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Evaluation of postoperative kidney function after administration of 6% hydroxyethyl starch during living-donor nephrectomy for transplantation

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Abstract

Purpose

We aimed to investigate whether 6% HES 130/0.4 was associated with postoperative reduction of estimated glomerular filtration rate (eGFR) in donor patients who underwent nephrectomy for living kidney transplantation.

Methods

This retrospective study included 213 living kidney transplant donors treated at Kyushu University Hospital in Japan from April 2014 to March 2018. Patients who were administered 6% HES 130/0.4 were allocated in the HES group (n = 108), and those who were not were allocated in the control group (n = 105). The postoperative decrements in estimated glomerular filtration rates (eGFRs) from preoperative values were calculated on postoperative days (PODs) 1, 3, and 14. Decline in kidney function (DKF) according to the Kidney Disease: Improving Global Outcomes (KDIGO) classification were analyzed by multivariable-adjusted ordinal logistic regression to estimate odds ratios (ORs) for postoperative DKF.

Results

In HES group, administration amount of HES was median 9.4 [interquartile range: 8.2–14.3] ml/kg. Postoperative decrements in eGFR were similar in the control and HES groups on POD 1 (control group: mean 32.0 vs. HES group: 33.0 mL/min/1.73 m2), same as POD 3 (21.1 vs. 22.4 mL/min/1.73 m2) and POD 14 (26.0 vs. 25.9 mL/min/1.73 m2), even after adjusting for confounding factors. The multivariable-adjusted ORs for postoperative DKF did not significantly increase in the HES group on POD 1 (OR: 0.88), POD 3 (OR: 0.96), and POD 14 (OR: 0.52) compared with the control group.

Conclusion

Six percent HES 130/0.4 is not associated with postoperative renal dysfunction in donor patients undergoing nephrectomy for kidney transplantation.

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Funding

Supported by departmental funding only.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Kazuhiro Shirozu & Masatsugu Watanabe

  2. Operating Rooms, Kyushu University Hospital, Fukuoka, Japan

    Kaoru Umehara

  3. Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Akihiro Tsuchimoto

  4. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Yasuhiro Okabe

  5. Department of Anesthesiology and Critical Care Medicine, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan

    Ken Yamaura

Authors
  1. Kazuhiro Shirozu
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  2. Kaoru Umehara
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  3. Masatsugu Watanabe
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  4. Akihiro Tsuchimoto
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  5. Yasuhiro Okabe
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  6. Ken Yamaura
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Contributions

KS, YO and AT design the study, collected data, evaluated the data and drafted the manuscript. KU performed the statistical analyses and revised the manuscript. MW designed the study, and evaluated the data. KY evaluated the data and revised the manuscript.

Corresponding author

Correspondence to Kazuhiro Shirozu.

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The authors declare that they have no conflict of interest.

IRB

Faculty of Medical sciences, Kyushu University Institutional Review Board Clinical Research number #30–53.

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Shirozu, K., Umehara, K., Watanabe, M. et al. Evaluation of postoperative kidney function after administration of 6% hydroxyethyl starch during living-donor nephrectomy for transplantation. J Anesth 35, 59–67 (2021). https://doi.org/10.1007/s00540-020-02862-z

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  • DOI: https://doi.org/10.1007/s00540-020-02862-z

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