Newly Published
Perioperative Medicine  |   October 2017
No Differences in Renal Function between Balanced 6% Hydroxyethyl Starch (130/0.4) and 5% Albumin for Volume Replacement Therapy in Patients Undergoing Cystectomy: A Randomized Controlled Trial
Author Notes
  • From the Departments of Anesthesiology (T.K., F.B., S.H., N.H., F.K., J.P., K.H.-K., P.C., M.R.) and Urology (A.K.), Hospital of the University of Munich, and Department of Medical Informatics, Biometry, and Epidemiology (A.C.), Ludwig-Maximilians-Universität München, Munich, Germany.
  • Submitted for publication December 16, 2016. Accepted for publication September 15, 2017.
    Submitted for publication December 16, 2016. Accepted for publication September 15, 2017.×
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Research Support: Supported by CSL Behring GmbH (Marburg, Germany).
    Research Support: Supported by CSL Behring GmbH (Marburg, Germany).×
  • Competing Interests: The authors declare no competing interests.
    Competing Interests: The authors declare no competing interests.×
  • Reproducible Science: Full protocol available at: tobias.kammerer@med.uni-muenchen.de. Raw data available at: tobias.kammerer@med.uni-muenchen.de.
    Reproducible Science: Full protocol available at: tobias.kammerer@med.uni-muenchen.de. Raw data available at: tobias.kammerer@med.uni-muenchen.de.×
  • Correspondence: Address correspondence to Dr. Kammerer: Department of Anaesthesiology, Hospital of the University of Munich, Ludwig-Maximilians-Universität München, Marchioninistraße 15, 81377 Munich, Germany. tobias.kammerer@med.uni-muenchen.de. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Perioperative Medicine / Coagulation and Transfusion / Renal and Urinary Systems / Electrolyte Balance
Perioperative Medicine   |   October 2017
No Differences in Renal Function between Balanced 6% Hydroxyethyl Starch (130/0.4) and 5% Albumin for Volume Replacement Therapy in Patients Undergoing Cystectomy: A Randomized Controlled Trial
Anesthesiology Newly Published on October 26, 2017. doi:10.1097/ALN.0000000000001927
Anesthesiology Newly Published on October 26, 2017. doi:10.1097/ALN.0000000000001927
Abstract

Background: The use of artificial colloids has declined in critical care, whereas they are still used in perioperative medicine. Little is known about the nephrotoxic potential in noncritically ill patients during routine surgery. The objective of this trial was to evaluate the influences of albumin 5% and balanced hydroxyethyl starch 6% (130/0.4) on renal function and kidney injury.

Methods: One-hundred urologic patients undergoing elective cystectomy were randomly assigned for this prospective, single-blinded, controlled study with two parallel groups to receive either albumin 5% or balanced hydroxyethyl starch 6% (130/0.4) as the only perioperative colloid. The primary endpoint was the ratio of serum cystatin C between the last visit at day 90 and the first preoperative visit. Secondary endpoints were estimated glomerular filtration rate and serum neutrophil gelatinase-associated lipocalin until the third postoperative day and risk, injury, failure, loss, and end-stage renal disease criteria at postoperative days 3 and 90.

Results: The median cystatin C ratio was 1.11 (interquartile range, 1.01 to 1.23) in the albumin and 1.08 (interquartile range, 1.00 to 1.20) in the hydroxyethyl starch group (median difference = 0.03; 95% CI, –0.09 to 0.08; P = 0.165). Also, there were no significant differences concerning serum cystatin C concentrations; estimated glomerular filtration rate; risk, injury, failure, loss, and end stage renal disease criteria; and neutrophil gelatinase-associated lipocalin. Infusion requirements, transfusion rates, and perioperative hemodynamics were similar in both groups.

Conclusions: With respect to renal function and kidney injury, this study indicates that albumin 5% and balanced hydroxyethyl starch 6% have comparable safety profiles in noncritically ill patients undergoing major surgery.