Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study

@article{Schortgen2001EffectsOH,
  title={Effects of hydroxyethylstarch and gelatin on renal function in severe sepsis: a multicentre randomised study},
  author={Fr{\'e}d{\'e}rique Schortgen and Jean Claude Lacherade and Fabrice Bruneel and I. Cattaneo and François Hemery and François Lemaire and Laurent J. Brochard},
  journal={The Lancet},
  year={2001},
  volume={357},
  pages={911-916}
}
Resuscitation with low volume hydroxyethylstarch 130 kDa/0.4 is not associated with acute kidney injury
TLDR
Patients in the HES group were more severely ill on admission but AKI incidence was similar, as well as ICU mortality, and volume expansion with low volume HES 130 kDa/0.4 was not associated with AKI.
Effect of hydroxyethylstarch on renal function in cardiac surgery: a large scale retrospective study.
TLDR
The use of HES 200 kD, 0.5 DS in cardiac surgery does not seem to be associated with a clinically significant deterioration of postoperative renal function.
Effects of hydroxyethyl starch administration on renal function in critically ill patients
TLDR
In this observational study, haematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU.
Effects of hydroxyethyl starch administration on renal function in critically ill patients.
TLDR
Hematological cancer, the presence of sepsis, cardiovascular failure, and baseline renal function as assessed by the SOFA score were independent risk factors for the subsequent need for RRT in the ICU.
Hydroxyethyl starch 130/0.42 versus Ringer's acetate in severe sepsis.
TLDR
Patients with severe sepsis assigned to fluid resuscitation with HES 130/0.42 had an increased risk of death at day 90 and were more likely to require renal-replacement therapy, as compared with those receiving Ringer's acetate.
Renal effects of synthetic colloids and crystalloids in patients with severe sepsis: A prospective sequential comparison*
TLDR
Fluid resuscitation with only crystalloids was equally effective, resulted in a more positive fluid balance only on the first 2 days, and was associated with a lesser incidence of acute kidney injury.
Hydroxyethyl starch or saline for fluid resuscitation in intensive care.
TLDR
In patients in the ICU, there was no significant difference in 90-day mortality between patients resuscitated with 6% HES (130/0.4) or saline, however, more patients who received resuscitation with HES were treated with renal-replacement therapy.
Effects of Fluid Treatment With Hydroxyethyl Starch on Renal Function in Patients With Aneurysmal Subarachnoid Hemorrhage
TLDR
The results suggest that the administration of HES 6% 130/0.4 is safe in SAH patients without preexisting renal insufficiency, and the first days after SAH seem to be a vulnerable phase in which a variety of interventions are performed, including contrast-enhanced neuroradiologic procedures.
Impairment of renal function using hyperoncotic colloids in a two hit model of shock: a prospective randomized study
TLDR
Despite similar maintenance of macrocirculation 6% hydroxyethylstarch 130/0.42 and Ringer's acetate significantly preserve renal function and attenuate tubular damage better than 10% hydroxylstarch 200/ 0.5 in saline.
Iatrogenic hypoalbuminemia due to hydroxyethyl starch 130/0.4: a risk factor for acute kidney injury?
TLDR
The study is difficult to reconcile with other evidence, such as the absence of deleterious renal effects in a meta-analysis of 25 randomized trials evaluating hyperoncotic albumin administration or the increased incidence of ARF among patients receiving isooncotic 6% HES in a randomized trial.
...
...

References

SHOWING 1-10 OF 33 REFERENCES
Hydroxyethyl starch does not impair immediate renal function in kidney transplant recipients: a retrospective, multicentre analysis.
  • A. Deman, P. Peeters, J. Sennesael
  • Medicine, Biology
    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
  • 1999
TLDR
Renal function as measured by daily serum creatinine concentration and 24 h urinary output up to 14 days post-transplantation in the HS-group was comparable with that of controls, and could be related to higher donor age and haemodynamic instability, and recipient male preponderance, rather than to HES itself.
The influence of different intravascular volume replacement regimens on renal function in the elderly.
TLDR
It is concluded that intravascular volume therapy with gelatin and two different HES preparations did not adversely affect renal function in elderly patients without preoperative renal malfunction.
Volume therapy in the critically ill: is there a difference?
TLDR
Volume replacement with 10 % HES for 5 days in the ICU patient showed no disadvantages compared with an infusion regimen using 20 % albumin, and HES appears to be a valuable and significantly cheaper alternative to albumin – even for prolonged volume therapy in the critically ill patient.
Human albumin administration in critically ill patients: systematic review of randomised controlled trials.
TLDR
There is no evidence that albumin administration reduces mortality incritically ill patients with hypovolaemia, burns, or hypoalbuminaemia and a strong suggestion that it may increase mortality.
Cochrane Injuries Group Albumin ReviewersWhy albumin may not work
TLDR
There is no evidence that albumin administration reduces mortality incritically ill patients with hypovolaemia, burns, or hypoalbuminaemia and a strong suggestion that it may increase mortality.
The natural history of the systemic inflammatory response syndrome (SIRS). A prospective study.
TLDR
This prospective epidemiologic study of SIRS and related conditions provides the first evidence of a clinical progression from SirS to sepsis to severe sepsi and septic shock, and stepwise increases in mortality rates in the hierarchy.
Impairment of renal function in medical intensive care: predictability of acute renal failure.
TLDR
Bivariate and linear discriminant analyses revealed that variables related to bacterial infections and pancreatitis contributed to the discrimination, followed by bleeding, volume depletion, and chronic liver disease in the discriminant function.
Crystalloids vs. colloids in fluid resuscitation: a systematic review.
TLDR
Overall, there is no apparent difference in pulmonary edema, mortality, or length of stay between isotonic crystalloid and colloid resuscitation between randomized clinical trials of adult patients requiring fluid resuscitation vs. colloids.
Prognostic factors in acute renal failure due to sepsis. Results of a prospective multicentre study. The French Study Group on Acute Renal Failure.
TLDR
The results suggest that the use of biocompatible membranes may reduce significantly mortality in patients hospitalized with acute renal failure due to sepsis and the above-defined predictive factors are to be considered in studies on prognosis of ARF patients.
...
...