• Xin Xu, Buwei Yu, Youwen Lv, Qing Cai, Mengya Li, Guifeng Li, Shunjie Chen, and Qifang Li.
• Department of Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-like Intelligence, Clinical Research Center for Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai 200434, PR China; Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Shanghai 200434, PR China.
• Am. J. Med. Sci. 2024 Dec 1; 368 (6): 660667660-667.

BackgroundAccording to evidences from clinical practices and experiments, renal denervation achieved by removing both the afferent and sympathetic nerves has therapeutic impacts on poor renal function and hypertension in chronic kidney disease (CKD). Epidural anesthesia is presumed to function on the target spine segments with a complete sympathetic block. Based on this perspective, we hypothesized that epidural block with lidocaine could ameliorate renal injury in CKD rats.Method And ResultsMale Sprague-Dawley rats weighing 250-300 g were randomized into four groups: control, CKD, CKD + sham, and CKD + epidural block with lidocaine groups. CKD was induced by resection of the lower and upper thirds of the left kidney followed by right nephrectomy one week later. Significant differences in renal function, sympathetic activation as well as renal fibrosis parameters were observed between CKD and control rats. These parameters corresponded with typical phenotypes of CKD rats. Epidural block with lidocaine improved renal function as well as renal fibrosis, and reversed the abnormalities of the renal function and cardiovascular parameters either fully or partially.ConclusionEpidural block with lidocaine confers renal protection, which is presumably mediated by decreasing sympathetic nerve activities in the renal region and other target organs in CKD.Copyright © 2024 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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