Renoprotective effects of tadalafil on ischemia-reperfusion injury during partial nephrectomy in an animal model

Background: The safe time for partial nephrectomy is reported as 25 min for warm ischemia. However, even in the case of arterial ligation within 25 min, acute renal injury occurs, which causes serious complications in patients with chronic renal disease. Various drugs are being studied, but the effectiveness and safety are insufficient. This study aims to prove that tadalafil has a protective effect on renal function. Methods: We orally treated tadalafil for 14 days prior to ischemic-reperfusion (IR) injury with partial nephrectomy. 24 hours after IR injury, blood and kidney samples were collected for biochemical and molecular analysis. Serum BUN, serum creatinine and urine KIM-1 were analyzed from blood samples and collected kidney tissue samples were used for qPCR and histology analysis. Results: We observed that there was no effect on blood urea nitrogen or creatine levels, but it improved damaged kidney tissue by increasing number of glomeruli. Tadalafil protected kidney in the loss of glomerulus from IR injury. As oxidative stress related markers, tadalafil was effective in reducing iNOS, eNOS, and MPO expression. In addition, we confirmed that tadalafil significantly suppressed inflammatory related gene expressions, such as TNF-α, IL-1β, IL-6, CD4 and CD8. Conclusions: In conclusion, it was demonstrated that tadalafil inhibits oxidative stress and inflammation and increases renal tissue recovery ability in ischemic-reperfusion damage during partial nephrectomy.