Changes in renal function during acute spinal cord injury: implications for pharmacotherapy

Spinal Cord. 2013 Jul;51(7):528-31. doi: 10.1038/sc.2013.35. Epub 2013 Apr 23.

Abstract

Study design: Laboratory investigation in rats submitted to experimental spinal cord injury (SCI).

Objective: To characterize changes in renal function during acute SCI.

Methods: Sprague Dawley rats were subjected to severe spinal cord contusion at T8 level or to laminectomy as control. Twenty-four hours after spine surgery, clearance assessments of a single dose of iohexol (120 mg kg(-1)) or of p-aminohippuric acid (PAH, 100 mg kg(-1)) were used to evaluate glomerular filtration rate (GFR) and tubular secretion (TS), respectively. Blood sampling was used to determine concentrations of both compounds by high-performance liquid chromatography for pharmacokinetic measurements.

Results: Iohexol clearance decreased significantly after injury, which resulted in increased concentrations and half-life of iohexol in blood; PAH clearance remained unchanged.

Conclusion: GFR but not TS is altered during spinal shock. These observations should be of interest to professionals caring for early cord-injured patients, in order to prevent toxicity and therapeutic failure when administering drugs eliminated by the kidney.

MeSH terms

  • Acute Disease
  • Animals
  • Female
  • Glomerular Filtration Rate*
  • Iohexol / pharmacokinetics*
  • Kidney / metabolism*
  • Metabolic Clearance Rate
  • Rats
  • Rats, Sprague-Dawley
  • Spinal Cord Injuries / physiopathology*
  • p-Aminohippuric Acid / pharmacology*

Substances

  • Iohexol
  • p-Aminohippuric Acid