The Protective Effects And Mechanisms Of Propofol On Rat Renal Ischemia-reperfusion Injury

PrefaceAcute renal ischemia /reperfusion injury is a kind of common injury, it can cause the decrease of renal blood flow, toxic, or obstructive insult to the renal tubule or inflammation and loss of vascular integrity in the tubule interstitium or a rapid reduction in glomeruli function. Its morbidity and mortality remains unacceptably high (45% -60% ). The ischemia followed by reperfusion is characterized by numerous morphological changes, varying with the nature and integrity of the insult. These include: loss of epithelial brush border in the proximal tubule, loss of polarity, loss of cell - cell and cell - matrix contact, and then cell death as a result of necrosis and apoptosis. The ischemia injury is also accompanied by inflammatory and cytotoxic injury activated during reperfusion. Its pathogenesis was as the follows: decrease in ATP, increase in oxygen - derived free radicals, increase in intracellular calcium ions, endocrine hormone and molecules and cells of immunity, apoptosis of cells.Acute renal ischemia decreases the renal blood flow and shifts blood away from the cortex toward the medulla. Total renal blood flow is reduced but the blood flow to the cortex is reduced out of the proportion to that of the medulla. Since 80% the functional glomeruli are in the cortex, a shift away from these glomeruli results in a significantly decreased glomerular filtration rate. Tubular obstruction also may occur because of either swelling of tubular epithelial cells due to ischemia or the direct effect of tubular toxins. As the tubules swelling, they occlude the tubular lumen, thus causing a blockage of the flow of filtration. The increase tubule permeability results in back leakage of filtrate from the tubular lumen into the interstitium. In ischemia, accumulation of hypoxanthine as a...