Alterations in regional kidney oxygenation during expansion of extracellular fluid volume in conscious healthy sheep

Yugeesh R. Lankadeva, Roger G. Evans, Junko Kosaka, Lindsea C. Booth, Naoya Iguchi, Rinaldo Bellomo, Clive N. May

Research output: Contribution to journalEditorial

5 Citations (Scopus)

Abstract

Expansion of extracellular fluid volume with crystalloid solutions is a common medical intervention, but its effects on renal cortical and medullary oxygenation are poorly understood. Therefore, we instrumented sheep under general anesthesia to enable continuous measurement of systemic and renal hemodynamics, global renal oxygen delivery and consumption, and intrarenal tissue perfusion and oxygen tension (P O2 ) in conscious animals (n = 7). The effects of three sequential intermittent infusions of 500 ml of compound sodium lactate solution, administered at hourly intervals, were determined. Volume expansion induced transient increases in mean arterial pressure (+7 ± 2%), central venous pressure (+50 ± 19%), and cardiac output (+15 ± 3%). There were sustained increases in renal medullary tissue P O2 (+35 ± 10%) despite increases in global renal oxygen consumption (+66 ± 18%) and renal oxygen extraction (+64 ± 8%). Volume expansion did not significantly alter renal blood flow, renal oxygen delivery, or medullary perfusion. The sustained increase in medullary P O2 was paralleled by increased bladder urine P O2 (34 ± 4%). Cortical perfusion and P O2 did not change significantly. Our findings indicate that extracellular fluid volume expansion can increase renal medullary oxygenation, providing a potential mechanistic basis for its use as prophylaxis against iatrogenic acute kidney injury. They also indicate that continuous measurement of bladder urine P O2 could be used to monitor the effects of volume expansion on medullary oxygenation. However, the mechanisms mediating increased medullary oxygenation during volume expansion remain to be determined.

Original languageEnglish
Pages (from-to)R1242-R1250
JournalAmerican Journal of Physiology - Regulatory Integrative and Comparative Physiology
Volume315
Issue number6
DOIs
Publication statusPublished - Dec 1 2018
Externally publishedYes

Keywords

  • Bladder urine oxygenation
  • Cortical oxygenation
  • Medullary oxygenation
  • Renal blood flow
  • Volume expansion

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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