• Samuel Degoul, Emmanuel Chazard, Antoine Lamer, Gilles Lebuffe, Alain Duhamel, and Benoît Tavernier.
• CHU de Lille, Pôle d'anesthésie-réanimation, 59000 Lille, France. Electronic address: samuel.degoul@posteo.net.
• Anaesth Crit Care Pain Med. 2020 Apr 1; 39 (2): 199-206.

BackgroundIntraoperative use of hydroxyethyl starch (HES) may increase the risk of postoperative acute kidney injury (AKI). Data from large populations are lacking. We aimed to assess whether intraoperative administration of 6% HES 130/0.4 is associated with AKI in non-cardiac surgery.MethodsThis retrospective study used the electronic records concerning elective abdominal, urologic, thoracic and peripheral vascular surgeries from 2010 to 2015. HES and non-HES patients were compared using a propensity score matching. Postoperative AKI, defined by stage 3 of the Kidney Disease Improving Global Outcomes (KDIGO) score, was the primary outcome. Because the use of HES markedly decreased in 2013, additional analyses, restricted to the 2010-2012 period, were also performed.ResultsIn total, 23,045, and 11,691 patients were included in the whole, and restricted periods, respectively. The reduction in HES use was not accompanied by any change in the incidence of AKI. Unadjusted association between HES and KDIGO 3 AKI was significant (OR [95% CI] of 2.13 [1.67, 2.71]). For the whole period, 6460 patients were matched. Odd ratios for KDIGO 3 and all-stage AKI when using HES (10.3±4.7mL.kg-1) were 1.20 (95% CI [0.74, 1.95]), and 1.21 (95% CI [0.95, 1.54]), respectively. There was no association with the initiation of renal replacement therapy or in-hospital mortality either. Similar results were found for the restricted period.ConclusionThe intraoperative use of moderate doses of 6% HES 130/0.4 was not associated with increased risk of AKI. No conclusion can be drawn for higher doses of HES.Copyright © 2020 Société française d'anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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