Effects of renal autograft ischemia and reperfusion associated with renal transplantation on arterial blood pressure variables in clinically normal cats

Chad W. Schmiedt Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Andrew D. Mercurio Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Mathieu M. Glassman Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Jonathan F. McAnulty Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, WI 53706.

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Cathy A. Brown Athens Diagnostic Laboratory, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Scott A. Brown Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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Abstract

Objective—To evaluate the effect of renal autograft ischemia and reperfusion associated with renal transplantation on pulse rate and pressure and arterial blood pressure variables in clinically normal cats.

Animals—10 cats.

Procedures—A radiotelemetric implant was placed in each cat to measure hemodynamic variables; baseline data were recorded before surgery. Standard heterotopic renal implantation and contralateral nephrectomy were performed (day 0). Autografts were stored in cold sucrose phosphate solution for 30 minutes (n = 5) or 3 hours (5); cats were anephric during this period. Hemodynamic variables were recorded every 5 minutes for up to 16 days after surgery; mean daily values were calculated.

Results—Data from 6 cats were available for analysis. Two cats developed ureteral obstructions and became azotemic at 111 and 197 hours after kidney reperfusion. Mean serum creatinine and BUN concentrations were greater than baseline values on days 1 and 2. Although changes from baseline hemodynamic values were detected in some cats, arterial blood pressure measurements did not change significantly from baseline at any time point. Compared with baseline data, mean pulse rate was increased on days 1 and 2 and days 6 through 12; mean pulse pressure was increased on days 1 and 2.

Conclusions and Clinical Relevance—In clinically normal cats, hypertension was not induced by clinically relevant periods of ischemia-reperfusion injury of renal autografts and was not an inherent consequence of the transplantation process. Causes of marked posttransplantation hypertension in cats with chronic kidney disease require further investigation.

Abstract

Objective—To evaluate the effect of renal autograft ischemia and reperfusion associated with renal transplantation on pulse rate and pressure and arterial blood pressure variables in clinically normal cats.

Animals—10 cats.

Procedures—A radiotelemetric implant was placed in each cat to measure hemodynamic variables; baseline data were recorded before surgery. Standard heterotopic renal implantation and contralateral nephrectomy were performed (day 0). Autografts were stored in cold sucrose phosphate solution for 30 minutes (n = 5) or 3 hours (5); cats were anephric during this period. Hemodynamic variables were recorded every 5 minutes for up to 16 days after surgery; mean daily values were calculated.

Results—Data from 6 cats were available for analysis. Two cats developed ureteral obstructions and became azotemic at 111 and 197 hours after kidney reperfusion. Mean serum creatinine and BUN concentrations were greater than baseline values on days 1 and 2. Although changes from baseline hemodynamic values were detected in some cats, arterial blood pressure measurements did not change significantly from baseline at any time point. Compared with baseline data, mean pulse rate was increased on days 1 and 2 and days 6 through 12; mean pulse pressure was increased on days 1 and 2.

Conclusions and Clinical Relevance—In clinically normal cats, hypertension was not induced by clinically relevant periods of ischemia-reperfusion injury of renal autografts and was not an inherent consequence of the transplantation process. Causes of marked posttransplantation hypertension in cats with chronic kidney disease require further investigation.

Contributor Notes

Dr. Mercurio's present address is Veterinary Teaching Hospital, The Ohio State University, Columbus, OH 43210.

Supported by Veterinary Medical Experiment Station, University of Georgia.

Address correspondence to Dr. Schmiedt (cws@uga.edu).
  • 1.

    Kasiske BL, Anjum S, Shah R, et al. Hypertension after kidney transplantation. Am J Kidney Dis 2004;43:10711081.

  • 2.

    Tedla F, Hayashi R, McFarlane SI, et al. Hypertension after renal transplant. J Clin Hypertens (Greenwich) 2007;9:538545.

  • 3.

    Kyles AE, Gregory CR, Wooldridge JD, et al. Management of hypertension controls postoperative neurologic disorders after renal transplantation in cats. Vet Surg 1999;28:436441.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Thomas MC, Mathew TH, Russ GR, et al. Perioperative blood pressure control, delayed graft function, and acute rejection after renal transplantation. Transplantation 2003;75:19891995.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Cosio FG, Pelletier RP, Pesavento TE, et al. Elevated blood pressure predicts the risk of acute rejection in renal allograft recipients. Kidney Int 2001;59:11581164.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Schmiedt CW, Holzman G, Schwarz T, et al. Survival, complications, and analysis of risk factors after renal transplantation in cats. Vet Surg 2008;37:683695.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Brown CA, Munday JS, Mathur S, et al. Hypertensive encephalopathy in cats with reduced renal function. Vet Pathol 2005;42:642649.

  • 8.

    Sansom J, Rogers K, Wood JL. Blood pressure assessment in healthy cats and cats with hypertensive retinopathy. Am J Vet Res 2004;65:245252.

  • 9.

    Brown SA, Henik RA. Diagnosis and treatment of systemic hypertension. Vet Clin North Am Small Anim Pract 1998;28:14811494.

  • 10.

    Guyton AC, Hall JE. Dominant role of the kidney in long-term regulation of arterial pression and in hypertension: the integrated system for pressure control. In: Guyton AC, Hall JE, eds. Textbook of medical physiology. 10th ed. New York: WB Saunders Co, 2000;195209.

    • Search Google Scholar
    • Export Citation
  • 11.

    Kobayashi DL, Peterson ME, Graves TK, et al. Hypertension in cats with chronic renal failure or hyperthyroidism. J Vet Intern Med 1990;4:5862.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Schmiedt CW, Hurley KAE, Tong X, et al. Measurement of plasma renin concentration in cats by use of a fluorescence resonance energy transfer peptide substrate of renin. Am J Vet Res 2009;70:13151322.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Brown SA, Brown CA, Jacobs G, et al. Effects of the angiotensin converting enzyme inhibitor benazepril in cats with induced renal insufficiency. Am J Vet Res 2001;62:375383.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Hardie RJ, Schmiedt C, Phillips L, et al. Ureteral papilla implantation as a technique for neoureterocystostomy in cats. Vet Surg 2005;34:393398.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    McAnulty JF. Hypothermic storage of feline kidneys for transplantation: successful ex vivo storage up to 7 hours. Vet Surg 1998;27:312320.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Vanrenterghem Y, Waer M, Christiaens MR, et al. Bilateral nephrectomy of the native kidneys reduces the incidence of arterial hypertension and erythrocytosis in kidney graft recipients treated with cyclosporin. Leuven Collaborative Group for Transplantation. Transpl Int 1992;5(suppl 1):S35S37.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Midtvedt K, Hartmann A, Bentdal O, et al. Bilateral nephrectomy simultaneously with renal allografting does not alleviate hypertension 3 months following living-donor transplantation. Nephrol Dial Transplant 1996;11:20452049.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    King JN, Strehlau G, Wernsing J, et al. Effect of renal insufficiency on the pharmacokinetics and pharmacodynamics of benazepril in cats. J Vet Pharmacol Ther 2002;25:371378.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Buranakarl C, Mathur S, Brown SA. Effects of dietary sodium chloride intake on renal function and blood pressure in cats with normal and reduced renal function. Am J Vet Res 2004;65:620627.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Mathur S, Syme H, Brown CA, et al. Effects of the calcium channel antagonist amlodipine in cats with surgically induced hypertensive renal insufficiency. Am J Vet Res 2002;63:833839.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    Mathur S, Brown CA, Dietrich UM, et al. Evaluation of a technique of inducing hypertensive renal insufficiency in cats. Am J Vet Res 2004;65:10061013.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Ayus JC, Humphreys MH. Hemodynamic and renal functional changes after acute unilateral nephrectomy in the dog: role of carotid sinus baroreceptors. Am J Physiol 1982;242:F181F189.

    • Search Google Scholar
    • Export Citation
  • 23.

    Morioka S, Simon G, Gimenez HJ. Echocardiographic evidence for increased cardiac performance during early renal hypertension in dogs. Clin Exp Hypertens A 1983;5:14531470.

    • Search Google Scholar
    • Export Citation
  • 24.

    Toronyi E, Alfoldy F, Jaray J, et al. Evaluation of the state of health of living related kidney transplantation donors. Transpl Int 1998;11(suppl 1):S57S59.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Miller RH, Smeak DD, Lehmkuhl LB, et al. Radiotelemetry catheter implantation: surgical technique and results in cats. Contemp Top Lab Anim Sci 2000;39:3439.

    • Search Google Scholar
    • Export Citation

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