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Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007-2010).
J Vet Emerg Crit Care (San Antonio) 2016 Jan-Feb; 26(1):35-40JV

Abstract

OBJECTIVE

To determine the incidence of in-hospital adverse outcomes including acute kidney injury (AKI) and death in a population of dogs admitted to the intensive care unit (ICU) receiving 10% hydroxyethyl starch (HES) [250/0.5/5:1] compared with the general ICU population, while controlling for illness severity.

DESIGN

Cohort study conducted between January 2007 and March 2010.

SETTING

Veterinary teaching hospital.

ANIMALS

Consecutive sample of dogs receiving HES (n = 180) were compared with a randomly selected sample of dogs (n = 242) admitted to the ICU over the same period.

INTERVENTIONS

None

MEASUREMENTS AND MAIN RESULTS

AKI was defined as an at least 2-fold increase in baseline creatinine concentration or new onset of oliguria/anuria persisting for ≥12 hours. The primary outcome was a composite of in-hospital death or AKI. Unadjusted and adjusted analysis controlling for illness severity using the acute patient physiologic and laboratory evaluation (APPLEfast) score and other confounders was performed. HES was administered either as incremental boluses (median dose 8.2 mL/kg/day, interquartile range [IQR] 5.0-11.3 mL/kg/day) or as a continuous rate infusion (CRI; median dose 26mL/kg/day, IQR 24.0-48 mL/kg/day). In unadjusted analysis, HES administration was associated with increased risk of mortality (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 1.51-3.58, P < 0.001) or AKI (OR = 3.87, 95% CI = 1.21-12.37, P = 0.02). In an adjusted analysis after controlling for illness severity, admission type, and concurrent administration of blood products, HES administration remained an independent risk factor for the composite adverse outcome (OR = 1.98, 95% CI = 1.22-3.22, P = 0.005), with a number needed to harm (NNH) = 6 (95% CI = 4-23).

CONCLUSIONS

HES therapy is associated with increased risk of an adverse outcome including death or AKI in dogs. A randomized controlled trial investigating the safety of HES therapy in canine patients is warranted.

Authors+Show Affiliations

Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26587795

Citation

Hayes, Galina, et al. "Retrospective Cohort Study On the Incidence of Acute Kidney Injury and Death Following Hydroxyethyl Starch (HES 10% 250/0.5/5:1) Administration in Dogs (2007-2010)." Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), vol. 26, no. 1, 2016, pp. 35-40.
Hayes G, Benedicenti L, Mathews K. Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007-2010). J Vet Emerg Crit Care (San Antonio). 2016;26(1):35-40.
Hayes, G., Benedicenti, L., & Mathews, K. (2016). Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007-2010). Journal of Veterinary Emergency and Critical Care (San Antonio, Tex. : 2001), 26(1), pp. 35-40. doi:10.1111/vec.12412.
Hayes G, Benedicenti L, Mathews K. Retrospective Cohort Study On the Incidence of Acute Kidney Injury and Death Following Hydroxyethyl Starch (HES 10% 250/0.5/5:1) Administration in Dogs (2007-2010). J Vet Emerg Crit Care (San Antonio). 2016;26(1):35-40. PubMed PMID: 26587795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Retrospective cohort study on the incidence of acute kidney injury and death following hydroxyethyl starch (HES 10% 250/0.5/5:1) administration in dogs (2007-2010). AU - Hayes,Galina, AU - Benedicenti,Leontine, AU - Mathews,Karol, Y1 - 2015/11/20/ PY - 2015/05/19/received PY - 2015/06/26/revised PY - 2015/07/18/accepted PY - 2015/11/21/entrez PY - 2015/11/21/pubmed PY - 2016/9/22/medline KW - AKI KW - canine KW - colloids KW - complications KW - fluid therapy SP - 35 EP - 40 JF - Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) JO - J Vet Emerg Crit Care (San Antonio) VL - 26 IS - 1 N2 - OBJECTIVE: To determine the incidence of in-hospital adverse outcomes including acute kidney injury (AKI) and death in a population of dogs admitted to the intensive care unit (ICU) receiving 10% hydroxyethyl starch (HES) [250/0.5/5:1] compared with the general ICU population, while controlling for illness severity. DESIGN: Cohort study conducted between January 2007 and March 2010. SETTING: Veterinary teaching hospital. ANIMALS: Consecutive sample of dogs receiving HES (n = 180) were compared with a randomly selected sample of dogs (n = 242) admitted to the ICU over the same period. INTERVENTIONS: None MEASUREMENTS AND MAIN RESULTS: AKI was defined as an at least 2-fold increase in baseline creatinine concentration or new onset of oliguria/anuria persisting for ≥12 hours. The primary outcome was a composite of in-hospital death or AKI. Unadjusted and adjusted analysis controlling for illness severity using the acute patient physiologic and laboratory evaluation (APPLEfast) score and other confounders was performed. HES was administered either as incremental boluses (median dose 8.2 mL/kg/day, interquartile range [IQR] 5.0-11.3 mL/kg/day) or as a continuous rate infusion (CRI; median dose 26mL/kg/day, IQR 24.0-48 mL/kg/day). In unadjusted analysis, HES administration was associated with increased risk of mortality (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 1.51-3.58, P < 0.001) or AKI (OR = 3.87, 95% CI = 1.21-12.37, P = 0.02). In an adjusted analysis after controlling for illness severity, admission type, and concurrent administration of blood products, HES administration remained an independent risk factor for the composite adverse outcome (OR = 1.98, 95% CI = 1.22-3.22, P = 0.005), with a number needed to harm (NNH) = 6 (95% CI = 4-23). CONCLUSIONS: HES therapy is associated with increased risk of an adverse outcome including death or AKI in dogs. A randomized controlled trial investigating the safety of HES therapy in canine patients is warranted. SN - 1476-4431 UR - https://www.unboundmedicine.com/medline/citation/26587795/Retrospective_cohort_study_on_the_incidence_of_acute_kidney_injury_and_death_following_hydroxyethyl_starch__HES_10_250/0_5/5:1__administration_in_dogs__2007_2010__ L2 - https://doi.org/10.1111/vec.12412 DB - PRIME DP - Unbound Medicine ER -