J Vet Sci.  2018 Sep;19(5):608-619. 10.4142/jvs.2018.19.5.608.

Evaluation of renal injury caused by acute volume replacement with hydroxyethyl starch 130/0.4 or Ringer's lactate solution in pigs

• Ferreira D
• Cruz R
• Venâncio
• Faustino-Rocha AI
• Silva A
• Mesquita J
• Ortiz AL
• Vala H

• KMID: 2420929
• DOI: http://doi.org/10.4142/jvs.2018.19.5.608

Abstract

This work aimed to evaluate the effects on renal tissue integrity after hydroxyethyl starch (HES) 130/0.4 and Ringer's lactate (RL) administration in pigs under general anesthesia after acute bleeding. A total of 30 mL/kg of blood were passively removed from the femoral artery in two groups of Large White pigs, under total intravenous anesthesia with propofol and remifentanil. After bleeding, Group 1 (n = 11) received RL solution (25 mL/kg) and Group 2 (n = 11) received HES 130/0.4 solution (20 mL/kg). Additionally, Group 3 (n = 6) was not submitted to bleeding or volume replacement. Pigs were euthanized and kidneys were processed for histopathological and immunohistochemical analyses. Minimal to moderate glomerular, tubular, and interstitial changes, as well as papillary necrosis, were observed in all experimental groups. Pre-apoptosis and apoptosis indicators were higher in pigs that received HES 130/0.4, indicating a higher renal insult. Both HES 130/0.4 and RL administration may cause renal injury, although renal injury may be more significant in pigs receiving HES 13/0.4. Results also suggest that total intravenous anesthesia with propofol and remifentanil may cause renal injury, and this effect can be dose related.

Keyword

apoptosis; hemorrhage; renal injury

MeSH Terms

Anesthesia, General
Anesthesia, Intravenous
Apoptosis
Femoral Artery
Hemorrhage
Kidney
Lactic Acid*
Necrosis
Propofol
Starch*
Swine*
Lactic Acid
Propofol
Starch

Figure

• 

  Fig. 1 Representative sections of kidney showing glomerular lesions. Glomerular hypercellularity (Grade 2, A; Grade 1, B), hyaline droplet degeneration in Bowman's space (Grade 2, C; Grade 1, D), and mesangial expansion (Grade 2, E; Grade 1, F) in Group 1 (Ringer's lactate-treated) (A, C, and E) and Group 2 (hydroxyethyl starch 130/0.4) (B, D, and F). Periodic acid-Schiff stain (A–F). Scale bars = 25 µm (A–F).

• 

  Fig. 2 Representative sections of kidney showing tubular and interstitial lesions. Tubular blebbing of renal tubules (Grade 3, A; Grade 2, B), hyaline casts (Grade 1, C and D), hyaline material deposits (Grade 1, E and F) and interstitial fibrosis and tubular atrophy (Grade 2, G; Grade 1, H) in Group 1 (Ringer's lactate) (A, C, E, and G) and Group 2 (hydroxyethyl starch 130/0.4) (B, D, F, and H). Periodic acid-Schiff stain (A–F). H&E stain (G and H). Scale bars = 25 µm (A, B, G, and H), 50 µm (C–F).

• 

  Fig. 3 Representative sections of kidney with vascular lesions. Edema (Grade 2, A), congestion (Grade 1, B), hemorrhage (Grade 2, C) and hyperemia (Grade 2, D) in Group 1 (Ringer's lactate) (A and C) and Group 2 (hydroxyethyl starch 130/0.4) (B and D). Periodic acid-Schiff stain (A). H&E stain (B–D). Scale bars = 25 µm (A, B, and D), 100 µm (C).

• 

  Fig. 4 Immunoreactivity results for cytochrome c (A–C), M30 (D–F), and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) (G–I) in all experimental groups. (A) Very intense cytoplasmic immunolabeling in convoluted tubules in Group 1 (Ringer's lactate). (B) Very intense cytoplasmic immunolabeling in convoluted tubules in Group 2 (hydroxyethyl starch 130/0.4). (C) Moderate cytoplasmic immunolabeling in convoluted tubules in Group 3 (control). (D) Moderate immunolabeling in proximal convoluted tubules in Group 1. (E) Intense immunolabeling in collecting tubules in Group 2. (F) Absence of immunolabeling in collecting tubules in Group 3. (G) Weak immunostaining in convoluted tubules in Group 1. (H) Intense nuclear immunostaining in convoluted tubules in Group 2. (I) Negative immunostaining in Group 3. H&E stain (A–I). Scale bars = 25 µm (A–C and G–I). 20× (D and F), 40× (E).

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