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Hyperglycemic kidney damage in an animal model of prolonged critical illness
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Vanhorebeek, Ilse, Gunst, Jan, Ellger, Bjoern, Boussemaere, Magaly, Lerut, Evelyne, Debaveye, Yves, Rabbani, Naila, Thornalley, Paul J., Schetz, Miet and Van den Berghe, Greet (2009) Hyperglycemic kidney damage in an animal model of prolonged critical illness. In: 90th Annual Meeting of the Endocrine-Society, San Francisco, CA, June 15-18, 2008. Published in: Kidney International, Vol.76 (No.5). pp. 512-520. ISSN 0085-2538. doi:10.1038/ki.2009.217
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Official URL: http://dx.doi.org/10.1038/ki.2009.217
Abstract
Acute kidney injury frequently complicates critical illness and increases mortality; maintaining normoglycemia with insulin has been shown to reduce the incidence of intensive care unit (ICU)-acquired kidney injury. Here we tested the mechanisms by which this intervention might achieve its goal, using a rabbit model of burn-induced prolonged critical illness in which blood glucose and insulin were independently regulated at normal or elevated levels. Hyperglycemia caused elevated plasma creatinine and severe morphological kidney damage that correlated with elevated cortical glucose levels. Renal cortical perfusion and oxygen delivery were lower in hyperglycemic/hyperinsulinemic rabbits, compared to other groups, but this did not explain the elevated creatinine. Mitochondrial respiratory chain activities were severely reduced in the hyperglycemic groups (30-40% residual activity), and were inversely correlated with plasma creatinine and cortical glucose. These activities were much less affected by normoglycemia, and hyperinsulinemia was not directly protective. Mitochondrial damage, evident at day 3, preceded the structural injury evident at 7 days. Our study found that hyperglycemia evoked cellular glucose overload in the kidneys of critically ill rabbits, and this was associated with mitochondrial dysfunction and renal injury. Normoglycemia, independent of insulinemia, protected against this damage.
| Item Type: | Conference Item (Paper) | ||||
|---|---|---|---|---|---|
| Subjects: | R Medicine > RC Internal medicine | ||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016) Faculty of Medicine > Warwick Medical School |
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| Journal or Publication Title: | Kidney International | ||||
| Publisher: | Nature Publishing Group | ||||
| ISSN: | 0085-2538 | ||||
| Official Date: | September 2009 | ||||
| Dates: |
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| Volume: | Vol.76 | ||||
| Number: | No.5 | ||||
| Number of Pages: | 9 | ||||
| Page Range: | pp. 512-520 | ||||
| DOI: | 10.1038/ki.2009.217 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| Funder: | Fund for Scientific Research (FWO, Research Council of the Katholieke Universiteit Leuven, KULeuven Research Council Postdoctoral Fellowships, FWO Research Assistant Fellowship, Innovative Medizinische Forschung, B Braun, Germany, British Heart Foundation Research Fellowship | ||||
| Grant number: | G.0533.06; GOA2007/14; EL 610304 | ||||
| Conference Paper Type: | Paper | ||||
| Title of Event: | 90th Annual Meeting of the Endocrine-Society | ||||
| Type of Event: | Conference | ||||
| Location of Event: | San Francisco, CA | ||||
| Date(s) of Event: | June 15-18, 2008 |
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