Protective effects of ulinastatin on kidney injury in rabbits after cardiopulmonary resuscitation

AIM: To investigate the effect of ulinastatin (UTI) on inflammatory cell infiltration, expression of tumor necrosis factor-α (TNF-α) and concentration of oxidative stress product malondialdehyde (MDA) in the kidney medulla after cardiopulmonary resuscitation (CPR) in rabbits and to access its potential mechanisms in kidney injury after CPR.METHODS: Twenty-four male New Zealand adult rabbits were randomly divided into control group and UTI group after return of spontaneous circulation (ROSC) from 5 min ventricular fibrillation induced by alternating current. The UTI at the dose of 2.5×10⁴ U/kg was administered immediately after ROSC to the animals in UTI group, the same volume of saline were injected in control group. The urinary output was recorded and the serum concentration of BUN and creatinine were detected every 4 h after ROSC. The animals were sacrificed 24 h after ROSC and the kidney medullas were obtained to observe the degree of inflammatory cell infiltration, the expression of TNF-α and the concentration of MDA.RESULTS: Six rabbits in control group and 6 animals in UTI group survived to the end point of experiment. The urinary output was decreased gradually to the lowest 8 h-12 h after ROSC and then increased in both groups. The urinary output in UTI group was more than that in control group 8 h after ROSC (P<0.05). The serum concentrations of BUN and creatinine were significantly lower in UTI group than those in control group 4 h after ROSC (P<0.05). The myeloperoxidase-positive cells in control group were much higher than that in UTI group (P<0.05). The expression of TNF-α and concentration of MDA in the kidney medullas in UTI group were lower than those in control group (P<0.05, P<0.01).CONCLUSION: The standard dose of UTI (2.5×10⁴ U/kg) administered in rabbits suffered from ventricular fibrillation for 5 min may alleviate the degree of inflammatory cell infiltration, decrease the expression of TNF-α and reduce the concentration of MDA in kidney medulla. UTI has protective effects on the renal function after CPR.