Renal response to shock wave exposure in experimental animals: dynamic histomorphological and functional evaluation

Introduction. The issue of concomitant renal parenchyma damage during extracorporeal shock wave exposure (ESWE) remains relevant due to the lack of a unified concept regarding the mechanism of renal parenchyma injury.

Objective. To elucidate the mechanisms of renal injury and protection during ESWE considering histomorphological and functional changes in experimental animals.

Materials & methods. The study was conducted on 50 sexually mature non-linear male white rats weighing 240–290 grams. The animals were randomly divided into two groups: an intact animal group (control group, n = 10) and a group of animals (n = 40) that underwent a single ESWE. Subsequently, euthanasia was performed on the animals after ESWE at 1 (n = 10), 3 (n = 10), 7 (n = 10), and 14 (n = 10) days under general anaesthesia via decapitation. Blood sampling was performed via cardiac puncture for research purposes. The kidney subjected to ESWE was used for homogenate preparation and histomorphological studies. Markers of free radical oxidation were studied: protein carbonyl groups (PCG) and malondialdehyde (MDA), reflecting the degree of damage to the renal tubular epithelium. Additionally, antioxidant defence (AOD) enzymes in the renal homogenate were determined, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR), and reduced glutathione (GSH), reflecting the degree of renal antioxidant protection. Functional renal impairments in experimental animals after ESWE were assessed by measuring urea and creatinine levels in blood serum. Histomorphological assessment of changes in the kidneys under the influence of RSWE was carried out when collecting material at 1, 3, 7, and 14 days after ESWE. The excised material was subjected to light optical and microscopic examination.

Results. Following ESWE to the kidney, from days 1 to 3, there is an activation of free-radical oxidation processes of proteins and lipids in the nephroepithelium (protein carbonyl groups, malondialdehyde), accompanied by a decrease in the activity of antioxidant defense enzymes (SOD, GPx, GR, GSH). This ultimately leads to membrane-destructive changes, cell death of the nephroepithelium, and alteration of kidney tissue. By day 7, pronounced histomorphological changes contribute to impaired renal function, as evidenced by increased urea and creatinine levels in the blood serum. Only by day 14 do markers of kidney damage, its histomorphological structure, and functional capacity approach normal levels. The analysis of indicators of free-radical oxidation of proteins and lipids in the nephroepithelium, assessment of antioxidant enzyme activity, and renal functional capacity, along with histomorphological changes after ESWE on days 1, 3, 7, and 14 of the study, allowed for clarification of the mechanism and stages of damage and recovery of the structural and functional renal parameters in experimental animals.

Conclusion. Mechanisms and temporal stages of kidney damage and recovery after ESWE have been identified in experimental animals.

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