Effect of a 3% gelatin solution on urinary KIM-1 levels in patients after thyroidectomy: a preliminary randomized controlled trial

Abstract

Optimal fluid therapy significantly affects the maintenance of proper tissue perfusion and, consequently, kidney function. An adverse effect of colloids on kidney function is related to the incidence of postoperative kidney failure. The study aimed to assess the effect of a 3% gelatin solution on kidney function based on the urinary kidney injury molecule-1 (uKIM-1) level. This study used a parallel design and enrolled 64 adult patients with a mean age of 52.5 ± 13.1 years, all of whom underwent a thyroidectomy procedure under general anesthesia. Patients were randomly assigned to three comparison groups, each receiving a different dose of 3% gelatin solution during the thyroidectomy procedure. The patients from study groups A (n = 21) and B (n = 21) received a 3% gelatin solution at a dose of 30 ml/kg and 15 ml/kg body weight, respectively, during the first hour of the procedure. The patients from the control group C (n = 22) received an isotonic multi-electrolyte solution. Serum creatinine levels were determined, and urine samples were collected to determine levels of uKIM-1 before, 2 h, and 24 h after surgery. The patients’ demographic data, type and volume of fluid and hemodynamic status during the surgery were collected from relevant anesthesia protocols and were included in the study data. There were no statistically significant changes between groups in hemodynamic parameters such as systolic and diastolic blood pressure, heart rate, and oxygen saturation values. A statistically significant increase in uKIM-1 level was noted in patients receiving the 3% gelatin solution regardless of the dose. A statistically significant difference in uKIM-1 level was observed between groups A, B, and C measured 24 h after surgery, with the highest uKIM-1 level in group A. Measurement of uKIM-1 level could be an early and sensitive biomarker of kidney injury. Kidney toxicity of a 3% gelatin solution, evaluated based on the level of uKIM-1 in urine, correlates with transfused fluid volume. This study was retrospectively registered in the ISRCTN clinical trials registry (ISRCTN73266049, 08/04/2021: https://www.isrctn.com/ISRCTN73266049).

Unraveling the immunological landscape in acute pancreatitis progression to sepsis: insights from a Mendelian randomization study on immune cell traits

“…Moreover, innovative approaches to augment IL-7 in immunosuppressed septic shock patients have been shown to enhance T lymphocyte functions ex vivo, including increased production of IFN-g and TNF-a (36). The ability of IL-7 to promote T cell viability, trafficking, and functionality aligns with observed improvements in survival rates among sepsis patients (37). This apparent contradiction, wherein CD127-mediated pathways contribute to the progression of sepsis while IL-7 supplementation shows therapeutic benefits, may be explained by considering the temporal dynamics of sepsis.…”

The Preparation of Curcumin-Loaded Pickering Emulsion Using Gelatin–Chitosan Colloidal Particles as Emulsifier for Possible Application as a Bio-Inspired Cosmetic Formulation

“…Furthermore, curcumin entrapped within the emulsion can also contribute to the sun screening properties via not only the absorption of solar radiation in the UV range of 420 nm, but by preventing solar radiation-induced intracellular damage through antioxidant mechanisms [ 2 , 3 ]. Moreover, all the excipients used in the present study, such as GA, CMC, curcumin, and coconut oil, are of a pharmaceutical grade, and are used well within their reported toxicity limits, thus ensuring the green nature of the as-prepared formulation [ 50 , 51 , 52 ].…”