Effect of hydroxyethylstarch on renal function in cardiac surgery: a large scale retrospective study.
BACKGROUND
Recent reports indicated negative effects of hydroxyethylstarch (HES) on renal function. The goal of this large scale retrospective study was to detect whether there was an association between postoperative deterioration of renal function and the use of HES 200 kD, 0.5 DS in the cardiac surgery setting.


METHODS
Retrospective analysis of daily collected data in 3124 patients who underwent coronary artery bypass and/or valvular surgery. Three groups were compared according to differences in fluid therapy: --GEL: gelatin was used as priming fluid of extracorporeal circulation (ECC) and for postoperative filling (n = 1276). --MIX: HES was used as priming fluid of ECC an gelatin was used for postoperative filling (n = 1008). --HES: HES was used as priming fluid of ECC and for postoperative filling (n = 840).


RESULTS
There were no significant differences in postoperative serum creatinine concentrations between the 3 groups: GEL: 12,2 +/- 0,5 mg/l; MIX: 12,3 +/- 0.5 mg/l; HES: 12,3 +/- 0.6 mg/l. The need for postoperative extrarenal epuration was not significantly different between the 3 periods: GEL: 2,9%; MIX: 3,1%; HES: 3,8%.


CONCLUSIONS
The use of HES 200 kD, 0.5 DS in cardiac surgery does not seem to be associated with a clinically significant deterioration of postoperative renal function.
Wiesen
P
P
General Intensive Care, University Hospital of Liège, Domaine universitaire du Sart Tilman, Liège, Belgium.
Canivet
J L
JL
Ledoux
D
D
Roediger
L
L
Damas
P
P
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology; D000368:Aged; D001810:Blood Volume / Q000187:drug effects; D006348:Cardiac Surgical Procedures; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D004231:Diuresis; D005260:Female; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000494:pharmacology*; D007668:Kidney / Q000187:drug effects*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000494:pharmacology*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000139:chemically induced / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes; D003404:Creatinine