Ratlarda İdrar Alkalinizasyonunun Kolistine Bağlı Nefrotoksisiteyi Önlemedeki Etkisinin İnvivo Olarak Değerlendirilmesi

Abstract

ABSTRACT Colistin is a vital antibiotic that is used in drug-resistant nosocomial infections. The most important side effect of this drug that causes severe morbidity and mortality is nephrotoxicity. Colistin is toxic to the tubules of the kidney and it causes acute tubular necrosis. Colistin is a weak acid. In this study, it is aimed to evauate the possible protection of urine alkalinisation that is used in toxicities of weak acids. Sprauge Dawley rats were divided into four groups. Rats were kept in controlled environment (temperature 22±2oC and 12 hours light/dark cyclus). Group I (control) were injected 0,1 cc intramuscular distilated water twice a day for seven days. Group II (colistin group) were injected 750000 IU/kg/day of colistin,divided into two doses, twice a day for seven days. Group III (colistin and bicarbonate group) were injected same dose of colistin, after they reach urinary pH >7 by addition of bicarbonate in their drinking water. Urine of the rats collected by bladder stroking were checked for pH and density with dipstick each day. Group IV (colistin and NaCl group) were injected the same dose of colistin after reaching Group III’s urine density by adding NaCl in their drinking water. Urine samples were collected before and after the study. After the study, blood samples were collected by cardiac punction and necropsy was performed. Serum urea levels showed borderline statistical difference (p=0,046) but, it was not clinically correlated when compared histopathologically. Serum creatinine values showed no statistical difference (p=0,131). According to tubular degeneration average scores (scored 0: normal to 5: necrosis, histologically); Group I scored “0”, Group II scored “4,25±0,89”, Grup III scored “2±1,26”, and Grup IV scored “1,5±0,55”. In Group III and Group IV, protection was achieved against nephrotoxic agent (p<0,001). Bicarbonate group was not superior to NaCl group (p=0,601). Urine densities and tubular degeneration scores were statistically correlated independent of the groups. The lower the urine density was, the lower the tubular score (p=0.001). Bicarbonate hydration is not superior to NaCl hydration, and both are effective similarly. Decrease in urine density is correlated with tubular protection.