Antioxidant administration with the initiation of fever prevents renal scarring in the rat model of acute pyelonephritis
Purpose To evaluate the efficacy of antioxidant administration starting at the onset of fever detection in reducing renal scars in an animal model of acute pyelonephritis (APN), and comparing the effectiveness of Allopurinol and vitamin E in the prevention of renal scaring. Material and methods Twenty male Wister rats divided to 4 groups. Group 1 to 3 underwent direct inoculation of 0.1 ml of E-coli suspension into the parenchyma of the right kidney. Group 4 received 0.1 ml of saline. Group I were treated with ceftriaxone for 5 days, starting 3 days after bacterial inoculation; group II & III received Allopurinol and vitamin E as soon as animal's body temperature rose above 37°C. followed by the administration of daily ceftriaxone 3 says after inoculation for five days. Six weeks later all rats were sacrificed; both kidneys examined histopathologically for scarring. Renal cell apoptosis index was determined in paraffin embedded kidneys (using TUNEL assay). Results The fever started 4.6±1.3 hours (measured by continues digital rectal thermometer) after inoculation in all rats. Histopathologically, subsequent scar formation had occurred in all rats of the group 1 which didn't receive antioxidant agents. The inflammation and fibrosis was mildest in group 2 and 3 (Allopurinol and Vitamin E); whereas it was significantly lower in group 3 than in group 2 (p Conclusions Initiation of the antioxidant agents following detection of fever can be effective in reducing the severity of scarring in APN. Comparing the total scar scores in experimental groups, vitamin E has more protective effect against renal damage due to APN than Allopurinol.