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      Postconditioning ameliorates mitochondrial DNA damage and deletion after renal ischemic injury

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          Abstract

          Background

          Reactive oxygen species (ROS) play a major role in causing injury in ischemia-reperfusion (I/R). Mitochondrial DNA (mtDNA) is particularly vulnerable to oxidative damage. We propose that increased mitochondrial ROS production is likely to damage mtDNA, causing further injury to mitochondria, and postconditioning (POC) may ameliorate kidney I/R injury by mitigating mitochondrial damage.

          Methods

          Rats were divided into seven groups: (i) Sham-operated animals with an unconstricted renal artery; (ii) Sham + 5-hydroxydecanoate (5-HD); (iii) I/R; (iv) I/R + 5-HD; (v) POC; (vi) Sham POC and (vii) POC + 5-HD. Renal injury, oxidative DNA damage, mtDNA deletions, mitochondrial membrane potential (MMP) and expression of the ATP-sensitive K + (K ATP) channel subunit Kir6.2 were evaluated.

          Results

          Following 1 h of reperfusion, animals in the I/R group exhibited increased ROS, oxidative mtDNA damage shown by 8-hydroxy-2-deoxyguanosine staining, multiple base pair deletions and decreased MMP. However, POC rats exhibited less ROS, oxidative mtDNA damage and deletions and improved MMP. After 2 days of reperfusion, serum creatinine was elevated in I/R rats and the number of TdT-mediated dUTP nick-end labeled-positive tubular cells was increased and was associated with activation of caspase-3. Therefore, POC prevented the deleterious effects of I/R injury. Furthermore, the expression of mitochondrial Kir6.2 was widely distributed in renal tubular epithelial cells in Sham and POC rats and was lower in I/R rats. All of the protective effects of POC were reversed by the K + (K ATP) channel blocker 5-HD.

          Conclusion

          POC may attenuate I/R injury by reducing mitochondrial oxidative stress and mtDNA damage and sustaining MMP.

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          Most cited references42

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          Acute kidney injury, mortality, length of stay, and costs in hospitalized patients.

          The marginal effects of acute kidney injury on in-hospital mortality, length of stay (LOS), and costs have not been well described. A consecutive sample of 19,982 adults who were admitted to an urban academic medical center, including 9210 who had two or more serum creatinine (SCr) determinations, was evaluated. The presence and degree of acute kidney injury were assessed using absolute and relative increases from baseline to peak SCr concentration during hospitalization. Large increases in SCr concentration were relatively rare (e.g., >or=2.0 mg/dl in 105 [1%] patients), whereas more modest increases in SCr were common (e.g., >or=0.5 mg/dl in 1237 [13%] patients). Modest changes in SCr were significantly associated with mortality, LOS, and costs, even after adjustment for age, gender, admission International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis, severity of illness (diagnosis-related group weight), and chronic kidney disease. For example, an increase in SCr >or=0.5 mg/dl was associated with a 6.5-fold (95% confidence interval 5.0 to 8.5) increase in the odds of death, a 3.5-d increase in LOS, and nearly 7500 dollars in excess hospital costs. Acute kidney injury is associated with significantly increased mortality, LOS, and costs across a broad spectrum of conditions. Moreover, outcomes are related directly to the severity of acute kidney injury, whether characterized by nominal or percentage changes in serum creatinine.
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            Acute kidney injury increases risk of ESRD among elderly.

            Risk for ESRD among elderly patients with acute kidney injury (AKI) has not been studied in a large, representative sample. This study aimed to determine incidence rates and hazard ratios for developing ESRD in elderly individuals, with and without chronic kidney disease (CKD), who had AKI. In the 2000 5% random sample of Medicare beneficiaries, clinical conditions were identified using Medicare claims; ESRD treatment information was obtained from ESRD registration during 2 yr of follow-up. Our cohort of 233,803 patients were hospitalized in 2000, were aged > or = 67 yr on discharge, did not have previous ESRD or AKI, and were Medicare-entitled for > or = 2 yr before discharge. In this cohort, 3.1% survived to discharge with a diagnosis of AKI, and 5.3 per 1000 developed ESRD. Among patients who received treatment for ESRD, 25.2% had a previous history of AKI. After adjustment for age, gender, race, diabetes, and hypertension, the hazard ratio for developing ESRD was 41.2 (95% confidence interval [CI] 34.6 to 49.1) for patients with AKI and CKD relative to those without kidney disease, 13.0 (95% CI 10.6 to 16.0) for patients with AKI and without previous CKD, and 8.4 (95% CI 7.4 to 9.6) for patients with CKD and without AKI. In summary, elderly individuals with AKI, particularly those with previously diagnosed CKD, are at significantly increased risk for ESRD, suggesting that episodes of AKI may accelerate progression of renal disease.
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              J-aggregate formation of a carbocyanine as a quantitative fluorescent indicator of membrane potential.

              The spectral properties of a novel membrane potential sensitive probe (JC-1) were characterized in aqueous buffers and in isolated cardiac mitochondria. JC-1 is a carbocyanine with a delocalized positive charge. It formed under favorable conditions a concentration-dependent fluorescent nematic phase consisting of J-aggregates. When excited at 490 nm, the monomers exhibited an emission maximum at 527 nm and J-aggregates at 590 nm. Increasing concentrations of JC-1 above a certain concentration caused a linear rise in the J-aggregate fluorescence, while the monomer fluorescence remained constant. The membrane potential of energized mitochondria (negative inside) promoted a directional uptake of JC-1 into the matrix, also with subsequent formation of J-aggregates. The J-aggregate fluorescence was sensitive to transient membrane potential changes induced by ADP and to metabolic inhibitors of oxidative phosphorylation. The J-aggregate fluorescence was found to be pH independent within the physiological pH range of 7.15-8.0 and could be linearly calibrated with valinomycin-induced K+ diffusion potentials. The advantage of JC-1 over rhodamines and other carbocyanines is that its color altered reversibly from green to red with increasing membrane potentials. This can be exploited for imaging live mitochondria on the stage of a microscope.
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                Author and article information

                Journal
                Nephrol Dial Transplant
                Nephrol. Dial. Transplant
                ndt
                ndt
                Nephrology Dialysis Transplantation
                Oxford University Press
                0931-0509
                1460-2385
                November 2013
                10 September 2013
                10 September 2013
                : 28
                : 11
                : 2754-2765
                Affiliations
                [1 ]Department of Pathology, Norman Bethune School of Medicine, Jilin University , Jilin, China
                [2 ]Department of Cardiology, China–Japan Union Hospital , Jilin University , Jilin, China
                Author notes
                Correspondence and offprint requests to: Xiuying Zhang; E-mail: zhxy0515@ 123456hotmail.com
                [*]

                Dr. Yulin Li was considered as a co-corresponding author, yllipathology@ 123456gmail.com

                [†]

                Xiaohua Tan and Lei Zhang contributed equally to this work.

                Article
                gft278
                10.1093/ndt/gft278
                3811057
                24021677
                3205bd5a-f45a-422c-a65d-0e7cf2242e6d
                © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 13 December 2012
                : 22 April 2013
                Categories
                Original Article
                Basic Science

                Nephrology
                mitochondrial dna,mitochondrial k+ (katp) channel,postconditioning,reactive oxygen species,renal protection

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