posted on 2017-03-21, 22:32authored byPei Chen Connie Ow
Tissue hypoxia
has been implicated in the pathogenesis of various kidney diseases. Yet,
because of technical limitations, temporal and spatial aspects of tissue
hypoxia in the pathogenesis of kidney disease have received little attention.
The recent development of the oxygen telemeter allowed for the possibility for
the investigation into the contribution of tissue hypoxia in the progression of
kidney diseases over long periods of time. We validated and established that
the inherent offset in the telemeter was stable throughout the implantation
period after a 5 day ‘bedding in’ period.
The primary aim of this PhD project was to utilize the
recently developed oxygen telemeter; the Clark electrode and pimonidazole
adduct immunohistochemistry to determine both the temporal and spatial
distribution of tissue hypoxia in the subacute phase of acute kidney injury
induced by renal ischemia reperfusion injury. The tissue damage in response to
an hour of anoxia was vast, such that tubular elements were often observed to
be riddled with intraluminal casts, cellular sloughing and thinning of the
epithelium. Interestingly, despite the extensive cellular damage, we could not
detect tissue hypoxia at 24 h and 5 days after reperfusion of the kidney in
both the cortex and the medulla using the oxygen telemeter and the Clark
electrode. In contrast, the widespread staining pattern of pimonidazole adduct suggest
otherwise i.e. cellular hypoxia was prominent in the subacute phase of ischemia
reperfusion injury. A large proportion of these stained adducts was associated
with tissue damage. Thus, the presence of these adducts was likely artifactual
and is not reflective of ‘true hypoxia’. The absence of tissue hypoxia was
likely contributed by the marked reduction of renal oxygen consumption and well
maintained renal oxygen delivery. In conclusion, the absence of tissue hypoxia
in the acute and subacute phase of ischemia reperfusion injury indicates that
tissue hypoxia may not be an important driver of the pathogenesis of ischemia
reperfusion injury. However, tissue damage in the subacute phase may lead to
tissue hypoxia in the chronic phase of ischemia reperfusion injury. This line
of inquiry could be investigated by instrumenting rats with the oxygen
telemeter for weeks following recovery from ischemia surgery.
Using Clark electrodes, we directly quantified tissue PO2 in
rats with advanced polycystic kidney disease. There was extensive tissue
hypoxia in both the renal parenchyma and within the cysts. Renal tissue hypoxia
in these rats was driven by a greater reduction in renal oxygen delivery than
renal oxygen consumption.
The data presented in this thesis reinforce the need to
consider both spatial and temporal aspects of tissue hypoxia in various forms
of kidney disease in order to verify the importance of tissue hypoxia in
driving the pathogenesis of kidney diseases.