The risk of AKI in patients treated with intravenous solutions containing hydroxyethyl starch

Clin J Am Soc Nephrol. 2013 Mar;8(3):497-503. doi: 10.2215/CJN.10921012. Epub 2013 Jan 18.

Abstract

Intravenous fluids are arguably one of the most commonly administered inpatient therapies and for the most part have been viewed as part of the nephrologist's toolkit in the management of acute kidney disease. Recently, findings have suggested that intravenous fluids may be harmful if given in excess (quantitative toxicity) and that some may be more harmful than others (qualitative toxicity), particularly for patients who already have AKI. Recent clinical trials have investigated hydroxyethyl starch solutions and found worrying results for the renal community. In this brief review, we consider the published literature on the role of hydroxyethyl starch solutions in AKI, with particular emphasis on two large recent randomized clinical trials conducted in Europe and Australia.

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / mortality
  • Acute Kidney Injury / therapy
  • Evidence-Based Medicine
  • Fluid Therapy / adverse effects*
  • Fluid Therapy / mortality
  • Humans
  • Hydroxyethyl Starch Derivatives / administration & dosage
  • Hydroxyethyl Starch Derivatives / adverse effects*
  • Infusions, Intravenous
  • Plasma Substitutes / administration & dosage
  • Plasma Substitutes / adverse effects*
  • Risk Assessment
  • Risk Factors

Substances

  • Hydroxyethyl Starch Derivatives
  • Plasma Substitutes