Renal bioenergetics during early gram-negative mammalian sepsis and angiotensin II infusion

May, Clive N., Ishikawa, Koichi, Wan, Li, Williams, John, Wellard, R. Mark, Pell, Gaby S., Jackson, Graeme D., & Bellomo, Rinaldo A. (2012) Renal bioenergetics during early gram-negative mammalian sepsis and angiotensin II infusion. Intensive Care Medicine.

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Purpose: To measure renal adenosine triphosphate (ATP) (bioenergetics) during hypotensive sepsis with or without angiotensin II (Ang II) infusion.

Methods: In anaesthetised sheep implanted with a renal artery flow probe and a magnetic resonance coil around one kidney, we induced hypotensive sepsis with intravenous Escherichia coli injection. We measured mean arterial pressure (MAP), heart rate, renal blood flow RBF and renal ATP levels using magnetic resonance spectroscopy. After 2 h of sepsis, we randomly assigned sheep to receive an infusion of Ang II or vehicle intravenously and studied the effect of treatment on the same variables. Results: After E. coli administration, the experimental animals developed hypotensive sepsis (MAP from 92 ± 9 at baseline to 58 ± 4 mmHg at 4 h). Initially, RBF increased, then, after 4 h, it decreased below control levels (from 175 ± 28 at baseline to 138 ± 27 mL/min). Despite decreased RBF and hypotension, renal ATP was unchanged (total ATP to inorganic phosphate ratio from 0.69 ± 0.02 to 0.70 ± 0.02). Ang II infusion restored MAP but caused significant renal vasoconstriction. However, it induced no changes in renal ATP (total ATP to inorganic phosphate ratio from 0.79 ± 0.03 to 0.80 ± 0.02).

Conclusions:During early hypotensive experimental Gram-negative sepsis, there was no evidence of renal bioenergetic failure despite decreased RBF. In this setting, the addition of a powerful renal vasoconstrictor does not lead to deterioration in renal bioenergetics.

Impact and interest:

16 citations in Scopus
17 citations in Web of Science®
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ID Code: 48611
Item Type: Journal Article
Refereed: Yes
Additional Information: discussed in editorial: DOI 10.1007/s00134-012-2489-0 ; Springer OnlineFirst publication.
Keywords: Acute kidney injury, Angiotensin II, Magnetic resonance spectroscopy, Renal blood flow, Septic shock
DOI: 10.1007/s00134-012-2487-2
ISSN: 1432-1238
Subjects: Australian and New Zealand Standard Research Classification > BIOLOGICAL SCIENCES (060000) > PHYSIOLOGY (060600)
Divisions: Current > Schools > School of Chemistry, Physics & Mechanical Engineering
Past > QUT Faculties & Divisions > Faculty of Science and Technology
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2012 Copyright jointly held by Springer and
Copyright Statement: The original publication is available at SpringerLink
Deposited On: 14 Feb 2012 22:14
Last Modified: 14 Feb 2012 22:30

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