E-Mail karger@karger.com Original Report: Laboratory Investigation Am J Nephrol 2013;38:368–378 DOI: 10.1159/000355537 Perspective on Rhabdomyolysis-Induced Acute Kidney Injury and New Treatment Options Sukru Ulusoy a Gulsum Ozkan a Mehmet Alkanat b Sevdegül Mungan c Esin Yuluğ d Asım Orem e Departments of a Nephrology, b Physiology, c Pathology, d Histology and Embryology, and e Biochemistry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey cal score, iNOS, caspase 3, caspase 1 and calpain 1 expression in the rhabdomyolysis group compared to the controls and a decrease in eNOS expression. In the rhabdomyolysis + GSPE group, however, there was a decrease in these media- tors, together with an increase in eNOS expression. Conclu- sion: This study shows for the first time in the literature that calpain 1 is involved in the pathogenesis of rhabdomyolysis- induced AKI, and that GSPE may have a renoprotective ef- fect. © 2013 S. Karger AG, Basel Introduction Rhabdomyolysis is a life-threatening condition char- acterized by damage to striated muscle cells, release into the circulation of intracellular contents and the initiation of various clinical and laboratory abnormalities. It may have traumatic or nontraumatic causes [1]. One of its most important complications is rhabdomyolysis-in- duced acute kidney injury (AKI), reported at levels of 4–50% in different publications and capable of causing mortality of up to 8% despite technological advances [2, 3]. Key Words Apoptosis · Caspases · Calpain 1 · Grape seed proanthocyanidin extract · Rhabdomyolysis induced acute kidney injury Abstract Aim: The purpose of this study was to assess the role of cas- pase-dependent apoptosis, caspase 1, calpain 1, inducible nitric oxide synthase (iNOS) and endothelial nitric oxide syn- thase (eNOS) and the protective effect of grape seed proan- thocyanidin extract (GSPE) in the development of rhabdo- myolysis-induced acute kidney injury (AKI). Materials and Methods: Twenty-one rats were divided into 3 groups – con- trol, rhabdomyolysis and rhabdomyolysis + GSPE. Rhabdo- myolysis was induced in the rhabdomyolysis and rhabdomy- olysis + GSPE groups with the injection into both hind limbs of 10 ml/kg hypertonic (50%) glycerol following 24-hour de- hydration on the 6th day. The rhabdomyolysis + GSPE group was given GSPE at 100 mg/kg by gavage for 7 days. The ex- periment was concluded 48 h after glycerol injection. Blood specimens were collected, and kidney tissues were extracted for histopathological examination. Results: We identified an increase in blood urea nitrogen, creatinine, histopathologi- Received: July 23, 2013 Accepted: September 8, 2013 Published online: October 22, 2013 Nephrolo gy American Journal of Dr. Şükrü Ulusoy Karadeniz Teknik Üniversitesi, Tıp Fakültesi Nefroloji Bilim Dalı TR–61080 Trabzon (Turkey) E-Mail sulusoy2002  @  yahoo.com © 2013 S. Karger AG, Basel 0250–8095/13/0385–0368$38.00/0 www.karger.com/ajn Downloaded by: Karadeniz Teknik University 194.27.90.188 - 10/29/2013 11:47:45 AM