Effects of carbon dioxide pneumoperitoneum on renal function in obstructive jaundice: an experimental study in a rat model;

Abstract

Introduction: Both pneumoperitoneum (PNP) and obstructive jaundice (OJ) are known to lead to acute kidney injury (AKI) potentially, but the combined effect has not been investigated. Aim: This study aimed to investigate the effects of PNP on renal functions in a rat model of OJ. Methods: We divided forty-eight rats into eight groups of six rats. Group 1 was the control (sham-operated) group; Groups 2, 3, and 4 were induced 5, 10, and 15 mmHg of CO2 PNP, respectively (Groups 1-4: “non-OJ Groups”); Group 5 was the OJ group; and Groups 6, 7 and 8 were OJ groups that were induced with 5, 10, and 15 mmHg CO2 PNP was respectively (Groups 5-8: “OJ Groups”). The common bile duct was ligated and divided into OJ Groups. After 48 hours, a 5-10-15 mmHg PNP was induced by mini-laparotomy with a Veress needle in Groups 6, 7, and 8, maintained for 60 minutes. Results: There were no statistically significant differences between groups regard-ing blood urea Nitrogen and Creatinin levels (p> 0.05). Neutrophil gelatinase-associated lipocalin (NGAL) values were significantly higher in OJ Groups than in non-OJ Groups (p< 0.05). Serum Cystatin-C values were significantly higher in OJ Groups with 10 and 15 mmHg PNP than in non-OJ Groups (p< 0.05). Conclusion: In the early stage of AKI, NGAL and Cystatin-C levels might be higher, while standard renal function tests were normal. Our findings highlight the apparent unfa-vorable effect of OJ with PNP on renal functions and early recognition of AKI with the measurement of NGAL and Cystatin-C in these conditions. © 2023, Asociacion Regional de Dialisi y Transplantes Renales de Capital Federal y Provincia de Buenos Aires. All rights reserved.