The effect of hyperbaric oxygen therapy on rhabdomyolysis-induced myoglobinuric acute renal failure in rats

Myoglobinuric acute renal failure (MARF) may develop after severe muscle injury. Heme oxygenase-1 (HO-1), a stress-response protein, has been implicated as a protective agent against MARF. We hypothesized that hyperbaric oxygen therapy (HBOT) may alleviate MARF by inducing renal HO-1 expression. Wistar-Albino rats were randomly assigned into three groups: Control (n=4), MARF (n=8), MARF+HBO (n=8). MARF was induced by intramuscular glycerol (50%, 8mL/kg) injection. Saline (8mL/kg) was injected into the hind limb of the animals in the control group. Animals in the MARF+HBO group received two sessions of HBO therapy (90min at 2.5atm) 2 and 18h after glycerol injection. Serum and tissue samples were taken at 24h. Serum urea and creatinine levels increased in the MARF and MARF+HBO groups confirming the development of MARF. But, serum urea and creatinine levels were similar in MARF and MARF+HBO groups. Oxidative stress parameters were similar among all groups. Histological renal injury score was similar in MARF and MARF+HBO groups. HO-1 level, determined by immunohistochemistry, was significantly higher in MARF and MARF+HBO groups, compared to the control group. Although HO-1 level in MARF+HBO group was higher than MARF group, it was not statistically significant. We found that HBOT did not reduce renal injury in experimental MARF model. HBOT is used to reduce the muscle damage after crush injury, which may be accompanied by MARF. Therefore, more studies are needed to understand the effects of HBO treatment on renal functions after MARF.