Fluorescence of pyridine nucleotide and flavoproteins as an indicator of substrate oxidation and oxygen demand of the isolated perfused rat kidney

Pretransplantation assessment of renal viability with NADH fluorimetry

BACKGROUND

A pathophysiologic feature possibly involved in ischemic injury in transplant kidneys is mitochondrial dysfunction caused by disintegration of oxidative metabolic pathways. Because the ability to synthesize ATP by respiratory activity determines the organ's capacity to recover from ischemic injury, an assessment of respiratory activity may provide information related to graft viability.

METHODS

NADH fluorimetry can be used to monitor kidney cortex metabolism noninvasively. During perfusion with (an)-aerobic perfusate, NADH fluorescence images were recorded. We evaluated the NADH oxidation kinetics of 20 rat kidneys, which were divided over four experimental groups. For six minimally damaged kidneys and six kidneys that had been stored for one hour at 37 degrees C, perfusion was followed by transplantation. We related the kinetic parameters of these kidneys with their post-transplantation function and histology. The transplant function was monitored by serum creatinine and urea levels.

RESULTS

Storage of transplant kidneys for one hour at 37 degrees C significantly reduced the post-transplantation function. Isolated perfusion of grafts, however, was not detrimental for renal function. The rate of NADH oxidation decreased with decreasing graft quality, and a good correlation between NADH oxidation kinetics and post-transplantation function was found.

CONCLUSIONS

A reduction of NADH oxidation rates as a consequence of warm ischemia supports the view that mitochondrial respiratory activity is impaired by ischemic injury. The correlation between NADH oxidation kinetics in perfused grafts and their post-transplantation function indicates that NADH fluorimetry may be useful in predicting the viability of preserved grafts prior to transplantation.

Nephrotoxicity: a rational approach to target cell injury in vitro in the kidney

1. The kidney is a complex organ in which there is cellular heterogeneity. Many nephrotoxic chemicals target preferentially for discrete cell types, but adjacent, morphologically different cells are unaffected. This selectivity has made the assessment of nephrotoxicity in vivo (and the study of underlying mechanisms) difficult. Discrete renal injury can, however, be exploited in vitro, to study the interactions between the toxic compound and the target cell. 2. Several in vitro models have been used to study the potential interaction between the target cells and chemicals, including perfusion of the isolated kidney, renal slices, freshly isolated fragments, primary cultures and continuous cell lines. Where appropriate, isolated organelles and purified enzymes can also be used. 3. The target cell toxicity in vivo of adriamycin, 2-bromoethanamine and hexachlorobutadiene N-acetyl cysteine conjugate is selectively maintained towards glomerular epithelial, medullary interstitial and proximal tubular cells, respectively, in vitro, showing that the "in vivo-in vitro gap" can be bridged. Characteristics unique to each of these renal cell types, such as the selective uptake of a toxin, enzyme systems for generating biologically reactive intermediates, and the presence of lipid droplets (rich in polyunsaturated fatty acid) and peroxidase activity have been identified, and one or more of these may explain the mechanisms of selective injury in discrete regions of the kidney.

Functional role of thromboxane production by acutely rejecting renal allografts in rats

We investigated the role of thromboxane in mediating the reduction in renal function and renal blood flow characteristic of acute renal allograft rejection. We transplanted kidneys from Lewis rats to Brown-Norway recipients. By the third day after transplantation, histologic changes that were consistent with cellular rejection occurred in the kidney. These changes were associated with a moderate reduction in renal function. By day 6, histologic changes of rejection were advanced and included interstitial and perivascular infiltration by mononuclear cells. The clearances of inulin and para-aminohippuric acid were also markedly reduced. As renal function deteriorated, thromboxane B2 (TXB2) production by ex vivo perfused renal allografts increased progressively from 2 to 6 d after transplantation. However, prostaglandin (PG) E2 and 6-keto PGF1 alpha production remained essentially unchanged. There was a significant inverse correlation between the in vivo clearance of inulin and the log of ex vivo TXB2 production. Infusion of the thromboxane synthetase inhibitor UK-37248-01 into the renal artery of 3-d allografts significantly decreased urinary TXB2 excretion and significantly increased renal blood flow (RBF) and glomerular filtration rate (GFR). Although renal function improved significantly after the acute administration of UK-37248-01, GFR and RBF did not exceed 33 and 58% of native control values, respectively. In other animals, daily treatment with cyclophosphamide improved the clearances of inulin and para-aminohippuric acid and reduced thromboxane production by 6-d renal allografts. These studies demonstrate that histologic evidence of rejection is associated with increased renal thromboxane production. Inhibition of thromboxane synthetase improves renal function in 3-d allografts. Cytotoxic therapy improves renal function, reduces mononuclear cell infiltration, and decreases allograft thromboxane production. Thus, the potent vasoconstrictor thromboxane A2 may play a role in the impairment of renal function and renal blood flow during acute allograft rejection.

Regulation of conversion of thyroxine to triiodothyronine in perfused rat kidney

The factors regulating the renal uptake of thyroxine (T4), its conversion to 3,5,3'-triiodothyronine (T3), and the urinary iodothyronine excretion were studied in the perfused rat kidney. Increasing the perfusate free T4 (FT4) concentration from 1 to 11.5 times that of euthyroid rat serum resulted in a linear increase in T4 uptake and T3 production that was not saturated at the highest dose. When FT4 concentrations were increased by decreasing the perfusate albumin concentration from 7.5 to 2.5 g/dl, T4 uptake and T3 production increased in proportion to the FT4 concentration. Propylthiouracil (PTU), a 5'-deiodinase inhibitor, decreased renal T3 production by 60.5% without affecting tissue T4 uptake. In the absence of glomerular filtration, T4 uptake and T3 production were unchanged, indicating that T4 is extracted by the contraluminal surface of the renal tubule. However, probenecid, an inhibitor of contraluminal organic acid uptake, did not decrease but increased T4 uptake and T3 production by increasing the perfusate FT4 fraction in the perfusate. There was no net renal 3,3',5'-triiodothyronine (rT3) production from T4, and degradation and urinary excretion of T3 were negligible. The urinary excretion of T4 and T3 correlated closely with the degree of proteinuria.

Effect of acetate on transport of organic acid (fluorescein) in renal proximal tubules of frog

The effect of acetate on active fluorescein transport in intact proximal tubules of surviving frog kidney was studied. When the kidneys were incubated in a 120 mM Na+ medium, 10 mM acetate stimulated fluorescein uptake in the tubules. The stimulation was more pronounced if the kidneys had been previously preincubated for 3 h in the substrate-free solution. Lowering of the Na+ concentration in the bathing medium to 10 mM resulted in the disappearance of the acetate effect. Preincubation of the kidneys with acetate at 2-4 degrees C gave rise to stimulation of the fluorescein transport only in the 120 mM Na+ acetate-free medium. The acetate effect on the fluorescein uptake was partially prevented by ouabain. The stimulation of the uptake by acetate in the 120 mM Na+ medium correlated with an increase in the extent of reduction of pyridine nucleotides in the tubules. The pyridine nucleotides were reduced more markedly after incubation of the kidneys in the 10 mM Na+ medium, when acetate had no effect on the fluorescein transport. In both the 120 MM and the 10 mM Na+ media, the cold preincubation of the kidneys with 2.5 mM ADP or 2.5 mM ATP resulted in only slight stimulation of the fluorescein uptake. But in both media the uptake was significantly enhanced after cold preincubation of the kidneys with 2 mM NADH. After the cold preincubation with ADP, stimulation of the fluorescein transport by acetate was observed in the case of the 10 mM Na+ medium also. The absence of any stimulatory effect of acetate on the organic acid transport in the 10 mM Na+ medium is explained as the result of the transformation of mitochondria in the tubular cells into the inactive state 4 due to a decrease in the intracellular ADP level. Reducing equivalents are supposed to take part in energization and/or regulation of transport processes in plasma membranes of the renal proximal tubules.