Changes Of Renal Ultrastructure And Expression Of HIF-1 Alpha During Renal Ischemia-reperfusion In Human Partial Nephrectomy

Objective: Observe and evaluate the ultrastructure changes of human renal tissue during ischemia-reperfusion undergoing partial nephrectomy,and discuss the safe ischemia time of human kidneys.Detect and evaluate the expression of HIF-1? in human renal tissue during ischemia-reperfusion undergoing partial nephrectomy.Methods: Collect the renal tissue samples during different periods of the process of ischemia reperfusion of 20 renal cancer patients undergoing partial nephrectomy in the Fujian Provincial Hospital from May 2017 to October 2017.Fall samples into pre-blocking group,blocking 10 min group,blocking 20 min group,pre-repatency group,post-repatency 5min group according to sample colleting time.Observe and evaluate the degree of injury of samples ultrastructure changes by electron microscopy,and detecte the expression of HIF-1?mRNA and protein in the renal tissue.Results: The damage scores of glomerulus of the pre-blocking group,blocking 10 min group,blocking 20 min group,pre-repatency group,post-repatency 5min group are 3.167,2.45,2.4,2.167 and 3.167.Of which there were significant differences in the score of the pre-repatency group and the post-repatency 5min group(P=0.034).The damage scores of renal tubule of the pre-blocking group,blocking 10 min group,blocking 20 min group,pre-repatency group,post-repatency 5min group are 4.37,4.1,4,4,4.63.At the same period,the score of glomerular injury was significantly lower than that of renal tubules during ischemia reperfusion,and the P are 0.017,0,0.003,0.001,0.008,respectively.The relative expression of HIF-1? mRNA during ischemia reperfusion period are 1.498,1.516,1.44,1.543,1.485,and there are no significant difference between each groups.The expression grades of HIF-1?protein during ischemia reperfusion period are 1.6,16.5,1.625,1.474,1.5,and there are no significant difference between each groups.Conclusion: Ischemia and reperfusion can cause ultrastructure changes of glomeruli and renal tubules.In a certain period of ischemia,ischemia reperfusion injury cause minor injury,and the tolerance of glomeruli to ischemic injury is stronger than that of renal tubules,and is more sensitive to reperfusion injury than that of renal tubules.During a short ischemia time,there is no significant correlation between the ultrastructure changes of kidney and the type of ischemia or the time of ischemia.There is no obvious increasing in the expression of HIF-1? in renal tissue at a short ischemia time or the early stage of reperfusion.