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Effects of hydroxyethyl starch 130/0.4 on serum creatinine concentration and development of acute kidney injury in nonazotemic cats


Sigrist, Nadja; Kälin, N; Dreyfus, Anou (2017). Effects of hydroxyethyl starch 130/0.4 on serum creatinine concentration and development of acute kidney injury in nonazotemic cats. Journal of Veterinary Internal Medicine, 31(6):1749-1756.

Abstract

BACKGROUND:: Hydroxyethyl-starch (HES) solutions might have renal adverse effects in humans and dogs.
OBJECTIVE: To determine if administration of 6% HES-130/0.4 is associated with an increase in serum creatinine concentration and development of acute kidney injury (AKI) in nonazotemic cats.
ANIMALS: A total of 62 critically ill cats; 26 HES exposed and 36 unexposed.
METHODS: Retrospective cohort study (2012-2015). Serum creatinine concentrations were recorded and changes in serum creatinine concentrations before exposure (baseline) and 2-10 and 11-90 days, respectively, were determined. Development of AKI was defined as a > 150% increase or >26 μmol/L increase in serum creatinine concentration from baseline. Risk factors, such as HES administration, cumulative volume of HES (mL/kg) and number of days of HES administration leading to development of AKI, and change in serum creatinine were analyzed.
RESULTS: Cats in the HES cohort received a mean volume of 98.5 ± 76.2 mL/kg (range, 8-278 mL/kg) HES over a median of 4 (range, 1-11) days, resulting in a median dose of 20.1 (range, 8-40.5) mL/kg per day. Short-term %change in serum creatinine concentration (P = 0.40) and development of AKI (P = 0.32) were not significantly different between cohorts. Multivariable logistic regression did not identify HES dose in mL/kg (P = 0.33) and number of days of HES application (P = 0.49) as a risk factor for development of AKI.
CONCLUSION AND CLINICAL IMPORTANCE: Hydroxyethyl-starch administration to critically ill nonazotemic cats seems to be safe. A larger prospective study is required to determine the effect of HES administration at higher dosages and for prolonged time periods.

Abstract

BACKGROUND:: Hydroxyethyl-starch (HES) solutions might have renal adverse effects in humans and dogs.
OBJECTIVE: To determine if administration of 6% HES-130/0.4 is associated with an increase in serum creatinine concentration and development of acute kidney injury (AKI) in nonazotemic cats.
ANIMALS: A total of 62 critically ill cats; 26 HES exposed and 36 unexposed.
METHODS: Retrospective cohort study (2012-2015). Serum creatinine concentrations were recorded and changes in serum creatinine concentrations before exposure (baseline) and 2-10 and 11-90 days, respectively, were determined. Development of AKI was defined as a > 150% increase or >26 μmol/L increase in serum creatinine concentration from baseline. Risk factors, such as HES administration, cumulative volume of HES (mL/kg) and number of days of HES administration leading to development of AKI, and change in serum creatinine were analyzed.
RESULTS: Cats in the HES cohort received a mean volume of 98.5 ± 76.2 mL/kg (range, 8-278 mL/kg) HES over a median of 4 (range, 1-11) days, resulting in a median dose of 20.1 (range, 8-40.5) mL/kg per day. Short-term %change in serum creatinine concentration (P = 0.40) and development of AKI (P = 0.32) were not significantly different between cohorts. Multivariable logistic regression did not identify HES dose in mL/kg (P = 0.33) and number of days of HES application (P = 0.49) as a risk factor for development of AKI.
CONCLUSION AND CLINICAL IMPORTANCE: Hydroxyethyl-starch administration to critically ill nonazotemic cats seems to be safe. A larger prospective study is required to determine the effect of HES administration at higher dosages and for prolonged time periods.

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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
630 Agriculture
Uncontrolled Keywords:Acute kidney injury, Feline, Hydroxyethyl-starch, Renal injury
Language:English
Date:1 September 2017
Deposited On:17 Oct 2017 13:42
Last Modified:19 Feb 2018 08:54
Publisher:Wiley Open Access
ISSN:0891-6640
OA Status:Gold
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/jvim.14813
PubMed ID:28862347

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