title: Hydroxyethyl starch (HES) does not directly affect renal function in patients with no prior renal impairment.
abstract: OBJECTIVE
  To examine the effects of hydroxyethyl starch (HES) on renal function.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Operating theatre of a university hospital.
  
  
  METHODS
  60 ASA physical status I and II male patients undergoing middle ear surgery.
  
  
  METHODS
  Patients received either lactated Ringer's solution (LRS) or one of three HES solutions. The HES solutions were administered in a dose of 15 mL/kg bodyweight (bw), the Ringer's solution in a dose of 60 mL/kg bw, after induction of anesthesia over a period of one hour.
  
  
  METHODS
  Blood and urine samples for hormone and enzyme tests were obtained at defined times before, during, and after surgery. Urine excretion, glomerular filtration rate (GFR), renal plasma flow, and routine hemodynamic parameters were measured simultaneously.
  
  
  RESULTS
  There were no significant intergroup differences regarding GFR, renal plasma flow, or tubular and glomerular integrity as measured by specific proteins and enzymes (alpha-1-microglobulin, Tamm-Horsfall-protein, immunoglobulin G, and N-acetyl-beta-D-glucosaminidase). Arginine vasopressin decreased in all groups during and following anesthesia, aldosterone and plasma renin activity decreased only in the HES groups, and angiotensin II decreased only in the HES 200/0.5 group. Central venous pressure increased during fluid administration in the LRS group and returned to baseline sooner in the HES groups.
  
  
  CONCLUSIONS
  Hydroxyethyl starch administration appears to be risk-free with regard to renal function in patients without preexisting renal dysfunction who undergo general anesthesia. The relevance of the decrease in aldosterone following HES therapy needs further investigation.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, Germany. marius.g.dehne@chiru.med.uni-giessen.de
authors.forename: M G
authors.initials: MG
authors.lastname: Dehne
authors.forename: J
authors.initials: J
authors.lastname: Mühling
authors.forename: A
authors.initials: A
authors.lastname: Sablotzki
authors.forename: K
authors.initials: K
authors.lastname: Dehne
authors.forename: N
authors.initials: N
authors.lastname: Sucke
authors.forename: G
authors.initials: G
authors.lastname: Hempelmann
mesh_terms: D000328:Adult; D000368:Aged; D000758:Anesthesia; D015415:Biomarkers; D002496:Central Venous Pressure / Q000187:drug effects; D003404:Creatinine / Q000652:urine; D004432:Ear, Middle / Q000601:surgery; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006728:Hormones / Q000097:blood; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects*; D007552:Isotonic Solutions; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000009:adverse effects*; D011446:Prospective Studies; D012079:Renal Circulation / Q000187:drug effects; D000077331:Ringer's Solution; D014563:Urodynamics / Q000187:drug effects
chemical_list: D015415:Biomarkers; D006728:Hormones; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077331:Ringer's Solution; D003404:Creatinine