| Bjective: To investigate the effect of 6% HES (130/0.4) on perioperative renal function in the patients uncergoing kidney transplantation, and to discuss the probable mechanism of its protective effect. 6% HES(130/0.4)is expected to be a plasma substitute as efficacious as current HES solutions while offering such advantages as more complete renal elimination and reduced tissue storage. Methods: 60 ASA physical status III andⅣpatients ,aged 23-64y, weighed 43-92kg, scheduled for kidney transplantation were randomly allocated into two groups: group A was administered with 6% hydroxyethyl starch HES(130/0.4) (n=30) and group B was administered with 4% Succinylated Gelatin (n=30). Intravenously (IV) infusion of either 6% HES (130/0.4) or 4% Succinylated Gelatin(mean molecular weight 130 kD and 22300 mn respectively) by the time the anesthesia started. ABP, CVP, MAP, HR and SpO2 were monitored as a routine. A total dosage of colloid of 15ml·kg-1 were applied.β2-MG of blood and urine,α1-MG of urine,mALB of urine,BUN and Cr were measured pre-operation,the first day, the third day, the seventh day and the fourteenth day of post-operation respectively.β2-MG of urine,α1-MG of urine,mALB of urine,BUN and Cr were measured pre-operation, the first day, the third day, the seventh day and the fourteenth day of post-operation respectively.Results Hemodynamics remained stable in each group, and no adverse event was observed in any patient. Allβ2-MG of blood and urine,α1-MG of urine,mALB of urine and BUN decreased post-operation according to pre-operation. At the moment of T0,T1,T2,T3,T4, no statistic meaning was found inβ2-MG of blood in both groups (P>0.05), but at T5 and T6 they were respectively 1.473±0.893μg·ml-1, 1.553±0.552μg·ml-1 and 3.194±2.309μg·ml-1, 4.916±3.643μg·ml-1 which they presented to be significantly different(P<0.05).β2-MG of urine did not show any differernce at the time of T0,T3,T4 betwwen the groups(P>0.05), at the time of T5 and T6 it was quite different(P<0.05) though.α1-MG of urine in T6 had a sifnificant meaning between the groups (P<0.05) which did not happen in other time. mALB of urine also showed a significant meaning in T4 (P<0.05) when others not . Cr decreased and the urine volume increased a lot, but they all had no statistic meaning, the concentration of Na+ maintained steady. Conclusions: Intravenous infusion of 15ml·kg-1 of the new 6% HES (130/0.4) was tolerated well and maintained cardiovascular stability in patients undergoing kidney transplantation. 6% HES (130/0.4) proved equivalent to 4% Succinylated Gelatin in every measured respect. Its pharmacokinetic profile may render 6% HES (130/0.4) an attractive alternative to current 4% Succinylated Gelatin solutions.
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