Sodium fumarate in the prevention of ischemia-reperfusion injury in renal surgery: outcomes and prospects

Objective: to review the current outcomes and future prospects of using sodium fumarate (SF) for the prevention of ischemia–reperfusion injury in renal surgery. Materials and methods. The drug used in the study was Konfumin, whose active ingredient is SF. The experimental sample consisted of 78 female Wistar rats. Renal warm ischemia (RWI) and reperfusion injury were modeled, involving either unilateral or bilateral kidney preservation. SF, administered as an infusion solution, was used to evaluate the effectiveness of infusion therapy in this renal injury model. It was administered as an intravenous infusion at doses of 1 mL/kg or 2 mL/kg. The infusion protocol included five administrations: one day prior to warm ischemia, on the day of the procedure, and over the subsequent three days. Clinical observation was then carried out. Results. Experimental therapy with SF led to a marked reduction in inflammation in the ischemic kidneys of rats, as evidenced by significant improvements in key markers of nephron function. The treatment also contributed to favorable pathomorphological changes associated with acute ischemia–reperfusion injury (IRI). Data from experimental models involving warm ischemia and reperfusion of a single kidney, as well as models with an intact contralateral kidney, demonstrated that SF, administered intravenously at doses ranging from 1 to 2.5 mL/kg, exerted a nephroprotective effect. This protective effect was reflected in the positive remodeling of ischemic renal infarction and its consequences, involving improvements across vascular, glomerular, tubular, and interstitial components of the renal parenchyma. Conclusion. SF, administered intravenously at doses of 1–2.5 mL/kg, demonstrated a clear nephroprotective effect. This was evidenced by favorable pathomorphological changes in ischemic renal infarction and its sequelae.

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