title: Impact of 6% hydroxyethyl starch 130/0.42 and 4% gelatin on renal function in a pediatric animal model.
abstract: OBJECTIVE
  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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Witt
authors.forename: Silke
authors.initials: S
authors.lastname: Glage
authors.forename: Katharina
authors.initials: K
authors.lastname: Schulz
authors.forename: Ralf
authors.initials: R
authors.lastname: Lichtinghagen
authors.forename: Arne
authors.initials: A
authors.lastname: Simann
authors.forename: Lars
authors.initials: L
authors.lastname: Pape
authors.forename: Robert
authors.initials: R
authors.lastname: Sümpelmann
mesh_terms: D000818:Animals; D005260:Female; D005780:Gelatin / Q000097:blood / Q000494:pharmacology* / Q000652:urine; D006895:Hydroxyethyl Starch Derivatives / Q000097:blood / Q000494:pharmacology* / Q000652:urine; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests / Q000706:statistics & numerical data; D023421:Models, Animal; D010952:Plasma Substitutes / Q000494:pharmacology*; D013552:Swine
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D005780:Gelatin
keywords: colloids; gelatin; hydroxyethyl starch; i.v. infusions; pediatric anesthesia; renal function; renal parameters