title: Impact of high doses of 6% hydroxyethyl starch 130/0.42 and 4% gelatin on renal function in a pediatric animal model.
abstract: OBJECTIVE
  Despite serious renal side effects in critically ill adult patients, artificial colloids are still fundamental components of perioperative fluid therapy in infants and children, although the impact of 6% hydroxyethyl starch (HES) and 4% gelatin (GEL) on renal function during pediatric surgery has not been identified yet.
  
  
  OBJECTIVE
  To determine the impact of high doses of artificial colloids on renal function, we conducted an experimental animal study and hypothesized that neither the infusion of HES nor of GEL would have a serious impact on renal function.
  
  
  METHODS
  Fifteen sedated piglets were randomly assigned to receive an infusion of either 50 ml · kg(-1) HES or GEL, or a balanced electrolyte solution (crystalloid group). Before and 1 week after infusion, serum and urine renal function tests were recorded and renal biopsies were taken.
  
  
  RESULTS
  Serum and urine renal function tests revealed no increase after administration of HES and GEL, and only a discrete increase in serum creatinine (median 9.8 μmol · l(-1), 95% CI 4.0-19.1) in the crystalloid group. Histopathological examination indicated a sparsely, multifocal infiltration of mononuclear cells in all groups and an unspecific pyelectasia of one animal in the GEL group.
  
  
  CONCLUSIONS
  After high doses of HES or GEL in piglets, no relevant impact on renal function could be found. These results confirm that AKI after HES or GEL is very unlikely in hemodynamically stable perioperative patients with normal renal function.
authors.affiliation: Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Witt
authors.affiliation: Institute of Laboratory Animal Science and Experimental Pathology, Hanover Medical School, Hanover, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Glage
authors.affiliation: Institute for Clinical Chemistry, Hanover Medical School, Hanover, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Lichtinghagen
authors.affiliation: Department of Paediatric Nephrology, Hanover Medical School, Hanover, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Pape
authors.affiliation: Department for Paediatric Cardiology and Intensive Care, Hanover Medical School, Hanover, Germany.
authors.forename: Dietmar
authors.initials: D
authors.lastname: Boethig
authors.affiliation: Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
authors.forename: Nils
authors.initials: N
authors.lastname: Dennhardt
authors.affiliation: Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Heiderich
authors.affiliation: Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Leffler
authors.affiliation: Clinic of Anaesthesiology, Hanover Medical School, Hanover, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Sümpelmann
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005780:Gelatin / Q000009:adverse effects*; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects*; D007668:Kidney / Q000503:physiopathology; D007674:Kidney Diseases / Q000139:chemically induced*; D007677:Kidney Function Tests; D010952:Plasma Substitutes / Q000009:adverse effects*; 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