title: Impact of hydroxyethyl starch 70/0.5 on acute kidney injury after gastroenterological surgery.
abstract: BACKGROUND
  Previous studies reported a higher mortality risk and a greater need for renal replacement therapy in patients administered hydroxyethyl starch (HES) rather than other fluid resuscitation preparations. In this study, we investigated the association between 6% HES 70/0.5 use and postoperative acute kidney injury (AKI) in gastroenterological surgery patients.
  
  
  METHODS
  We conducted retrospective full-cohort and propensity-score-based analyses of patients who underwent gastroenterological surgery between June 2011 and August 2013 in a Japanese university hospital. The study sample comprised 66 AKI and 2,152 non-AKI patients in the full-cohort analysis and 35 AKI and 1,269 non-AKI patients in the propensity-score-based analysis. Propensity scores were calculated using an ordered logistic regression model in which the dependent variable comprised three groups based on HES infusion volumes (0, 1-999, and ≥ 1,000 ml). The association between HES groups and postoperative AKI incidence was analyzed using multiple logistic regression models. Other candidate independent variables included patient characteristics and intraoperative measures.
  
  
  RESULTS
  In the full-cohort analysis, 40 (60.6%) AKI patients were diagnosed as "risk", 15 (22.7%) as "injury," and 11 (16.7%) as "failure". In the propensity-score-based analysis, the corresponding values were 22 (62.9%), 8 (22.9%), and 5 (14.3%). There was no significant association between total infused HES and postoperative AKI incidence in either the full-cohort or the propensity-score-based analysis (P = 0.168 and P = 0.42, respectively).
  
  
  CONCLUSIONS
  AKI incidence was not associated with clinical 6% HES 70/0.5 administration in gastroenterological surgery patients treated at a single center.
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Umegaki
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Uba
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Chisato
authors.initials: C
authors.lastname: Sumi
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Sakamoto
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Jomura
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Kiichi
authors.initials: K
authors.lastname: Hirota
authors.affiliation: Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan.
authors.forename: Koh
authors.initials: K
authors.lastname: Shingu
keywords: Acute kidney injury; Gastroenterological surgery; Hydroxyethyl starch