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Hydroxyethyl Starch, Acute Kidney Injury, and Mortality

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Reducing Mortality in Acute Kidney Injury

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Abstract

Hydroxyethyl starch (HES) causes harm in critically ill patients, including renal injury and increased mortality. This has been concluded from high-quality randomized controlled trials with low risk of bias. In 2013, the European Medicines Agency and the US Food and Drug Administration determined that the use of HES solutions was associated with an increased risk of mortality and renal replacement therapy (RRT) or renal failure. HES is also associated with other serious adverse reactions such as increased bleeding, hepatic organ failure, anaphylactic reactions, and pruritus. For patients with severe sepsis or septic shock, the risks of increased mortality and more frequent use of RRT are considered to outweigh the limited benefits of more rapid attainment of hemodynamic stability as compared with crystalloids. Furthermore, sufficient evidence is not available to indicate that the benefits of using HES in other clinical settings (e.g., during surgery) outweigh the risks.

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Authors and Affiliations

  1. Department of Internal Medicine, Central Hospital of Bolzano, Lorenz Böhler Street 5, 39100, Bolzano, Italy

    Christian J. Wiedermann MD

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  1. Christian J. Wiedermann MD
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Correspondence to Christian J. Wiedermann MD .

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Editors and Affiliations

  1. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Giovanni Landoni

  2. Cardiac Anesthesia & ICU, AORN Dei Colli, Monaldi Hospital Cardiac Anesthesia & ICU, Naples, Italy

    Antonio Pisano

  3. IRCCS San Raffaele Scientific Institute, Dept of Anesthesia & Intensive care, Milano, Milano, Italy

    Alberto Zangrillo

  4. Austin Hospital, Heidelberg, Victoria, Australia

    Rinaldo Bellomo

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Wiedermann, C.J. (2016). Hydroxyethyl Starch, Acute Kidney Injury, and Mortality. In: Landoni, G., Pisano, A., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Acute Kidney Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-33429-5_20

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  • DOI: https://doi.org/10.1007/978-3-319-33429-5_20

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33427-1

  • Online ISBN: 978-3-319-33429-5

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