39 / 492
BSP-4
(P)
CAN RENAL FIBROSIS DUE TO PYELONEPHRITIS BE PREVENTED? : AN
EXPERIMENTAL STUDY
Mujdem Nur AZILI
1
, Esra KARAKUS
2
, Atilla SENAYLI
1
and Tugrul TIRYAKI
3
1) Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Pediatric surgery, Ankara, TURKEY
- 2) Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Pathology, Ankara, TURKEY - 3)
Ankara Child Diseases Hematology and Oncology Education and Research Hospital, Pediatric Surgery and Pediatric
Urology, Ankara, TURKEY
PURPOSE
The circulating renin-angiotensin system (RAS) regulates arterial pressure and sodium homeostasis. But inappropriate
activation of intrarenal RAS causes increased Angiotensin II (Ang II) levels that lead to renal injury, proliferation and
fibrosis. There are alternative pathways too; forming Ang II, probably a chymase. Chymase is secreted from mast cells.
An experimental study was performed to investigate the efficacy of captopril and ketotifen, which are ACE inhibitor and
mast cell stabilizer, on the prevention of scar formation after acute pyelonephritis.
MATERIAL AND METHODS
Acute pyelonephritis was created by injecting E. coli suspension into renal cortex. Fifty rats were divided to five equal
groups. Group A (sham) animals were given SF inoculums. Group B rats were given E. coli suspension. Group C rats
were given E. coli suspension and treated with cephotaxime. Group D rats were given E. coli and received cephotaxime
and captopril (50 mg/kg/day) via orogastric lavage. Group E rats were given E. coli and received cephotaxime and
ketotifen (1 mg/kg/day) via oral route.
RESULTS
To assess the efficacy of captopril and ketotifen for prevention of renal fibrosis, the rats were sacrified under anesthesia,
six weeks after the bacterial inoculation to determine degree of inflammation, abscess formation, scar formation. The
scores of inflamatuar criteria's increased significantly in the groups of B compared with the sham group (A) (p=0.001).
Captopril or ketotifen treatment with antibiotic were found to be the only factor decreasing scar formation (p=0.007).
The percentage of scar formation was 20% in the group of E, 50% in the group of D while 90% in the group of C. But
there was no significant difference between group D and E in the efficacy of preventing scar formation.
CONCLUSIONS
We conclude that captopril and ketotifen have a preventive effect in the development of renal fibrosis in an experimental
model of acute pyelonephritis in rats.