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Pharmacokinetics of hydroxyethyl starch
Cornelius Jungheinrich1, Thomas A Neff
1Clinical Research, Medical Scientific Affairs, Fresenius Kabi, Bad Homburg, Germany. Cornelius.Jungheinrich@fresenius-kabi.com
Clinical Pharmacokinetics
|June 22, 2005
Summary
New hydroxyethyl starch 130/0.4 offers improved pharmacokinetics and reduced tissue accumulation compared to older types. It shows minimal impact on coagulation and kidney function, even in renal impairment.
Area of Science:
- Pharmacology
- Nephrology
Background:
- Hydroxyethyl starch (HES) solutions are used as plasma volume expanders.
- Different HES specifications exhibit varying pharmacokinetic and pharmacodynamic properties.
- Recent advancements include HES 130/0.4 and new formulations of HES 670/0.75.
Purpose of the Study:
- To compare the pharmacokinetic and pharmacodynamic profiles of different HES types.
- To evaluate the safety and efficacy of HES 130/0.4, particularly in patients with renal insufficiency.
Main Methods:
- Pharmacokinetic analysis of HES distribution, metabolism, and excretion.
- Assessment of effects on blood coagulation factors (e.g., factor VIII, von Willebrand factor).
- Animal studies using (14)C tracers to measure tissue storage of HES.
Main Results:
- HES 130/0.4 demonstrates significantly lower plasma accumulation and higher clearance compared to HES 670/0.75 (hetastarch) and HES 200/0.5.
- Tissue storage is substantially lower for HES 130/0.4 than for HES 200/0.5 and hetastarch.
- HES 130/0.4 shows minimal influence on coagulation and no observed adverse effects on kidney function, even with high doses in renal impairment.
Conclusions:
- HES 130/0.4 offers a favorable pharmacokinetic profile, avoiding plasma and tissue accumulation.
- Its use is associated with minimal coagulation disturbances and preserved kidney function.
- HES 130/0.4 represents an improved option for volume expansion, including in patients with renal impairment.