Navigation Links
In lab studies, hydroxyethyl starch has direct harmful effects on kidney cells

July 11, 2014 The increased risk of kidney injury related to the use of hydroxyethyl starch (HES) in resuscitation fluids reflects the mass of HES molecules, according to a report in Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

The "total mass of HES molecules" explains the harmful effect of HES on cultured human renal proximal tubule cells (PTCs), concludes the laboratory study by Dr Christian Wunder and colleagues of University Hospital Wrzburg, Austria. Other factorssuch as differences in the origin or molecular weight of HES solutionsappear to play little or no role in cellular-level toxicity of HES.

What Factors Affect Toxic Effects of HES on Kidney Cells?

Hydroxyethyl starch is a starch derivative that has been widely used for fluid resuscitation with volume expansion for critically ill or injured patients in shock. A growing body of evidence suggests that HES solutions may have harmful effects, including an increased risk of kidney injury and death.

In previous studies, Dr Wunder and colleagues found that HES caused impaired kidney function in animals with sepsis (severe infection). Those studies showed that HES was localized mainly in the kidney PTCs. The researchers performed a series of in-depth follow-up experiments to look at factors influencing the toxic effects of HES on cultured human PTCs.

Most of the factors assessed had no major influence on reductions in cell viability caused by HES. Cellular toxicity was unrelated to the type of "carrier" solution used in the cell cultures, the use of HES made from different origins (potato versus corn starch), or the time cells spent in culture with HES.

The toxic effects were also similar for HES solutions of different molecular weights. That's an important finding, as newer low-molecular weight HES solutions were thought to be safer than previous products. There was also no evidence that the toxic effects of HES were related to the presence of inflammation.

Instead, the only significant factor was the total mass of HES molecules. The effect was dose-dependent: the greater the molecular mass, the greater the evidence of cell toxicity. The toxic effects started very soon after PTCs were exposed to HEC, and further increased at higher doses.

There is a long history of debate and confusion over potential harmful effects of HES solutions used for resuscitation. Recent studies have linked HES to reduced kidney function in patients with sepsis. Last year, both the US Food and Drug Administration and the European Medicines Agency issued statements that HES solutions should not be used in critically ill patients.

The new study suggests that the molecular mass of HES is the major factor responsible for damage to kidney cells. Other factors have no significant influenceeven with new low-molecular weight HES solutions, cellular-level toxic effects appear just as likely, once the total mass of HES molecules is taken into account.

Although the study was performed in the laboratory on cultured kidney cells, the PTC toxicity caused by HES appears consistent with the risks of kidney damage and death observed in critically ill patients. Dr Wunder and coauthors conclude, "Our data show that HES itself has a negative impact on renal PTC, which should be considered when used clinically."


Contact: Connie Hughes
Wolters Kluwer Health

Related biology news :

1. Are enough women included in medical device studies, as required by the FDA?
2. Resistant starch content of potatoes varies significantly by preparation and service method
3. Study shows that diet of resistant starch helps the body resist colorectal cancer
4. Study documents eating of soil, raw starch in Madagascar
5. Inexpensive, abundant starch fibers could lead to ouchless bandages
6. Avery Biomedical Devices, Inc. announces the appointment of Mark E Ginsburg, M.D. to its Board of Directors
7. CNIO scientists develop technology to redirect proteins towards specific areas of the genome
8. Wyss Institute founding director Don Ingber to deliver 2014 Graeme Clark Oration
9. Turtle migration directly influenced by ocean drift experiences as hatchlings
10. Galectins direct immunity against bacteria that employ camouflage
11. Ground breaking technique offers DNA Sat Nav direct to your ancestors home 1,000 years ago
Post Your Comments:
(Date:11/17/2015)... Pressure BioSciences, Inc. (OTCQB: PBIO) ("PBI" and ... of broadly enabling, pressure cycling technology ("PCT")-based sample preparation ... it has received gross proceeds of $745,000 from an ... "Offering"), increasing the total amount raised to date in ... are expected in the near future. ...
(Date:11/12/2015)... BOSTON , Nov. 12, 2015  A golden ... for Duchenne muscular dystrophy (DMD) has provided a new ... Boston Children,s Hospital, the Broad Institute of MIT and ... Brazil . Cell, ... some dogs "escape" the disease,s effects. The Boston Children,s ...
(Date:11/12/2015)... 2015   Growing need for low-cost, easy ... been paving the way for use of biochemical ... analytes in clinical, agricultural, environmental, food and defense ... in medical applications, however, their adoption is increasing ... continuous emphasis on improving product quality and growing ...
Breaking Biology News(10 mins):
(Date:11/25/2015)... CA (PRWEB) , ... November 25, 2015 , ... ... genomics company uBiome, were featured on AngelList early in their initial angel funding ... an AngelList syndicate for individuals looking to make early stage investments in the ...
(Date:11/24/2015)... 2015 /CNW/ - iCo Therapeutics ("iCo" or "the Company") ... for the quarter ended September 30, 2015. Amounts, ... and presented under International Financial Reporting Standards ("IFRS"). ... said Andrew Rae , President & CEO ... not only value enriching for this clinical program, ...
(Date:11/24/2015)... -- --> --> ... Market by Product & Services (Primer, Probe, Custom Oligos, ... End-User (Research, Pharmaceutical & Biotech, Diagnostic Labs) - Global ... expected to reach USD 1,918.6 Million by 2020 from ... 10.1% during the forecast period. Browse 183 ...
(Date:11/24/2015)... Ltd. (OTCQB: TIKRF) today announced that its Annual General Meeting of Shareholders ... Israel time, at the law offices of Goldfarb Seligman ... Floor, Tel Aviv, Israel . ... to the Board of Directors; , election of Liat ... an amendment to certain terms of options granted to our Chief Executive ...
Breaking Biology Technology: