title: Changes in Serum Creatinine Concentration and Acute Kidney Injury (AKI) Grade in Dogs Treated with Hydroxyethyl Starch 130/0.4 From 2013 to 2015.
abstract: BACKGROUND
  Hydroxyethyl starch (HES) solutions may cause acute kidney injury (AKI) in humans.
  
  
  OBJECTIVE
  To compare AKI grades in 94 dogs exposed and 90 dogs that were unexposed to 6% HES-130/0.4.
  
  
  METHODS
  Dogs receiving 6% HES-130/0.4 (HES cohort) or crystalloids (unexposed cohort) between 2013 and 2015.
  
  
  METHODS
  Historical cohort study. Diagnosis, total cumulative dose and total mL/kg of HES administered, time frame of HES administration and serum creatinine concentrations up to 90 days after initiation of HES treatment were retrospectively reviewed. The AKI grades were retrospectively determined by IRIS guidelines.
  
  
  RESULTS
  Exposed dogs received a median cumulative dose of 69.4 mL/kg (range, 2-429 mL/kg) HES over a median of 4 (range, 1-16) days, resulting in a median dose of 20.7 (range, 2-87) mL/kg/d. Although the cohorts differed in terms of age and diagnosis, AKI grades were not significantly different at the evaluated short- and long-term time points. Results of ordinal logistic regression identified the number of days of HES administration as significantly associated with an increase in AKI grade within 10 days (P = .038), whereas there was no significant association among HES exposure, HES mL/kg/d, and an increase in AKI grade.
  
  
  CONCLUSIONS
  HES-130/0.4-treated dogs were not more prone to develop AKI than HES-untreated, but the number of HES days was significantly associated with an increase in AKI grade within 10 days post-HES administration. The time frame of HES treatment should be kept short. Prospective, randomized clinical trials are required to assess the effect of HES on renal function in dogs.
authors.affiliation: Department of Small Animals, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.
authors.forename: N E
authors.initials: NE
authors.lastname: Sigrist
authors.affiliation: Department of Small Animals, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.
authors.forename: N
authors.initials: N
authors.lastname: Kälin
authors.affiliation: Section of Epidemiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Dreyfus
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology / Q000662:veterinary*; D000818:Animals; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood*; D000077324:Crystalloid Solutions; D004283:Dog Diseases / Q000139:chemically induced* / Q000453:epidemiology; D004285:Dogs; D005440:Fluid Therapy / Q000662:veterinary; D006895:Hydroxyethyl Starch Derivatives / Q000009:adverse effects / Q000627:therapeutic use*; D007552:Isotonic Solutions / Q000627:therapeutic use; D010952:Plasma Substitutes / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000077324:Crystalloid Solutions; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D003404:Creatinine
keywords: 
  HES
  ; Acute kidney injury; Canine; Renal damage