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Changes in Serum Creatinine Concentration and Acute Kidney Injury (AKI) Grade in Dogs Treated with Hydroxyethyl Starch 130/0.4 From 2013 to 2015


Sigrist, N E; Kälin, N; Dreyfus, A (2017). Changes in Serum Creatinine Concentration and Acute Kidney Injury (AKI) Grade in Dogs Treated with Hydroxyethyl Starch 130/0.4 From 2013 to 2015. Journal of Veterinary Internal Medicine, 31(2):434-441.

Abstract

Background: Hydroxyethyl starch (HES) solutions may cause acute kidney injury (AKI) in humans.
Objective: To compare AKI grades in 94 dogs exposed and 90 dogs that were unexposed to 6% HES-130/0.4.
Animals: Dogs receiving 6% HES-130/0.4 (HES cohort) or crystalloids (unexposed cohort) between 2013 and 2015. Methods: Historical cohort study. Diagnosis, total cumulative dose and total mL/kg of HES administered, time frame of
HES administration and serum creatinine concentrations up to 90 days after initiation of HES treatment were retrospectively reviewed. The AKI grades were retrospectively determined by IRIS guidelines.
Results: Exposed dogs received a median cumulative dose of 69.4 mL/kg (range, 2–429 mL/kg) HES over a median of 4 (range, 1–16) days, resulting in a median dose of 20.7 (range, 2–87) mL/kg/d. Although the cohorts differed in terms of age and diagnosis, AKI grades were not significantly different at the evaluated short- and long-term time points. Results of ordi- nal logistic regression identified the number of days of HES administration as significantly associated with an increase in AKI grade within 10 days (P = .038), whereas there was no significant association among HES exposure, HES mL/kg/d, and an increase in AKI grade.
Conclusions and Clinical Importance: HES-130/0.4-treated dogs were not more prone to develop AKI than HES- untreated, but the number of HES days was significantly associated with an increase in AKI grade within 10 days post-HES administration. The time frame of HES treatment should be kept short. Prospective, randomized clinical trials are required to assess the effect of HES on renal function in dogs.

Abstract

Background: Hydroxyethyl starch (HES) solutions may cause acute kidney injury (AKI) in humans.
Objective: To compare AKI grades in 94 dogs exposed and 90 dogs that were unexposed to 6% HES-130/0.4.
Animals: Dogs receiving 6% HES-130/0.4 (HES cohort) or crystalloids (unexposed cohort) between 2013 and 2015. Methods: Historical cohort study. Diagnosis, total cumulative dose and total mL/kg of HES administered, time frame of
HES administration and serum creatinine concentrations up to 90 days after initiation of HES treatment were retrospectively reviewed. The AKI grades were retrospectively determined by IRIS guidelines.
Results: Exposed dogs received a median cumulative dose of 69.4 mL/kg (range, 2–429 mL/kg) HES over a median of 4 (range, 1–16) days, resulting in a median dose of 20.7 (range, 2–87) mL/kg/d. Although the cohorts differed in terms of age and diagnosis, AKI grades were not significantly different at the evaluated short- and long-term time points. Results of ordi- nal logistic regression identified the number of days of HES administration as significantly associated with an increase in AKI grade within 10 days (P = .038), whereas there was no significant association among HES exposure, HES mL/kg/d, and an increase in AKI grade.
Conclusions and Clinical Importance: HES-130/0.4-treated dogs were not more prone to develop AKI than HES- untreated, but the number of HES days was significantly associated with an increase in AKI grade within 10 days post-HES administration. The time frame of HES treatment should be kept short. Prospective, randomized clinical trials are required to assess the effect of HES on renal function in dogs.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
05 Vetsuisse Faculty > Chair in Veterinary Epidemiology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2017
Deposited On:03 May 2017 15:43
Last Modified:04 May 2017 20:54
Publisher:Wiley Open Access
ISSN:0891-6640
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/jvim.14645

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