A comparative study of the use of dexamethasone, N-acetyl cysteine, and theophylline to ameliorate renal ischemia–reperfusion injury in experimental rat models : a biochemical and immuno-histochemical approach

Abstract EN

Renal ischemia–reperfusion injury (IRI) is commonly encountered in clinical practice during renal transplantation.

In a trial to find the drug that best safeguards the kidney against IRI, dexamethasone (Dex), N-acetyl cysteine (NAC), and theophylline (Theo) were tested in experimental rat models.

This study included 105 adult male albino rats, which were randomly assigned to the following five groups: Group I – sham-operated, n = 5, Group II – IRI n = 25, Group III – IRI + Dex n = 25, Group IV – IRI + NAC n = 25, and Group V –IRI + Theo n = 25.

IRI was induced for 40 min followed by reperfusion.

Rats were sacrificed 1, 2, 4, 6, and 24 h after reperfusion.

This was preceded by blood and urine sampling for biochemical study of serum Cystatin C (Cys C), serum creatinine, and urinary Cys C.

Kidneys were processed for histopathological evaluation and immune-histochemical staining for Cys C.

The expression of Cys C in the proximal tubular cells was significantly lower in the IRI group compared to that of the sham group.

There was a significant rise in the levels of serum and urinary Cys C after 1 h in the IRI group, while the rise in creatinine occurred later.

Dex was superior to NAC and Theo 24 h after the IR insult, and the serum levels of creatinine and Cys C were significantly lower in this group than the other two drug groups (P <0.001 in both cases).

Our study revealed a clear benefit for the use of Dex to ameliorate IRI over NAC and Theo if used immediately following the insult.

The effect is evident 24-h after its use.

The role of serum Cys C as an early marker of acute kidney injury compared to serum creatinine is confirmed.