Introduction: Acute kidney injury (AKI) is caused by the ischemic reperfusion injury brought on by ESWL exposure.
Aim of the Work: To study the impact of medicinal ozone on acute renal cortical injury induced by ESWL.
Material and Methods: Forty-four adult male Wistar rats were divided into: the control group; subdivided into negative control group (received no treatment) and positive control group (received intra-peritoneal injection of ozone/oxygen combination given once daily at a dose of 1mg/kg), the ESWL group; received 2000 shocks on the right kidney at a power level of 90 to 100% at a rate of 60 shockwaves per minute under X-ray guidance and the ESWL+medical ozone group; received the ozone flow maintained at 3 L/min, equivalent to a gas combination of 97% O2 and 3% O3 with an ozone concentration of 60mg/ml via intra-peritoneal injection. After three days, blood samples were obtained to estimate serum urea and creatinine. Kidney tissues were processed for measurement of malondialdehyde (MDA), superoxide dismutase (SOD) and glutathione peroxidase (GPx), and light and electron microscopic examination. Morphometric and statistical analyses were performed.
Results: The ESWL group revealed significantly high levels of serum creatinine and urea and tissue MDA, and decreased SOD and GPx levels. There were shrinkage of glomeruli, distorted feet processes and thick basement membrane. Tubules were distorted with cytoplasmic vacuoles. The area% of collagen fibers and iNOS and HSP-70 immunoreactivity increased while the glomerular diameter decreased. Medical ozone caused marked improvement, both structurally and functionally.
Conclusion: Medical ozone can ameliorate ESWL-induced AKI via its antioxidant and anti-inflammatory properties.