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Nephrotoxicity of hemoglobin solutions
1Department of Surgery, Texas Tech University Health Sciences Center, School of Medicine, Lubbock 79430.
Biomaterials, Artificial Cells, and Artificial Organs
|January 1, 1990
Summary
Hemoglobin solutions (HbS) can cause kidney damage, but purification and crosslinking prevent this. Protecting kidneys with alkalinization or mannitol ensures safe hemoglobin-based oxygen carriers.
Area of Science:
- Biomedical Engineering
- Nephrology
- Pharmacology
Background:
- Nephrotoxicity is a significant challenge for hemoglobin solutions (HbS) used as blood substitutes.
- Understanding and mitigating HbS-induced kidney damage is crucial for clinical application.
Purpose of the Study:
- To investigate the nephrotoxic potential of different hemoglobin solutions (HbS) in rabbits.
- To identify key factors in HbS formulation that influence kidney function and histology.
Main Methods:
- Five distinct HbS formulations were administered to rabbits, replacing one-third of blood volume.
- Renal function was assessed via PAH clearance, creatinine clearance, fractional sodium excretion, and urine/plasma osmolarity.
- Kidney histology was evaluated 24 hours post-administration.
Main Results:
- HbS-I (impure, uncrosslinked), HbS-II (pure, uncrosslinked), and HbS-III (purified, crosslinked) showed significant nephrotoxicity.
- HbS-IV (purified, crosslinked, pH 8.4) and HbS-V (purified, crosslinked, with mannitol) were well tolerated.
- Nephrotoxicity decreased with increasing Hb purification and crosslinking.
Conclusions:
- Complete purification and crosslinking of HbS are essential to prevent nephrotoxicity.
- Alkalinizing urine (pH 8.4) or adding mannitol can further protect the kidneys from HbS-induced damage.
- Optimized HbS formulations hold promise for safe blood volume replacement.
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