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Peer-reviewed veterinary case report

Prospective randomized controlled blinded clinical trial evaluating biomarkers of acute kidney injury following 6% hydroxyethyl starch 130/0.4 or Hartmann's solution in dogs.

Journal:
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
Year:
2021
Authors:
Boyd, Corrin J et al.
Affiliation:
College of Science · Australia
Species:
dog

Abstract

OBJECTIVE: To evaluate the effect of 6% hydroxyethyl starch (HES) 130/0.4, compared with a Hartmann's solution control (CRYST), on urine biomarkers of acute kidney injury (AKI) in dogs prescribed a fluid bolus. DESIGN: Randomized, controlled, blinded clinical trial January 2018 to February 2019. SETTING: University teaching hospital. ANIMALS: Forty client-owned dogs. INTERVENTIONS: Dogs prescribed a fluid bolus were randomized to receive at least 10&#xa0;mL/kg of HES or CRYST with clinicians and investigators blinded to fluid type. Study fluid was used for further boluses as required in the following 24&#xa0;hours, to a limit of 40&#xa0;mL/kg total, after which fluid administration was open-label. MEASUREMENTS AND MAIN RESULTS: Urine was collected prior to and 6, 12, and 24&#xa0;hours after the first study fluid bolus. Urine concentrations of AKI biomarkers: neutrophil gelatinase-associated lipocalin (NGAL), cystatin C, kidney injury molecule-1 (KIM), clusterin, and osteopontin were measured using a magnetic bead multiplexed assay. Osmolality-indexed biomarker concentrations were compared between groups over time with linear mixed-effects models, with P&#xa0;<&#xa0;0.05 considered significant. The mean volume of study fluid administered was not significantly different between groups (HES: 23.1&#xa0;mL/kg, CRYST: 25.9&#xa0;mL/kg; P&#xa0;=&#xa0;0.47, t-test). There were no significant differences between groups in change over time of osmolality-indexed urine concentrations of NGAL (P&#xa0;=&#xa0;0.91), cystatin C (P&#xa0;=&#xa0;0.95), KIM (P&#xa0;=&#xa0;0.77), clusterin (P&#xa0;=&#xa0;0.63), or osteopontin (P&#xa0;=&#xa0;0.91). The maximum Veterinary Acute Kidney Injury (VAKI) score up to 7 days during hospitalization (P&#xa0;=&#xa0;1.0) and in-hospital mortality (P&#xa0;=&#xa0;0.49) were not significantly different between groups, as compared by Fisher's exact test. CONCLUSIONS: There were no differences in change over time of urine AKI biomarkers in dogs treated with 10 - 40&#xa0;mL/kg HES or CRYST over 24&#xa0;hours. Larger clinical trials with patient-centered outcomes are required to investigate the safety of HES in dogs.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/33709516/