Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Schimetta, W; Kröll, W; Pölz, W; Colombo, T; Gassmayr, SE; Sirtl, C; List, WF.
Serum elimination of HES in moderately reduced renal function
Anasthesiol Intensivmed Notfallmed Schmerzther. 2002; 37(8):468-474
Doi: 10.1055/s-2002-33159
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Kröll Wolfgang
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- Abstract:
- Objective: If or at which conditions hydroxyethyl starch (HES) is administerable in presence of reduced renal function, is a question still to be answered. The aim of this study was to give hints, whether a moderately reduced renal function (creatinine concentrations around 2,0 mg/dl) induces clinically relevant changes in pharmacokinetics of HES 200/0.5. Methods: Each of 8 test persons with elevated serum creatinine concentration (1.6-2.9 mg/dl - group H) and 6 test persons with normal serum creatinine concentration (0.7 - 1.1 mg/dl - group N) were infused with 500 ml of 10% HES 200/0.5 within 30 minutes. Concentrations of creatinine and HES were measured before starting the infusion, immediately after the end of the infusion as well as 30 minutes, 60 minutes, 3 hours, 6 hours and 24 hours I ater. Additionally in group H also the mean values of the intravital molecular mass of HES (weight average molecular weight Mw and number average molecular weight Mn) were assessed. HES concentrations were quantified by the hexokinase method. HES molecular mass spectrum was analyzed by an HPLC method. The mean dwelling time served as an indicator for HES pharmacokinetics. Results: The serum creatinine concentrations remained stable within the observation period. The HES serum concentrations were comparable between the two groups at any examination. Immediately after the end of the infusion, the HES serum concentration reached a maximum of 17.5 mg/ml (group H) and 17.4 mg/ml (group N), 24 hours later HES serum concentration ranged between 1.4 and 2.0 mg/ml (group H) respectively between 1.1 and 2.8 mg/ml (group N). The calculation for the mean dwelling time resulted in 5.0 hours for group H and 4.5 hours for group N (median values) without significant difference between the groups (p = 0.147). At the end of the observation period, the mean values of the molecular weight Mw and Mn measured in group H - reached the closest convergence (Mw: 71,000 Dalton; Mn: 58,000 Dalton; Mw/Mn: 1.32 - median values). Conclusion: Compensated renal failure with serum creatinine concentrations up to 2.9 mg/dl does not significantly delay the serum elimination of HES 200/0.5. All findings support the opinion that a peri-operative volume substitution with HES 200/0.5 can be applied in patients suffering from moderately reduced renal function in the same way as in patients without any renal impairment.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Chromatography, High Pressure Liquid -
- Creatinine - blood
- Female - blood
- Half-Life - blood
- Hetastarch - blood
- Humans - blood
- Kidney Diseases - metabolism
- Kidney Function Tests - metabolism
- Male - metabolism
- Molecular Weight - metabolism
- Plasma Substitutes - chemistry
- Find related publications in this database (Keywords)
- hydroxyethyl starch
- reduced renal function
- moderate renal failure
- mean dwelling time
- serum creatinine