Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function

Mutter, Thomas C; Ruth, Chelsea; Dart, Allison

doi:10.1002/14651858.cd007594.pub3

Cited by 148 publications

(149 citation statements)

References 92 publications

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“…(Grade 2+) STRONG agreement Rationale: Several randomized or observational studies and meta-analyses have examined the beneficial effect of a preferential administration of colloids compared to crystalloids [62][63][64][65][66][67][68][69][70][71][72][73]. In the ICU, the use of HES, regardless of its type, has been reported to be associated with an increase in mortality rate, AKI incidence and the need for RRT in several meta-analyses with a high level of proof [58][59][60][61][62][63][64][65][66][67][68][69][70][71]73]. A Cochrane meta-analysis simultaneously considering all colloids did not find any beneficial effect associated with the preferential use of colloids, regardless of nature, compared with crystalloids.…”

Section: How To Assess the Risk Of Akimentioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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Acute kidney injury (AKI) is a syndrome that has progressed a great deal over the last 20 years. The decrease in urine output and the increase in classical renal biomarkers, such as blood urea nitrogen and serum creatinine, have largely been used as surrogate markers for decreased glomerular filtration rate (GFR), which defines AKI. However, using such markers of GFR as criteria for diagnosing AKI has several limits including the difficult diagnosis of non-organic AKI, also called "functional renal insufficiency" or "pre-renal insufficiency". This situation is characterized by an oliguria and an increase in creatininemia as a consequence of a reduction in renal blood flow related to systemic haemodynamic abnormalities. In this situation, "renal insufficiency" seems rather inappropriate as kidney function is not impaired. On the contrary, the kidney delivers an appropriate response aiming to recover optimal systemic physiological haemodynamic conditions. Considering the kidney as insufficient is erroneous because this suggests that it does not work correctly, whereas the opposite is occurring, because the kidney is healthy even in a threatening situation. With current definitions of AKI, normalization of volaemia is needed before defining AKI in order to avoid this pitfall.

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Section: How To Assess the Risk Of Akimentioning

confidence: 99%

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Ichai

Vinsonneau

Souweine

et al. 2016

Anaesthesia Critical Care & Pain Medicine

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“…Effect of HES fluid administration on therapeutic doses was no different from effect of crystalloid fluid on changes in serum creatinine levels. Nevertheless, mean creatinine serum level in crystalloid group and HES 200/0.5 group increased significantly Meta-analysis conducted by Mutter et al (2013) concluded differently. HES has the potential to increase the risk of acute kidney damage.…”

Section: Discussionmentioning

confidence: 90%

The Use of Hydroxyethyl Starch 200/0,5 as Plasma Subtitutes Is Safe in Hypovolemic Patients as Indicated in Changes of N-Acetyl--Glucosaminidase and Creatinin Serum Parameters

Shinta¹,

Khotib²,

Rahardjo³

et al. 2016

FMI

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“…In particular hydroxyl ethyl starch (HES) has been associated with osmotic nephrosis and is best avoided [18]. Among the crystalloids buffered solutions such as Ringer's lactate may have benefits over isotonic saline [19].…”

Section: Prevention and Management Of Sepsis Induced Aki A) Fluid Resmentioning

confidence: 99%

Acute kidney injury in sepsis

Wijayaratne

Wijewickrama

2017

Sri Lanka j Surg

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Sepsis is life-threatening organ dysfunction resulting from a dysregulated host response to infection. It is one of the commonest causes of acute kidney injury (AKI) and is associated with an increase in both morbidity and mortality. Both haemodynamic and non-haemodynamic factors are involved in the pathogenesis of AKI in sepsis. Newer tests are available for the early diagnosis of AKI in septic patients and may provide an opportunity for prevention. The current mainstay of prevention is adequate fluid resuscitation and maintenance of systemic blood pressure, noradrenaline being the vasopressor of choice. Renal replacement therapy may improve outcomes. Continuous renal replacement modalities are preferred in those who are haemodynamically unstable. There is no consensus on the optimal timing or dose of renal replacement therapy.

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Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function

Cited by 148 publications

References 92 publications

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies)

The Use of Hydroxyethyl Starch 200/0,5 as Plasma Subtitutes Is Safe in Hypovolemic Patients as Indicated in Changes of N-Acetyl--Glucosaminidase and Creatinin Serum Parameters

Acute kidney injury in sepsis

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