renal insufficiency was relieved markedly during the cross circulation, although temporarily, but long enough to provide better survival condition. Most dogs were supported adequately to overcome the oliguric crisis and return to the diuretic phase.In normal dogs used in the cross circulation the development of an apathetic state, and elevation in blood concentrations of NPN, urea nitrogen and creatinine were observed. These dogs urinated several times during the experiment and experienced frequent pulse and respiratory rates. Arrhythmias of a temporary nature were observed. These dogs returned to normal in one to three days after the cross circulation.
