Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007–2010)

Hayes, Galina; Benedicenti, Leontine; Mathews, Karol A.

doi:10.1111/vec.12412

Cited by 78 publications

(72 citation statements)

References 22 publications

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“…In human studies and in 1 canine study, a dose‐response relationship of HES administration has been proposed . The Pharmacovigilance Risk Assessment Committee (PRAC) of the European Medicine Agency therefore recommends using HES solutions at the lowest effective dose, generally for a maximum of 24 hours and avoiding administration as a constant rate infusion (CRI).…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, in an in vitro model of human proximal tubular cells, it was concluded that not the type or size of the HES molecule but rather the number of molecules or cumulative dose was responsible for proximal tubular cell harm . In dogs, the type of HES might influence renal injury, as administration of 10% HES 250/0.5 leads to an increase in AKI while 6% HES 130/0.4 did not . The 2 available studies in cats examined the same tetrastarch; therefore, conclusions regarding the type (pentastarch versus tetrastarch) or concentration (10% versus 6%) remain unanswered.…”

Section: Discussionmentioning

confidence: 99%

“…In veterinary medicine, studies investigating potential renal adverse effects of HES solutions are limited. In dogs, conflicting results were found regarding the incidence of acute kidney injury (AKI) after HES administration in hospitalized dogs . A single study investigated the effect of HES on renal function in cats and did not identify an increase in plasma creatinine concentration in cats exposed to HES‐130/0.4 …”

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confidence: 99%

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Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats

Sigrist

Kälin

Dreyfus

2017

Veterinary Internal Medicne

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BackgroundHydroxyethyl‐starch (HES) solutions might have renal adverse effects in humans and dogs.ObjectiveTo determine if administration of 6% HES‐130/0.4 is associated with an increase in serum creatinine concentration and development of acute kidney injury (AKI) in nonazotemic cats.AnimalsA total of 62 critically ill cats; 26 HES exposed and 36 unexposed.MethodsRetrospective cohort study (2012–2015). Serum creatinine concentrations were recorded and changes in serum creatinine concentrations before exposure (baseline) and 2–10 and 11–90 days, respectively, were determined. Development of AKI was defined as a > 150% increase or >26 μmol/L increase in serum creatinine concentration from baseline. Risk factors, such as HES administration, cumulative volume of HES (mL/kg) and number of days of HES administration leading to development of AKI, and change in serum creatinine were analyzed.ResultsCats in the HES cohort received a mean volume of 98.5 ± 76.2 mL/kg (range, 8–278 mL/kg) HES over a median of 4 (range, 1–11) days, resulting in a median dose of 20.1 (range, 8–40.5) mL/kg per day. Short‐term %change in serum creatinine concentration (P = 0.40) and development of AKI (P = 0.32) were not significantly different between cohorts. Multivariable logistic regression did not identify HES dose in mL/kg (P = 0.33) and number of days of HES application (P = 0.49) as a risk factor for development of AKI.Conclusion and Clinical ImportanceHydroxyethyl‐starch administration to critically ill nonazotemic cats seems to be safe. A larger prospective study is required to determine the effect of HES administration at higher dosages and for prolonged time periods.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats

Sigrist

Kälin

Dreyfus

2017

Veterinary Internal Medicne

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“…Hetastarch has the potential to cause acute kidney injury, thought to be due to the accumulation of lysosomes in the proximal tubule from pinocytosis of the colloid particles, leading to tubular swelling and interstitial inflammation (Hayes et al . ). Synthetic colloid use contributes to coagulopathy through decreased levels of von Willebrand factor (vWF) and Factor VIII (fVIII) and decreased expression/activation of platelet integrin α IIb β 3 (Smart et al .…”

Section: Therapeutic Targetsmentioning

confidence: 99%

Bacterial translocation in critical illness

Krentz¹,

Allen²

2017

J of Small Animal Practice

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Bacterial translocation involves the passage of intestinal bacteria to extraintestinal sites and has been shown to increase morbidity and mortality in critical illness. This review outlines the pathophysiology of bacterial translocation, host defence mechanisms, and reviews the evidence for the clinical management of critically ill patients in order to minimise the negative outcomes associated with bacterial translocation.

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“…Potential adverse effects of these fluids include dilutional coagulopathy, volume overload and possible colloid-induced kidney injury (Hayes and others 2016). Other injuries induced by the trauma, such as pulmonary contusions or pre-existing comorbidities (eg, cardiac disease), may mean a less aggressive fluid approach is indicated, and if traumatic brain injury is present the use of hypertonic saline may be indicated.…”

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confidence: 99%

Abdominal trauma in dogs 2. management

Cortellini¹,

Humm²

2018

In Practice

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Trauma represents a big challenge for emergency doctors both in human and veterinary medicine. There have been great advancements in trauma medicine in people and these often provide an inspiration for veterinary surgeons. However, the vast differences in the facilities and finances available in human and veterinary medicine make the approach to trauma in both fields quite different. This article, the second in a two-part series, describes how to manage canine trauma patients. The first part focused on the initial investigation of canine abdominal trauma (Humm and Cortellini 2017). Although this article will mention guidelines in people, these should not be automatically applied to dogs, especially when more relevant evidence for this species exists.

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Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007–2010)

Abstract: HES therapy is associated with increased risk of an adverse outcome including death or AKI in dogs. A randomized controlled trial investigating the safety of HES therapy in canine patients is warranted.

Cited by 78 publications

References 22 publications

Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats

Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats

Bacterial translocation in critical illness

Abdominal trauma in dogs 2. management

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