Abstract
Although postoperative renal dysfunction is relatively rare after cesarean delivery, preeclampsia is considered as the high-risk population. On the other hand, hydroxyethyl starch (HES) administration for preventing maternal hypotension induced by spinal anesthesia for cesarean delivery is a common practice. However, the effect of HES administration during cesarean delivery on postoperative kidney function in parturients with severe preeclampsia is not well investigated. We retrospectively reviewed both medical and anesthesia records of patients with severe preeclampsia who underwent cesarean delivery from January 2011 to December 2013. Preoperative blood examinations were compared with postoperative values. All parturients received 6% HES 70/0.5 for preventing anesthesia-induced hypotension or for volume resuscitation during cesarean delivery. A total of 87 severe preeclampsia parturients were underwent cesarean section during the period. The amounts of HES administration were 859 ± 206 mL. There was significant reduction in serum creatinine, from 0.70 ± 0.29 mg/dL preoperatively to 0.62 ± 0.17 mg/dL in 3–7 days after the cesarean. Only one patient had postoperatively elevated serum creatinine up to clinically significant level (from 0.64 mg/dL to 1.35 mg/kg).
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Acknowledgements
We would like to thank Professor Emeritus Hideki Miyao, Department of Anesthesia, Saitama Medical Center, Saitama Medical University, for his dedicated support and helpful discussion regarding basic physiology of fluid therapy.
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This study received no external funding. All authors have no conflict of interests to declare.
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Mazda, Y., Tanaka, M., Terui, K. et al. Postoperative renal function in parturients with severe preeclampsia who underwent cesarean delivery: a retrospective observational study. J Anesth 32, 447–451 (2018). https://doi.org/10.1007/s00540-018-2492-x
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DOI: https://doi.org/10.1007/s00540-018-2492-x