title: Reversal of acute renal failure using hemodilution with hydroxyethyl starch.
abstract: Acute renal failure (ARF) was induced in two groups of unilaterally nephrectomized dogs by occluding the renal artery, vein, and ureter of the remaining kidney for 2 hours. The control group (Group I), had no therapy; in the experimental group (Group II), isovolemic hemodilution was carried out using 6% hydroxy ethyl starch (HES) as diluent. The hematocrit in the experimental animals was lowered from 41.62 +/- 3.6% to 23.75 +/- 5.2% after renal occlusion. The mean arterial pressure and the mean pulmonary arterial pressure were unchanged in either group. Cardiac output increased following hemodilution from 1.66 +/- 0.35 to 2.70 +/- 0.50 L/min while it remained unchanged in Group I. Control animals developed ARF characterized by progressive rise in serum creatinine concentration and death. Only 1/7 Group I animals was alive on day 7 compared to 7/7 of Group II (p less than 0.01). ARF that developed initially in Group II began to resolve after day 4. There was a progressive and significant fall in serum creatinine concentration from 6.48 +/- 0.67 mg/dl on day 4 to 4.08 +/- 0.83 mg/dl on day 7 (p less than 0.001). Immediate isovolemic hemodilution with HES can reverse ARF induced by ischemia.
mesh_terms: D058186:Acute Kidney Injury / Q000628:therapy*; D000818:Animals; D001794:Blood Pressure; D002302:Cardiac Output; D003404:Creatinine / Q000097:blood; D004285:Dogs; D005260:Female; D006400:Hematocrit; D006438:Hemodilution; D006895:Hydroxyethyl Starch Derivatives / Q000627:therapeutic use*; D007511:Ischemia / Q000150:complications; D007668:Kidney / Q000098:blood supply; D008297:Male; D011651:Pulmonary Artery; D013213:Starch / Q000031:analogs & derivatives*; D013997:Time Factors
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D013213:Starch; D003404:Creatinine