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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

This study established a protocol focusing on the technical refinement of a mouse model of bilateral renal ischemia-reperfusion for acute kidney injury research.

Abstract

Cardiac arrest poses a large public health burden. Acute kidney injury (AKI) is an adverse marker in survivors of cardiac arrest following the return of spontaneous circulation (ROSC) after successful cardiopulmonary resuscitation. Conversely, recovery of kidney function from AKI is a predictor of favorable neurological outcomes and hospital discharge. However, an effective intervention to prevent kidney damage caused by cardiac arrest after ROSC is lacking, suggesting that additional therapeutic strategies are required. Renal hypoperfusion and reperfusion are two pathophysiological mechanisms that cause AKI after cardiac arrest. Animal models of ischemia-reperfusion-induced AKI (IR-AKI) of both kidneys are comparable with patients with AKI following ROSC in a clinical setting. However, IR-AKI of both kidneys is technically challenging to analyze because the model is associated with high mortality and wide variation in kidney damage, which may affect the analysis. Lightweight mice were chosen, placed under general anesthesia with isoflurane, subjected to surgery with a dorsolateral approach, and their body temperature maintained during operation, thereby reducing tissue damage and establishing a reproducible acute renal IR-AKI research protocol.

Introduction

Cardiac arrest occurs more than 80,000 times annually in the United States1,2. The mortality rate of cardiac arrest is extremely high3,4,5,6. AKI is a major risk factor associated with high mortality and poor neurological outcomes in patients with cardiac arrest after ROSC7,8,9,10,11,12

Protocol

All animal experiments were conducted in accordance with the Guide for the Care and Use of Laboratory Animals, published by the US National Institutes of Health (NIH publication no. 85-23, revised 1996). The study protocol was approved by and in accordance with the guidelines of the Institutional Animal Care and Use Committee at Fu-Jen Catholic University. See the Table of Materials for details about all materials and instruments used in this protocol.

1. Prepar.......

Representative Results

The quality of the bilateral renal IR-AKI surgery should be assessed before further microscopic or molecular analysis. During surgery, renal ischemia should be confirmed by seeing whether the kidney has changed color from pink to dark red soon after the renal pedicle is clamped with a microvascular clip (Figure 1). After surgery, kidney damage caused by IR-AKI surgery can be further validated with a few microliters of serum through submandibular blood collection for biochemical analysis wher.......

Discussion

The proposed bilateral IR-AKI protocol is suitable for investigating the mechanism of hypoperfusion and reperfusion injury of both kidneys. The protocol suggests that lightweight mice, general anesthesia with isoflurane, a dorsolateral approach to the surgery, and body temperature maintenance during the operation mitigate the associated technical difficulties, shorten the duration of the surgery, and increase the consistency of the procedure for acute bilateral renal IR-AKI research.

Technical.......

Acknowledgements

This model was developed with the financial support from Ministry of Science and Technology, Taiwan (MOST 109-2320-B-030-006-MY3). This manuscript was edited by Wallace Academic Editing.

....

Materials

NameCompanyCatalog NumberComments
Absorbable Suture, 6-0EthiconJ510G-BX
Betadine solutionShineteh Istrument
CarprofenSigmaPHR1452
Cotton ballsShineteh Istrument
Graefe ForcepsFine Science Tools11051-10
Heating padShineteh Istrument
IsofluranePiramal Critical Care Inc.26675-46-7
Moria Vessel ClampFine Science Tools18320-11
Olsen-Hegar needle holderFine Science Tools12002 - 12
SalineShineteh Istrument
Scalpel bladesShinvas2646
Small Animal Anesthesia MachineSheng-Cing Instruments Co.STEP AS-01
Tissue scissorsFine Science Tools14072 - 10

References

  1. Holmberg, M. J., et al. Annual incidence of adult and pediatric in-hospital cardiac arrest in the United States. Circulation: Cardiovascular Quality and Outcomes. 12 (7), 005580 (2019).
  2. Benjamin, E. J., et al.

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