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J Vet Emerg Crit Care (San Antonio). 2019 Mar;29(2):132-142. doi: 10.1111/vec.12814. Epub 2019 Feb 14.

Evaluation of biomarkers of kidney injury following 4% succinylated gelatin and 6% hydroxyethyl starch 130/0.4 administration in a canine hemorrhagic shock model.

Author information

1
School of Veterinary and Life Sciences, Murdoch University, Perth, WA, Australia.
2
Department of Veterinary Biosciences, The Ohio State University, Columbus, OH, USA.
3
Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, WA, Australia.
4
Emergency Medicine, University of Western Australia, WA, Australia.
5
Department of Veterinary Pathobiology, Texas A&M University, College Station, TX, USA.
6
Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, WA, Australia.

Abstract

OBJECTIVE:

To investigate the association between synthetic colloids and biomarkers of acute kidney injury (AKI) in dogs with hemorrhagic shock.

DESIGN:

Experimental interventional study.

SETTING:

University.

ANIMALS:

Twenty-four healthy ex-racing Greyhounds.

INTERVENTIONS:

Anesthetized Greyhounds subjected to hemorrhage for 60 min were resuscitated with 20 mL/kg of fresh whole blood (FWB), 6% hydroxyethyl starch (HES) 130/0.4, 4% succinylated gelatin (GELO), or 80 mL/kg of isotonic crystalloid (CRYST) over 20 min (n = 6 per treatment). Concentrations of biomarkers of AKI were measured at baseline, end of hemorrhage, and at 40 (T60), 100 (T120), and 160 (T180) min after fluid bolus. Biomarkers included neutrophil gelatinase-associated lipocalin in urine and serum (uNGAL; sNGAL), and urine cystatin C (uCYSC), kidney injury molecule-1 (uKIM), clusterin (uCLUST), osteopontin, gamma-glutamyl transferase, monocyte chemoattractant protein-1 (uMCP), interleukin-6, interleukin-8, protein (uPROT), hyaluronan, and F2 -isoprostanes. Renal histology was scored for tubular injury and microvesiculation. Biomarker fold-change from baseline was compared between groups using mixed effects models (Bonferroni-Holm corrected P<0.05). Frequencies of histology scores were compared by Fisher's exact test.

MEASUREMENTS AND MAIN RESULTS:

In dogs treated with GELO, uNGAL fold-change was markedly greater compared with all other groups at T60, T120, and T180 (all P<0.001), and uCYSC was greater at T60 compared with CRYST (P<0.001), and at T120 and T180 compared with all other groups (all P<0.001). Smaller, albeit significant, between-group differences in uKIM, uCLUST, uMCP, and urine protein concentration were observed across the FWB, GELO, and HES groups, compared with CRYST. The GELO group more frequently had marked tubular microvesiculation than the other groups (P = 0.015) although tubular injury scores were comparable.

CONCLUSION:

In dogs with hemorrhagic shock, GELO was associated with greater magnitude increases in urine biomarkers of AKI and more frequent marked tubular microvesiculation, compared with FWB, CRYST, and HES.

KEYWORDS:

cystatin C; fluid therapy; neutrophil gelatinase-associated lipocalin; synthetic colloids; urinary biomarkers

PMID:
30767375
DOI:
10.1111/vec.12814
[Indexed for MEDLINE]

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