title: Impact of perioperative administration of 6 % hydroxyethyl starch 130/0.4 on serum cystatin C-derived renal function after radical prostatectomy: a single-centre retrospective study.
abstract: Hydroxyethyl starch (HES) is used for repletion of acute intravasal volume loss in surgical patients. However, in critically ill patients, HES is associated with acute kidney injury. We aimed to evaluate the effect of HES on perioperative cystatin C (cystC)-derived estimated glomerular filtration rates (eGFRcystC) in patients undergoing open and robot-assisted radical prostatectomy.
  
  
  
  In this retrospective study we included 179 patients who underwent general anaesthesia for radical prostatectomy received HES perioperatively, and had complete cystC and fluid therapy data available. CystC and corresponding eGFRcystC at postoperative days 1, 3, and 5 were compared with preoperative baseline using Wilcox rank-sum test.
  
  
  
  In 179 eligible patients, 6 % HES 130/0.4 was administered in a median (25th to 75th percentile) dose of 1000 mL (1000 to 1000 mL). Baseline eGFRcystC was 109.4 mL/min (100.3 to 118.7 mL/min). eGFRcystC on postoperative days 1, 3, and 5 was 120.4 mL/min (109.4 to 134.0 mL/min), 120.4 mL/min (109.4 to 132.9 mL/min), and 117.9 mL/min (106.6 to 129.8 mL/min), respectively (p < 0.001 compared with baseline, each). No patient had an eGFRcystC-decrease of ≥25 % from baseline.
  
  
  
  The results indicate that the administration of a median dose of 1000 mL of 6 % HES 130/0.4 is not associated with a postoperative deterioration of renal function in patients with normal to near-normal baseline renal function undergoing radical prostatectomy.
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany. suedfeld.research@gmx.de.
authors: Stefan
authors: S
authors: Südfeld
authors: Martini Clinic, Prostate Cancer Center at University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Sami R
authors: SR
authors: Leyh-Bannurah
authors: Martini Clinic, Prostate Cancer Center at University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Lars
authors: L
authors: Budäus
authors: Martini Clinic, Prostate Cancer Center at University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Markus
authors: M
authors: Graefen
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Philip C
authors: PC
authors: Reese
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Franziska
authors: F
authors: von Breunig
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Daniel A
authors: DA
authors: Reuter
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany.
authors: Bernd
authors: B
authors: Saugel
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology; D000368:Aged; D016638:Critical Illness; D055316:Cystatin C / Q000097:blood*; D005440:Fluid Therapy / Q000379:methods; D005919:Glomerular Filtration Rate; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage* / Q000009:adverse effects; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D010952:Plasma Substitutes / Q000008:administration & dosage* / Q000009:adverse effects; D011468:Prostatectomy / Q000379:methods*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D013997:Time Factors
chemical_list: D055316:Cystatin C; D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes
keywords: Acute kidney injury; Anesthesia; Kidney function tests; Perioperative period