Hemostatic approach modulates CKD phenotype in subtotal nephrectomy rat model

The subtotal nephrectomy rat model remains a cornerstone for studying chronic kidney disease (CKD) progression and modification. In this model, surgical pole resection is a widely used approach to create the remnant kidney. However, variations in hemostatic methods during parenchymal transection, whether active (fibrin glue, thrombin), passive (collagen/gelatin matrices), or thermal (electrocautery), may give rise to distinct postoperative phenotypes due to varying degrees of vascular injury, fibrosis, and inflammatory activation. In this study, we summarize experimental findings comparing mean arterial pressure (MAP), electrolyte handling, and creatinine clearance (CrCl) in nephrectomized rats treated with active, passive, or thermal hemostatic agents. To do this, a ⅔ nephrectomy was performed on eighteen male Sprague–Dawley rats by complete removal of the right kidney and surgical resection of the upper and lower poles of the left kidney. Following pole resection, hemostasis was achieved using one of three techniques: Tisseel, Surgifoam, or electrocautery (n = 6 per group). Following recovery, post-nephrectomy baseline (BL) CrCl was established on a normal diet; the animals were subsequently challenged with a high-potassium diet (5% KCl; HKD) for seven days. At day seven, we found animals in the Surgifoam group to have significantly higher CrCl when compared to animals in the cautery group. Additionally, animals in both the Surgifoam and Tisseel groups yielded higher CrCl on day seven relative to their established BL, while animals in the cautery group showed little to no change. After discontinuing the HKD, the animals were challenged with a high-sodium diet (4% NaCl; HND) for six weeks, where we observed those in the Surgifoam group to have significantly lower MAP at the six-week mark when compared to animals in the electrocautery group. Because sodium excretion was similar in the Surgifoam and electrocautery groups, our findings suggest that Surgifoam-treated nephrectomized rats on HND exhibit improved pressure-natriuresis compared to those treated with electrocautery. In summary, all three groups developed hallmark features of CKD; however, the cautery group was seen to be markedly more susceptible to diet-induced fluctuations in mean arterial pressure, and exhibited impaired creatinine clearance and pressure-natriuresis relative to the Surgifoam and Tisseel group. Future work will include histological analysis of renal and cardiac tissues to quantify fibrotic remodeling and assessment of left ventricular hypertrophy, providing a more comprehensive understanding of how hemostatic methods influence phenotypic outcomes in the subtotal nephrectomy model. Exploring how varying surgical interventions modulate these processes will refine the translational relevance of the model and reproducibility in studies of CKD progression and modification. This abstract was presented at the American Physiology Summit 2026 and is only available in HTML format. There is no downloadable file or PDF version. The Physiology editorial board was not involved in the peer review process.