Abstract

Renal failure due to ischemic injury is a common denominator of various clinical situations in critically ill patients. This study was designed to characterize the TPSO/Cholesterol synthesis and cell division pathways in response to different levels of ischemia. Porcine kidneys were subjected to either 60min-warm ischemia (WI) or auto-transplanted after cold storage for 24h at 4°C (CS), or both conditions (WI+CS), pathway activation and function were evaluated at 3h, 3 and 7 days after reperfusion.

CS combined to WI affects renal functions indicating a high degree of injury. During the first week of reperfusion, renal levels of free and esterified cholesterol, major cellular components, increased in CS group with an attenuated production when WI was associated. CS and WI+CS groups exhibited an elevated expression of cell cycle induction markers such as PCNA and stathmin. TSPO expression was highest in groups with the lowest injury, and correlated with kidney outcome, revealing its potential for diagnosis.

Keywords: Acute kidney injury, hypoxia, ischemia reperfusion injury, repair process