Late Effects on the Kidney of Selective Infusion of Adrenalin Into the Renal Artery: An Experimental Study in the Rabbit

Abstract

The left renal artery was catheterized in rabbits and 50 ml saline containing 20 μg adrenalin infused at a rate of 0.3 ml/min. Three to sixteen weeks later urography and angiography were performed prior to sacrifice. All the infused kidneys were damaged, some of them transformed to small, contracted, non-functional organs. The contralateral kidneys had undergone compensatory hypertrophy. No significant bacterial growth was observed. The systemic blood pressure was unchanged. The histological picture was that of cortical necrosis due to infarcts, with no resemblance to chronic pyelonephritis. Control studies with infusion of pure saline also resulted in parenchymal damage of approximately the same degree. Dextran administered intravenously prior to the infusion of adrenalin or physiological saline alone prevented parenchymal lesions. Addition of phentolamine to the solutions did not reduce the lesions significantly. When heparin was added, the results of saline infusion did not change significantly but there was less renal damage in connection with adrenalin infusion. It is concluded that the parenchymal lesions were caused mainly by formation of thrombi with subsequent infarction. The vasoconstrictor effect of adrenalin is of secondary importance. To avoid complications after catheterization of the renal artery over a longer period of time it is essential to prevent the formation of thrombi by suppressing thrombocyte adhesiveness with dextran and by using catheters of a material which favours the least possible platelet adhesion. A very gentle technique and the use of a slender and soft catheter are also necessary.