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Impact of 6% hydroxyethyl starch 130/0.42 and 4% gelatin on renal function in a pediatric animal model
Lars Witt1, Silke Glage, Katharina Schulz
1Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
Insights
Moderate doses of artificial colloids, including hydroxyethyl starch (HES) and gelatin (GEL), did not significantly impact renal function in piglets. This pediatric animal study suggests no immediate renal risk, but further clinical research is needed.
Area of Science:
- Pediatric Nephrology
- Critical Care Medicine
- Pharmacology
Background:
- Artificial colloids like hydroxyethyl starch (HES) and gelatin (GEL) are used for hemorrhagic shock in children.
- Potential renal side effects in critically ill adults are a concern.
- The perioperative impact of colloid infusion on renal function in both adults and children requires clarification.
Purpose of the Study:
- To investigate the impact of single doses of artificial colloids on renal function tests in a pediatric animal model.
- To test the hypothesis that moderate doses of 6% HES or 4% GEL do not seriously affect renal function in healthy piglets.
Main Methods:
- Fifteen sedated piglets were randomized into three groups: HES infusion, GEL infusion, or balanced electrolyte solution (control).
- Infusions were administered at 20 ml·kg(-1) over 30 minutes.
- Renal function was assessed via serum and urine tests, and renal biopsies were taken before and 7 days post-infusion.
Main Results:
- All measured renal function tests (creatinine, urea, cystatin C, neutrophil gelatinase-associated lipocalin) remained within normal ranges for all groups.
- Microscopic examination of renal tissues showed no significant alterations, including tubular necrosis or inflammation.
Conclusions:
- In this pediatric animal model, moderate doses of artificial colloids (HES and GEL) did not demonstrate a relevant impact on renal function.
- Further clinical studies are essential to definitively assess the risk of renal impairment associated with HES and GEL administration during major pediatric surgery.
Objectives:
Artificial colloids, frequently used to prevent hemorrhagic shock in children, may induce serious renal side effects in critically ill adult patients. The impact of perioperative colloid infusion on the renal function in adults and children remains unclear.
Aim:
To determine the impact of single doses of artificial colloids on renal function tests, we conducted an experimental animal study. We hypothesized that neither the infusion of moderate doses of 6% hydroxyethyl starch (HES) nor of 4% gelatin (GEL) would have a serious impact on the renal function of healthy piglets.
Methods:
Fifteen sedated piglets were randomly assigned to receive an infusion of either 20 ml·kg(-1) HES or GEL or a balanced electrolyte solution (BS, control group) over 30 min. Before and 7 days after infusion, serum and urine renal function tests were recorded and renal biopsies were taken.
Results:
Serum and urine renal function tests (e.g., creatinine, urea, cystatin C, and neutrophil gelatinase-associated lipocalin) were within normal ranges, and a microscopic examination of the renal tissue in all groups revealed no major alterations such as tubular necrosis, interstitial bleeding, interstitial inflammation, or vacuoles.
Conclusions:
In this pediatric animal model, the infusion of moderate doses of artificial colloids was not found to have any relevant impact on renal function. Further clinical investigations are necessary to provide a conclusive assessment of the risk for renal impairment after HES and GEL administration during major pediatric surgery.
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