Protective role of remote ischemic per-conditioning in acute renal injury induced by ischemia reperfusion via TLR-4 and TNF-α signaling pathway in rats

sIntroduction: Acute kidney injury (AKI) induced by ischemia-reperfusion (I / R) of the kidney as an inflammatory process in which multiple inflammatory factors are involved. Recently, one of the modalities of inflammation in AKI is Remote Ischemic Per-Conditioning (RIPerC). Materials and Methods: In this study, bilateral renal artery and vein occlusion were done for 45 minute and reperfusion and 24 h. The RIPerC model consisted of four five-minute cycles (two minutes of left femoral artery occlusion and three minutes of reperfusion) performed at the onset of renal ischemia. Rats were divided into control, I / R and RIPerC groups. At the end of the reperfusion period, urine, blood and kidney tissue samples were collected for functional, structural and molecular analysis. Results: Ischemia-reperfusion caused tissue damage and consequently renal dysfunction, which was shown by decreasing creatinine clearance and increasing relative excretion of sodium. In addition, in the I / R group, TLR-4 and TNF-α in mRNA levels were increased, whereas RIPerC simultaneously with I / R improved kidney structure and function and decreased TLR-4 and TNF-α expression levels. Conclusion: RIPerC protected the kidney against ischemia-reperfusion-induced kidney injury and probably this protective TEMPeffect was exerted by inhibition of TLR-4 signaling pathway in the kidney.