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Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats.
J Vet Intern Med 2017; 31(6):1749-1756JV

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.

Authors+Show Affiliations

Department for Small Animals, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.Department for Small Animals, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.Section of Epidemiology (Dreyfus), Vetsuisse Faculty, University of Zürich, Zürich, Switzerland.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28862347

Citation

Sigrist, N E., et al. "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, vol. 31, no. 6, 2017, pp. 1749-1756.
Sigrist NE, Kälin N, Dreyfus A. Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats. J Vet Intern Med. 2017;31(6):1749-1756.
Sigrist, N. E., Kälin, N., & Dreyfus, A. (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), pp. 1749-1756. doi:10.1111/jvim.14813.
Sigrist NE, Kälin N, Dreyfus A. Effects of Hydroxyethyl Starch 130/0.4 On Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats. J Vet Intern Med. 2017;31(6):1749-1756. PubMed PMID: 28862347.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of Hydroxyethyl Starch 130/0.4 on Serum Creatinine Concentration and Development of Acute Kidney Injury in Nonazotemic Cats. AU - Sigrist,N E, AU - Kälin,N, AU - Dreyfus,A, Y1 - 2017/09/01/ PY - 2017/01/19/received PY - 2017/05/23/revised PY - 2017/07/24/accepted PY - 2017/9/2/pubmed PY - 2018/9/18/medline PY - 2017/9/2/entrez KW - Acute kidney injury KW - Feline KW - Hydroxyethyl-starch KW - Renal injury SP - 1749 EP - 1756 JF - Journal of veterinary internal medicine JO - J. Vet. Intern. Med. VL - 31 IS - 6 N2 - 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. SN - 1939-1676 UR - https://www.unboundmedicine.com/medline/citation/28862347/Effects_of_Hydroxyethyl_Starch_130/0_4_on_Serum_Creatinine_Concentration_and_Development_of_Acute_Kidney_Injury_in_Nonazotemic_Cats_ L2 - https://doi.org/10.1111/jvim.14813 DB - PRIME DP - Unbound Medicine ER -