Efeitos comparativos do glutation, glutamina, alanina e da alanilglutamina adicionados a um perfusato de composição intracelular

Abstract

Renal transplantation is the substitutive therapy of choice for patients with advanced chronic kidney disease. Kidney preservation aims to ensure its functional viability. All procedures focused on protecting the body's functions, protecting energy reserves and morphological structure. Objectives: the physiopharmacological study of the perfused and isolated rabbit kidney with a solution of intracellular composition rich in potassium and magnesium containing 4g% of bovine albumin; To evaluate the effects of glutamine, alanine, alanylglutamine and glutathione at different concentrations and to evaluate the effects of subnormotermia. Male rabbits were anesthetized with urethane 1.2 g / kg intraperitoneally and 30 mg / kg pentobarbital intramuscularly. After the anesthesia was established, an incision was made in the midline and the left ureter cannulated with a polyethylene tube. The abdominal aorta was dissected and the collateral vessels connected. The mesenteric and right renal arteries were ligated and the right kidney was removed. The aorta was cannulated with a sterile metal cannula and perfusion of the left kidney started without interruption of flow. The preparation was then placed in the perfusion loop where it was maintained at 37 ° C or 22 ° C with infusion solution containing 4% albumin previously dialysed for 48 hours and oxygenated by a mixture of 95% O 2 and 5% CO 2. Every ten minutes, material was collected for perfusate and urine analysis for dosage of inulin, sodium, potassium and chloride. Perfusate flow, vascular resistance and PO2 / PCO2 ratios were monitored throughout the experiment. The animals were randomly assigned and divided into nine groups: solution A, 1 mM and 3 mM glutamine, 2 mM alanylglutamine and 5 mM, 1 mM glutamine + 2 mM alanine, 1 mM glutamine + 2 mM glutathione, 1 mM glutamine + glutathione 4 1 mM glutamine + 2 mM glutathione at 22 ° C. There were no alterations in the parameters of vascular resistance, absolute transport and percentage of potassium. Urinary flow was higher in GL1, GL1GSH2 and GL1GSH4 groups (p = 0.08). The RFG was higher in the GL1, GL1GSH2 and GL1GSH4 groups (p = 0.03). When the absolute sodium transport was analyzed, the highest values ​​belonged to the GL1GSH2, GL1GSH4 and ALGL5 groups (p = 0.001) and the percentage sodium transport had their highest values ​​in the GL1GSH2 and ALGL5 groups (p = 0.012). Regarding the absolute transport of chloride, the group with the best index is GL1GSH2 (p = 0.002). The percentage transport of chloride has its best result in the GL1GSH2 group (p = 0.046). The osmolar clearance was higher in the GL1 and GL1GSH2 groups (p = 0.007). We conclude that the addition of glutamine and glutathione to an intracellular composition solution may result in better physiological activity in terms of renal preservation and may be applicable in renal preservation for transplantation.