title: The effect of HES (130/0.4) usage as the priming solution on renal function in children undergoing cardiac surgery.
abstract: BACKGROUND
  Experience with hydroxyethyl starch (HES) in children is limited. This study was conducted to observe the effects of HES or Ringer's lactate (RL) usage as the priming solution on renal functions in children undergoing cardiac surgery.
  
  
  METHODS
  After ethical committee approval and parent informed consent, 24 patients were included in this prospective, randomized study. During cardiopulmonary bypass (CPB), Group I received RL and Group II received HES (130/0.4) as priming solution. Serum creatinine, blood urea nitrogen (BUN), β2-microglobulin, cystatin C, and urinary albumin and creatinine, serum, and urine electrolytes were analyzed after the induction (T1), before CPB (T2), during CPB (T3), after CPB (T4), at the end of the operation (T5), on 24th hour (T6), and on 48th hour postoperatively (T7). Fractional sodium excretion (FENa), urinary albumin/creatinine ratio, and creatinine clearance were calculated. Drainage, urine output, inotropes, diuretics, and blood requirements were recorded.
  
  
  RESULTS
  In both the groups, β2-microglobulin was decreased during CPB and cystatin C was decreased at T3,T4, and T5 periods (p < 0.05) and the levels remained within the normal range. Creatinine clearance did not differ in the HES group, but increased in the RL group (p < 0.05). Urine albumin/creatinine ratio was increased (p < 0.05) after CPB in the HES group, and it increased at T3, T4, and T5 in the RL group (p < 0.05). There were no differences in cystatin C, β2-microglobulin, FENa, urine albumin/creatinine ratio, creatinine clearance, total fluid amount, urine output, drainage, and inotropic and diuretic requirements between the groups.
  
  
  CONCLUSIONS
  We conclude that usage of HES (130/0.4) did not have negative effects on renal function, and it can be used as a priming solution in pediatric patients undergoing cardiac surgery.
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
authors.forename: Fulya G
authors.initials: FG
authors.lastname: Akkucuk
authors.forename: Meral
authors.initials: M
authors.lastname: Kanbak
authors.forename: Banu
authors.initials: B
authors.lastname: Ayhan
authors.forename: Bilge
authors.initials: B
authors.lastname: Celebioglu
authors.forename: Ulku
authors.initials: U
authors.lastname: Aypar
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D000293:Adolescent; D001774:Blood Chemical Analysis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000379:methods; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003404:Creatinine / Q000652:urine; D055316:Cystatin C / Q000097:blood; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007430:Intraoperative Care / Q000379:methods; D007552:Isotonic Solutions / Q000494:pharmacology; D007677:Kidney Function Tests; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D000077325:Ringer's Lactate; D018709:Statistics, Nonparametric; D016482:Urinalysis
chemical_list: D055316:Cystatin C; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D000077325:Ringer's Lactate; D003404:Creatinine