Impact of hydroxyethyl starch 70/0.5 on acute kidney injury after gastroenterological surgery.
10.4097/kjae.2016.69.5.460
- Author:
Takeshi UMEGAKI
1
;
Takeo UBA
;
Chisato SUMI
;
Sachiyo SAKAMOTO
;
Sachiko JOMURA
;
Kiichi HIROTA
;
Koh SHINGU
Author Information
1. Department of Anesthesiology, Hirakata Hospital, Kansai Medical University, Osaka, Japan. umegakit@hirakata.kmu.ac.jp
- Publication Type:Original Article
- Keywords:
Acute kidney injury;
Gastroenterological surgery;
Hydroxyethyl starch
- MeSH:
Acute Kidney Injury*;
Asian Continental Ancestry Group;
Humans;
Incidence;
Logistic Models;
Mortality;
Propensity Score;
Renal Replacement Therapy;
Resuscitation;
Retrospective Studies;
Starch*
- From:Korean Journal of Anesthesiology
2016;69(5):460-467
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Previous studies reported a higher mortality risk and a greater need for renal replacement therapy in patients administered hydroxyethyl starch (HES) rather than other fluid resuscitation preparations. In this study, we investigated the association between 6% HES 70/0.5 use and postoperative acute kidney injury (AKI) in gastroenterological surgery patients. METHODS: We conducted retrospective full-cohort and propensity-score-based analyses of patients who underwent gastroenterological surgery between June 2011 and August 2013 in a Japanese university hospital. The study sample comprised 66 AKI and 2,152 non-AKI patients in the full-cohort analysis and 35 AKI and 1,269 non-AKI patients in the propensity-score-based analysis. Propensity scores were calculated using an ordered logistic regression model in which the dependent variable comprised three groups based on HES infusion volumes (0, 1–999, and ≥ 1,000 ml). The association between HES groups and postoperative AKI incidence was analyzed using multiple logistic regression models. Other candidate independent variables included patient characteristics and intraoperative measures. RESULTS: In the full-cohort analysis, 40 (60.6%) AKI patients were diagnosed as "risk", 15 (22.7%) as "injury," and 11 (16.7%) as "failure". In the propensity-score-based analysis, the corresponding values were 22 (62.9%), 8 (22.9%), and 5 (14.3%). There was no significant association between total infused HES and postoperative AKI incidence in either the full-cohort or the propensity-score-based analysis (P = 0.168 and P = 0.42, respectively). CONCLUSIONS: AKI incidence was not associated with clinical 6% HES 70/0.5 administration in gastroenterological surgery patients treated at a single center.
