Nephrotoxicity of hydroxyethyl starch 130/0.4 infusion in patients receiving coronary artery bypass surgery: a retrospective study

Background: Hydroxyethyl starch (HES) is helpful to maintain the stable haemodynamics in patients receiving cardiac surgery. However, there are concerns regarding the nephrotoxicity of HES. Objectives: This study was to evaluate the nephrotoxicity of HES 130/0.4 in patients receiving on-pump coronary artery bypass surgery. Methods: Patients receiving on-pump coronary artery bypass surgery in Xinqiao Hospital between September 1, 2012 and December 31, 2014 were retrospectively reviewed. Acute kidney injury (AKI) was defined according to the RIFLE criteria, and the renal injury (sCystatin C) was compared between patients with and without HES 130/0.4 infusion in the first 72 h after surgery. Results: A total of 149 patients were included. The incidence of AKI within 72 h was similar between two groups, and the risk for AKI (95% CI, 0.979-1.139) was not increased by hetastarch, even at a dose of 37 ml/kg. Conclusion: HES 130/0.4 does not increase the risk for AKI when it is used for the volume therapy in patients receiving coronary artery bypass surgery, and may neither enhance tubular injury nor alter the glomerular filtration.