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Hydroxyethyl starch impairs renal water reabsorption in patients with cardiac shock

  • Zhi-Jie Yue1
  • Zhan Shi2
  • Zhuo Xie3
  • Chun-Ming Li2
  • Zhi-Yuan Guo2
  • Meng Guo2
  • Zhen-Guo Wang2
  • Da-Jie Hao1

1Department of Cardiology, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, 030032 Taiyuan, Shanxi, China

2Department of Cardiology, Affiliated Hospital of Army Medical University NCO School, 050047 Shijiazhuang, Hebei, China

3Department of Radiology, Army Medical University NCO School, 050081 Shijiazhuang, Hebei, China

DOI: 10.22514/sv.2021.136

Submitted: 13 June 2021 Accepted: 14 July 2021

Online publish date: 10 August 2021

*Corresponding Author(s): Zhi-Jie Yue E-mail: yue_fmmu@163.com
*Corresponding Author(s): Da-Jie Hao E-mail: haodajie1119@163.com

Abstract

Hydroxyethyl starch (HES) has been shown to be correlated with increased risk of renal dysfunction. While almost all articles focus on the side effect of HES on glomerular filtration function, it is barely known to us about the effect of HES on renal water reabsorption. The objective of this study is to assess the effect of HES on renal water reabsorption in patients with cardiac shock. In a retrospective cohort-study, 162 patients admitted to the department of cardiology and diagnosed as cardiac shock were randomized into four groups, depending on different treatments of NaCl (NaCl group), HES (HES group), HES and dopamine (HES + DOP group), HES and norepinephrine (HES + NE group). Data collected included age, sex, blood pressure, heart rate, left ventricular ejection fraction, serum creatinine, blood urea nitrogen, urine specific gravity, urine volume, oxygen saturation serum, drug dosage, and so on. Indices related to renal function were recorded before and after the anti-shock treatments. The comparison was performed among four groups at day 0 or at day 3, and indices of the same group were compared between day 0 and day 3. We found that HES and norepinephrine reduced the urine specific gravity in HES group (day 0 vs day 3, 1.019± 0.006 vs 1.012 ± 0.005, p < 0.001) and in HES + NE group (day 0 vs day 3, 1.019 ± 0.006 vs 1.011 ± 0.004, p < 0.001). Dopamine increased the urine volume of HES-treated patients at day 3 (p < 0.001), and in the meantime dopamine preserved urine specific gravity during anti-shock treatment at day 3 (p = 0.13). In conclusion, hydroxyethyl starch caused injured function of renal water reabsorption, and dopamine protected renal water reabsorption in HES-treated patients via increased renal blood.


Keywords

Hydroxyethyl starch; Dopamine; Cardiac shock; Renal dysfunction


Cite and Share

Zhi-Jie Yue,Zhan Shi,Zhuo Xie,Chun-Ming Li,Zhi-Yuan Guo,Meng Guo,Zhen-Guo Wang,Da-Jie Hao. Hydroxyethyl starch impairs renal water reabsorption in patients with cardiac shock. Signa Vitae. 2021.doi:10.22514/sv.2021.136.

References

[1] Vincent J, De Backer D. Circulatory Shock. New England Journal of Medicine. 2013; 369: 1726–1734.

[2] Bhat BV, Plakkal N. Management of Shock in Neonates. Indian Journal of Pediatrics. 2015; 82: 923–929.

[3] Jentzer JC, Coons JC, Link CB, Schmidhofer M. Pharmacotherapy update on the use of vasopressors and inotropes in the intensive care unit. Journal of Cardiovascular Pharmacology and Therapeutics. 2015; 20: 249–260.

[4] Buerke M, Lemm H, Dietz S, Werdan K. Pathophysiology, diagnosis, and treatment of infarction-related cardiogenic shock. Herz. 2011; 36: 73–83.

[5] Scheeren T, Bakker J, De Backer D, Annane D, Asfar P, Boerma EC, et al. Current use of vasopressors in septic shock. Annals of Intensive Care. 2019; 9: 20.

[6] De Backer D, Creteur J, Silva E, Vincent J. Effects of dopamine, norepinephrine, and epinephrine on the splanchnic circulation in septic shock: which is best? Critical Care Medicine. 2003; 31: 1659–1667.

[7] Lagny M, Roediger L, Koch J, Dubois F, Senard M, Donneau A, et al. Hydroxyethyl Starch 130/0.4 and the Risk of Acute Kidney Injury after Cardiopulmonary Bypass: a Single-Center Retrospective Study. Journal of Cardiothoracic and Vascular Anesthesia. 2016; 30: 869–875.

[8] Ünal MN, Reinhart K. Understanding the Harms of HES: a Review of the Evidence to Date. Turkish Journal of Anaesthesiology and Reanimation. 2019; 47: 81–91.

[9] De Hert S, De Baerdemaeker L. Why hydroxyethyl starch solutions should not be banned from the operating room. Anaesthesiology Intensive Therapy. 2014; 46: 336–341.

[10] Reinhart K, Takala J. Hydroxyethyl Starches. Anesthesia & Analgesia. 2011; 112: 507–511.

[11] Wong YL, Lautenschläger I, Zitta K, Hummitzsch L, Parczany K, Steinfath M, et al. Effects of hydroxyethyl starch (HES 130/0.42) on endothelial and epithelial permeability in vitro. Toxicology in Vitro. 2019; 60: 36–43.

[12] Bellmann R, Feistritzer C, Wiedermann CJ. Effect of molecular weight and substitution on tissue uptake of hydroxyethyl starch: a meta-analysis of clinical studies. Clinical Pharmacokinetics. 2012; 51: 225–236.

[13] Mutter TC, Ruth CA, Dart AB. Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function. Cochrane Database of Systematic Reviews. 2013; CD007594.

[14] Gerhartl A, Hahn K, Neuhoff A, Friedl H, Förster CY, Wunder C, et al. Hydroxyethylstarch (130/0.4) tightens the blood-brain barrier in vitro. Brain Research. 2020; 1727: 146560.

[15] Bagshaw SM, Chawla LS. Hydroxyethyl starch for fluid resuscitation in critically ill patients. Canadian Journal of Anaesthesia. 2013; 60: 709–713.

[16] Bellomo R, Giantomasso DD. Noradrenaline and the kidney: friends or foes? Critical Care. 2001; 5: 294–298.

[17] Dalimonte MA, DeGrado JR, Anger KE. Vasoactive Agents for Adult Septic Shock: an Update and Review. Journal of Pharmacy Practice. 2020; 33: 523–532.

[18] Ichai C, Passeron C, Carles M, Bouregba M, Grimaud D. Prolonged low-dose dopamine infusion induces a transient improvement in renal function in hemodynamically stable, critically ill patients: a single-blind, prospective, controlled study. Critical Care Medicine. 2000; 28: 1329–1335.

[19] Hollis AR, Ousey JC, Palmer L, Stephen JO, Stoneham SJ, Boston RC, et al. Effects of norepinephrine and combined norepinephrine and fenoldopam infusion on systemic hemodynamics and indices of renal function in normotensive neonatal foals. Journal of Veterinary Internal Medicine. 2008; 22: 1210–1215.

[20] Albanèse J, Leone M, Garnier F, Bourgoin A, Antonini F, Martin C. Renal effects of norepinephrine in septic and nonseptic patients. Chest. 2004; 126: 534–539.

[21] Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Åneman A, et al. Hydroxyethyl starch 130/0.42 versus Ringer’s acetate in severe sepsis. the New England Journal of Medicine. 2012; 367: 124–134.

[22] Brunkhorst FM, Engel C, Bloos F, Meier-Hellmann A, Ragaller M, Weiler N, et al. Intensive Insulin Therapy and Pentastarch Resuscitation in Severe Sepsis. New England Journal of Medicine. 2008; 358: 125–139.


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