Evaluation of postoperative kidney function after administration of 6% hydroxyethyl starch during living-donor nephrecto
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ORIGINAL ARTICLE
Evaluation of postoperative kidney function after administration of 6% hydroxyethyl starch during living‑donor nephrectomy for transplantation Kazuhiro Shirozu1 · Kaoru Umehara2 · Masatsugu Watanabe1 · Akihiro Tsuchimoto3 · Yasuhiro Okabe4 · Ken Yamaura5 Received: 17 April 2020 / Accepted: 26 September 2020 © Japanese Society of Anesthesiologists 2020
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 m 2) and POD 14 (26.0 vs. 25.9 mL/min/1.73 m 2), 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. Keywords Living donor kidney nephrectomy · Hydroxyethyl starch · Kidney injury · Estimated glomerular filtration rate
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00540-020-02862-z) contains supplementary material, which is available to authorized users.
1
Kaoru Umehara kaoru‑[email protected]
Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, 3‑1‑1 Maidashi, Higashi‑ku, Fukuoka 812‑8582, Japan
2
Masatsugu Watanabe [email protected]
Operating Rooms, Kyushu University Hospital, Fukuoka, Japan
3
Akihiro Tsuchimoto [email protected]‑u.ac.jp
Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
4
Yasuhiro Okabe y‑[email protected]‑u.ac.jp
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
5
Department of Anesthesiology and Criti
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