Hydroxyethyl starch and acute kidney injury in high-risk patients undergoing cardiac surgery: A prospective multicenter study - 14/06/21
On behalf of the Spanish Perioperative Cardiac Surgery Research Group
Abstract |
Background |
Hydroxyethyl starch (HES) solutions increase the risk of acute kidney injury (AKI) in critically ill patients admitted to intensive care unit (ICU) for medical indications. We conducted a cohort study to evaluate the renal safety of modern 6% HES solutions in high-risk patients having cardiac surgery.
Method |
In this multicentre prospective cohort study, we recruited 261 consecutive patients at high-risk for developing cardiac surgery-associated AKI, based on a Cleveland score ≥ 4 points, from July to December 2017th in 14 hospitals in Spain and the United Kingdom. Multivariable logistic regression modeling and propensity-score matched-pairs analysis were used to determine the adjusted association between administration of HES and AKI.
Results |
Of the cohort, 95 patients (36.4%) received 6% HES 130/0.4 either intraoperatively or postoperatively. Postoperative AKI occurred in 145 patients (55.5%). The unadjusted odds of AKI was significantly higher in the HES group, when compared to those not receiving HES (OR 2.22, 95% CI 1.30–3.80, p = 0.003). In multivariable logistic regression models, modern HES was not associated with significantly increased risk of AKI (adjusted OR 0.84, 95% CI 0.41–1.71, p = 0.63). In propensity score match-pairs analysis of 188 patients, the HES group experienced similar adjusted odds of AKI (OR 1.05, CI 95% 0.87–1.27, p = 0.57) and RRT (OR 1.06, CI 95% 0.92–1.22, p = 0.36).
Conclusions |
The use of modern hydroxyethyl starch 6% HES 130/0.4 was not associated with an increased risk of AKI nor dialysis in this cohort of patients at elevated risk for developing AKI after cardiac surgery.
Le texte complet de cet article est disponible en PDF.Highlights |
• | This is a multicenter prospective cohort study, with high-risk patients for developing CSA-AKI. |
• | Modern Hydroxyethyl starch was not associated with an increased risk of AKI in high-risk patients for developing CSA-AKI. |
• | Multivariable logistic regression modeling and propensity-score matched-pairs analysis were used. |
Keywords : Acute kidney injury, Cardiac surgery, High risk patients, Hydroxyethyl starch, Renal replacement
Plan
Vol 73
Article 110367- octobre 2021 Retour au numéro
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