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Critical Care
Published in: Critical Care 4/2013

01-08-2013 | Letter

Concerns about renal safety of HES 130

Authors: Christian J Wiedermann, Michael Joannidis

Published in: Critical Care | Issue 4/2013

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Excerpt

In a meta-analysis of 34 randomized trials evaluating hydroxyethyl starch (HES) 130/0.4 in 9,587 patients and a meta-analysis evaluating HES 130/0.42 in 804 patients, HES 130 was shown to increase mortality and the need for renal replacement therapy (RRT) [1]. In the largest included trial of the meta-analysis, the Crystalloid versus Hydroxyethyl Starch Trial (CHEST) with 7,000 ICU patients [2], HES 130/0.4 increased the need for RRT despite a low average daily dose of only 526 ml. The meta-analysis also included RRT data from the CRYSTMAS trial that had not been reported in the original publication of that trial but were later published in a letter to Critical Care [3] and also incorporated in revised US Prescribing Information for HES 130/0.4 [4]. …
Literature
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Gattas DJ, Dan A, Myburgh J, Billot L, Lo S, Finfer S: Fluid resuscitation with 6% hydroxyethyl starch (130/0.4 and 130/0.42) in acutely ill patients: systematic review of effects on mortality and treatment with renal replacement therapy. Intensive Care Med. 2013, 39: 558-568. 10.1007/s00134-013-2840-0.PubMedCrossRef
2.
Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, Glass P, Lipman J, Liu B, McArthur C, McGuinness S, Rajbhandari D, Taylor CB, Webb SA: Hydroxyethyl starch or saline for fluid resuscitation in intensive care. N Engl J Med. 2012, 367: 1901-1911. 10.1056/NEJMoa1209759.PubMedCrossRef
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Hartog CS, Reinhart K: CRYSTMAS study adds to concerns about renal safety and increased mortality in sepsis patients. Crit Care. 2012, 16: 454-10.1186/cc11673.PubMedPubMedCentralCrossRef
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Martin C, Jacob M, Vicaut E, Guidet B, Van Aken H, Kurz A: Effect of waxy maize-derived hydroxyethyl starch 130/0.4 on renal function in surgical patients. Anesthesiology. 2013, 118: 387-394. 10.1097/ALN.0b013e31827e5569.PubMedCrossRef
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Boussekey N, Darmon R, Langlois J, Alfandari S, Devos P, Meybeck A, Chiche A, Georges H, Leroy O: Resuscitation with low volume hydroxyethylstarch 130 kDa/0.4 is not associated with acute kidney injury. Crit Care. 2010, 14: R40-10.1186/cc8920.PubMedPubMedCentralCrossRef
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Ostermann M, Chang RW: Acute kidney injury in the intensive care unit according to RIFLE. Crit Care Med. 2007, 35: 1837-1843. 10.1097/01.CCM.0000277041.13090.0A.PubMedCrossRef
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Hoste EA, Clermont G, Kersten A, Venkataraman R, Angus DC, De Bacquer D, Kellum JA: Rifle classification for predicting in-hospital mortality in critically ill sepsis patients. Crit Care. 2006, 10: R73-10.1186/cc4915.PubMedPubMedCentralCrossRef
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Bagshaw SM, George C, Dinu I, Bellomo R: A multi-centre evaluation of the RIFLE criteria for early acute kidney injury in critically ill patients. Nephrol Dial Transplant. 2008, 23: 1203-1210.PubMedCrossRef
Metadata
Title
Concerns about renal safety of HES 130
Authors
Christian J Wiedermann
Michael Joannidis
Publication date
01-08-2013
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2013
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc12805

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