Glucose-insulin infusion reduces kidney injury in an experimental model of ischemic nephropathy.

BACKGROUND/AIMS: intensive insulin therapy may reduce renal dysfunction during severe illness in adult patients. We evaluated the effects of insulin-glucose (IG) in normoglycemic rats subjected to ischemia-reperfusion (I/R)-induced acute kidney injury. METHODS: animals received intravenous infusions of 5% glucose [control (C)] or IG for 96 h. I/R was induced by means of bilateral renal artery clamping for 45 min. Serum creatinine (sCr) and urea (sUr) levels were evaluated before and up to 72 h after injury. Tissue samples were evaluated 72 h after I/R on a scale of 0 (normal) to 4 (above 75%) in relation to the extent of kidney injury. RESULTS: after 48 h of I/R, sCr and sUr were increased 2- to 4-fold in C as compared to sham-operated controls (p < 0.05). IG produced significant improvements in renal function (p < 0.05). Upon histopathological analysis, the IG group presented less tubular damage in comparison to the C group: level 1, 60 versus 20%; level 2, 20 versus 30%; level 3, 20 versus 30%, and level 4, 0 versus 20%, respectively (n = 10; p = 0.057). CONCLUSION: our results suggest that IG infusion attenuates the renal damage induced by severe I/R independently of blood glucose control. This strategy may constitute a therapeutic option for the prevention and treatment of ischemic renal injury.