AI Article Synopsis
- The study assessed the risk of acute kidney injury (AKI) related to pentastarch in 563 cardiac surgery patients, finding a notable occurrence of AKI in 10% of cases.
- Key risk factors for AKI included age, gender, preoperative kidney function, and various surgical factors, with patients who developed AKI receiving a significantly higher volume of pentastarch compared to controls.
- The research concluded that the volume of pentastarch administered is dose-dependent in predicting AKI, with a critical threshold identified at 14 mL/kg.
Article Abstract
Unlabelled: OBJECTIVE, DESIGN AND PATIENTS: The risk of acute kidney injury (AKI) associated with hydroxyethyl starch may be limited to higher molecular weight agents. We retrospectively evaluated the risk of AKI using pentastarch 10% (250 kDa, 0.45) in a random cohort of 563 patients operated for a cardiac surgery at a university hospital.
Measures: We assessed previously identified preoperative, perioperative, and postoperative risk factors, and the volume of pentastarch given until the end of the first postoperative day. We defined AKI by a 50% rise in serum creatinine within 4 days after surgery. Different propensity adjustment methods were used to further assess the selection bias.
Results: Fifty-four (10%) patients developed AKI. Risk factors of AKI were age, female gender, preoperative creatinine clearance, hypertension, diuretic use, left ventricular ejection fraction, valvular surgery, duration of extracorporeal circulation, duration and dose of postoperative vasopressor support, and the number of red blood cells and fresh frozen plasma transfusions. Patients with AKI received 16 +/- 9 mL/kg of pentastarch as opposed to 10 +/- 7 mL/kg in controls (p < 0.001). Pentastarch remained independently predictive of AKI, with an adjusted odds ratio per mL/kg of 1.08 (95% confidence interval 1.04-1.12, p = 0.001). This risk was dose-dependent, and the optimal cutoff volume predicting AKI was 14 mL/kg. Different propensity adjustment methods were tested, and pentastarch as a risk factor of AKI was identified.
Conclusions: This study identified a dose-dependent risk of AKI with pentastarch following cardiac surgery, given until the end of the first postoperative day.
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| http://dx.doi.org/10.1097/CCM.0b013e31819cc1a0 | DOI Listing |
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