Administration of HES in elderly patients undergoing hip arthroplasty under spinal anesthesia is not associated with an increase in renal injury

Table 4 Renal function

Groups	D₀	D₁	D₂	D₃	D₄
p-NGAL (ng/ml)
HES	4.0 ± 0.3	4.2 ± 0.5	4.3 ± 0.5	4.2 ± 0.5	4.4 ± 0.6
LR	4.1 ± 0.8	4.0 ± 0.7	4.4 ± 0.9	4.1 ± 0.7	4.3 ± 0.8
u-NGAL (ng/ml)
HES	4.9 ± 0.8	5.1 ± 0.3	4.9 ± 0.4	5.2 ± 0.5	5.1 ± 0.4
LR	5.6 ± 0.7	5.2 ± 0.4	4.9 ± 0.3	5.0 ± 0.3	5.1 ± 0.3
p-IL18 (μg/l)
HES	79.3 ± 9.8	81.0 ± 10.4	84.2 ± 13.8	83.4 ± 10.2	85.1 ± 11.3
LR	81.0 ± 14.5	81.4 ± 9.0	83.8 ± 12.5	86.5 ± 14.1	81.5 ± 6.1
u-IL-18 (μg/l)
HES	82.7 ± 8.5	89.5 ± 5.8	109.6 ± 9.2^*	140.5 ± 10.9^*	159.7 ± 16.9^*
LR	86.6 ± 8.5	83.2 ± 4.8	118.5 ± 11.4^*	142.6 ± 18.1^*	162.0 ± 18.5^*
eGFR (ml/min/1.73 m²)
HES	63.9 ± 14.3	63.5 ± 13.5	64 ± 14.7	72.8 ± 10.4	68.6 ± 12.4
LR	61.9 ± 8.3	63.5 ± 9.6	63 ± 6.2	64 ± 9.4	66.4 ± 9.2
ACR
HES	1.96 ± 0.21	1.98 ± 0.19	1.90 ± 0.09	1.99 ± 0.13	1.95 ± 0.20
LR	1.89 ± 0.14	1.84 ± 0.20	1.90 ± 0.19	1.94 ± 0.15	1.92 ± 0.12
u-β2 micro-albumin (mg/l)
HES	96.4 ± 11.2	97.1 ± 12.2	101.7 ± 9.4	99.4 ± 15.7	103.0 ± 13.8
LR	93.2 ± 8.9	90.6 ± 8.2	99.8 ± 14.2	104.7 ± 15.0	93.2 ± 12.3
p-Creatinine (umol/l)
HES	92.5 ± 9.3	94.6 ± 7.9	93.1 ± 9.1	81.2 ± 8.6	85.9 ± 7.7
LR	85.7 ± 5.9	86 ± 9.1	85.3 ± 6.3	85.1 ± 7.9	82.6 ± 9.2
u-Albumin (g/l)
HES	87.4 ± 4.1	90.2 ± 4.3	91.1 ± 5.1	96.1 ± 6.3	97.5 ± 7.0
LR	86.6 ± 5.7	87.1 ± 2.8	92.3 ± 3.8	97 ± 4.7	98.1 ± 6.4

Patients in group LR received intraoperative placebo Lactate Ringers’ at a dose of 7.5 ml/kg; Patients in group HES received 6% HES 130/0.4 at a dose of 7.5 ml/kg in the first hour of surgery, and then, Lactate Ringers’ was administrated 5 ml/kg until the end of the surgery. Blood and urine sample were got at five time points: before anaesthesia (D₀), during surgery (D₁), the first day after surgery (D₂), the third day after surgery (D₃), the fifth day after surgery (D₄). ACR, eGFR, urine (u) and plasma (p) NGAL, plasma creatinine, urine β₂ micro-albumin and albumin were assessed. Values are presented as mean ± SD, *P < 0.05 vs. D₀
HES 6% hydroxyethyl starch 130/0.4, LR Lactate Ringers’, u-NGAL urine Neutrophil gelatinase–associated lipocalin, p-NGAL plasma Neutrophil gelatinase–associated lipocalin, eGFR estimated glomerular filtration rate, ACR ratio of urine trace albumin and urine creatinine

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