Evidence map›Paper›PMID 34564829›Full record

ArticleDrug safety2021

Renal Safety of Hydroxyethyl starch 130/0.42 After Cardiac Surgery: A Retrospective Cohort Analysis.

Benedict Morath, Andreas D Meid, Johannes Rickmann, Jasmin Soethoff, Markus Verch, Matthias Karck, Marcin Zaradzki

Abstract read
In one paragraph

Article in Drug safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Benedict Morath *Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany.
Andreas D Meid *Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Heidelberg, Germany.
Johannes RickmannCenter for Information and Medical Technology, Heidelberg University Hospital, Heidelberg, Germany.
Jasmin SoethoffDepartment of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Markus VerchDepartment of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Matthias KarckDepartment of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Marcin ZaradzkiDepartment of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany. marcin.zaradzki@med.uni-heidelberg.de.ORCID 0000-0001-5612-7754

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe risk for renal complications from hydroxyethyl starch 130/0.42 (HES) impacts treatment decisions in patients after cardiac surgery.

objectiveThe objective of this study was to determine the impact of postoperatively administered HES on renal function and 90-day mortality compared to sole crystalloid administration in patients after elective cardiac surgery.

methodsUsing electronic health records from a university hospital, confounding-adjusted models analyzed the associations between postoperative HES administration and the occurrence of postoperative acute kidney injury. In addition, 90-day mortality was evaluated. The impact of HES dosage and timing on renal function on trajectories of estimated glomerular filtration rates over the postoperative period was investigated using linear mixed-effects models.

resultsOverall 1009 patients (45.0%) experienced acute kidney injury. Less acute kidney injury occurred in patients receiving HES compared with patients receiving only crystalloids for fluid resuscitation (43.7% vs 51.2%, p = 0.008). In multivariate acute kidney injury models, HES had a protective association (odds ratio: 0.89; 95% confidence interval 0.82-0.96). Crystalloids were not as protective as HES (odds ratio: 0.98; 95% confidence interval 0.95-1.00). There was no association between HES and 90-day mortality (odds ratio: 1.05; 95% confidence interval 0.88-1.25). Renal function trajectories were dose dependent and biphasic, HES appeared to slow down the late postoperative decline.

conclusionsThis study showed no association between HES and the postoperative occurrence of acute kidney injury and thus further closes the evidence gap on HES safety in cardiac surgery patients. Although this was a retrospective cohort study, the results indicated that HES might be safely administered to cardiac surgery patients with regard to renal outcomes, especially if it was administered early and dosed appropriately.

Indexed as

Acute Kidney InjuryCardiac Surgical ProceduresCohort StudiesFemaleHumansHydroxyethyl Starch DerivativesKidneyMaleRetrospective StudiesHydroxyethyl Starch Derivatives

Identifiers

PMID34564829
PMCPMC8626393

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