Association between intraoperative starch use and postoperative kidney dysfunction in patients undergoing major gastro-intestinal surgery: A propensity score–matched analysis

Background: The impact of intraoperative starch-based fluid therapy on postoperative kidney dysfunction in patients undergoing major abdominal surgery is uncertain. Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the...

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Veröffentlicht in:Journal of perioperative practice 2025-01, Vol.35 (1-2), p.14-21
Hauptverfasser: Iyer, Karthik V, Giri, Sanjeeb, Ray, Bikash R, Muthiah, Thilaka, Anand, Rahul K, Kaur, Manpreet, Kumar, Rakesh, Punj, Jyotsna, Rewari, Vimi, Sahni, Peush, Maitra, Souvik
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container_end_page 21
container_issue 1-2
container_start_page 14
container_title Journal of perioperative practice
container_volume 35
creator Iyer, Karthik V
Giri, Sanjeeb
Ray, Bikash R
Muthiah, Thilaka
Anand, Rahul K
Kaur, Manpreet
Kumar, Rakesh
Punj, Jyotsna
Rewari, Vimi
Sahni, Peush
Maitra, Souvik
description Background: The impact of intraoperative starch-based fluid therapy on postoperative kidney dysfunction in patients undergoing major abdominal surgery is uncertain. Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the impact of intraoperative 6% hydroxyethyl starch on postoperative renal dysfunction. The primary outcome of this study was postoperative acute kidney injury as per KDIGO definition within 72 hours of surgery. Results: This study analysed data from 461 patients with a median (interquartile range) age of 45 (33–58) years, and 48.2% of all patients were female. The proportion (95% confidence interval) of patients who developed acute kidney injury was 0.18 (0.14−0.21); 62.9% of patients had acute kidney injury stage I, 32% had acute kidney injury stage II, and the rest were acute kidney injury stage III. In the propensity score–matched sample, the average treatment effect of intraoperative colloid use on postoperative serum creatinine at day 3 (p = 0.32), duration of postoperative intensive care unit stay (p = 0.97), duration of hospital stay (p = 0.37), postoperative worst international normalised ratio (p = 0.92), and postoperative transfusion requirement (p = 0.40) were not statistically significant. Conclusion: Intraoperative use of low molecular weight hydroxyethyl starch use was not associated with postoperative kidney dysfunction and coagulopathy in adult patients undergoing major open abdominal surgery.
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Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the impact of intraoperative 6% hydroxyethyl starch on postoperative renal dysfunction. The primary outcome of this study was postoperative acute kidney injury as per KDIGO definition within 72 hours of surgery. Results: This study analysed data from 461 patients with a median (interquartile range) age of 45 (33–58) years, and 48.2% of all patients were female. The proportion (95% confidence interval) of patients who developed acute kidney injury was 0.18 (0.14−0.21); 62.9% of patients had acute kidney injury stage I, 32% had acute kidney injury stage II, and the rest were acute kidney injury stage III. In the propensity score–matched sample, the average treatment effect of intraoperative colloid use on postoperative serum creatinine at day 3 (p = 0.32), duration of postoperative intensive care unit stay (p = 0.97), duration of hospital stay (p = 0.37), postoperative worst international normalised ratio (p = 0.92), and postoperative transfusion requirement (p = 0.40) were not statistically significant. Conclusion: Intraoperative use of low molecular weight hydroxyethyl starch use was not associated with postoperative kidney dysfunction and coagulopathy in adult patients undergoing major open abdominal surgery.</description><identifier>ISSN: 1750-4589</identifier><identifier>ISSN: 2515-7949</identifier><identifier>EISSN: 2515-7949</identifier><identifier>DOI: 10.1177/17504589231174967</identifier><identifier>PMID: 37646441</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Abdominal surgery ; Acute Kidney Injury - etiology ; Adult ; Carbohydrates ; Digestive System Surgical Procedures - adverse effects ; Female ; Fluid Therapy - methods ; Humans ; Hydroxyethyl Starch Derivatives - administration &amp; dosage ; Hydroxyethyl Starch Derivatives - adverse effects ; Intraoperative Care - methods ; Intravenous therapy ; Kidney diseases ; Kidneys ; Male ; Middle Aged ; Molecular weight ; Perioperative care ; Postoperative Complications - epidemiology ; Postoperative period ; Propensity Score ; Retrospective Studies ; Surgical outcomes</subject><ispartof>Journal of perioperative practice, 2025-01, Vol.35 (1-2), p.14-21</ispartof><rights>The Author(s) 2023</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2711-1fd8d81bc98cb13dd321664decbd4b38337b58a300287355c847b4ad6dbb93ec3</cites><orcidid>0000-0002-2328-9201 ; 0000-0001-9800-1367 ; 0000-0002-0832-7433</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/17504589231174967$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/17504589231174967$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,777,781,21800,27905,27906,43602,43603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37646441$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iyer, Karthik V</creatorcontrib><creatorcontrib>Giri, Sanjeeb</creatorcontrib><creatorcontrib>Ray, Bikash R</creatorcontrib><creatorcontrib>Muthiah, Thilaka</creatorcontrib><creatorcontrib>Anand, Rahul K</creatorcontrib><creatorcontrib>Kaur, Manpreet</creatorcontrib><creatorcontrib>Kumar, Rakesh</creatorcontrib><creatorcontrib>Punj, Jyotsna</creatorcontrib><creatorcontrib>Rewari, Vimi</creatorcontrib><creatorcontrib>Sahni, Peush</creatorcontrib><creatorcontrib>Maitra, Souvik</creatorcontrib><title>Association between intraoperative starch use and postoperative kidney dysfunction in patients undergoing major gastro-intestinal surgery: A propensity score–matched analysis</title><title>Journal of perioperative practice</title><addtitle>J Perioper Pract</addtitle><description>Background: The impact of intraoperative starch-based fluid therapy on postoperative kidney dysfunction in patients undergoing major abdominal surgery is uncertain. Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the impact of intraoperative 6% hydroxyethyl starch on postoperative renal dysfunction. The primary outcome of this study was postoperative acute kidney injury as per KDIGO definition within 72 hours of surgery. Results: This study analysed data from 461 patients with a median (interquartile range) age of 45 (33–58) years, and 48.2% of all patients were female. The proportion (95% confidence interval) of patients who developed acute kidney injury was 0.18 (0.14−0.21); 62.9% of patients had acute kidney injury stage I, 32% had acute kidney injury stage II, and the rest were acute kidney injury stage III. In the propensity score–matched sample, the average treatment effect of intraoperative colloid use on postoperative serum creatinine at day 3 (p = 0.32), duration of postoperative intensive care unit stay (p = 0.97), duration of hospital stay (p = 0.37), postoperative worst international normalised ratio (p = 0.92), and postoperative transfusion requirement (p = 0.40) were not statistically significant. 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Low molecular weight starch is expected to cause less postoperative kidney dysfunction. Methods: This retrospective study evaluated the impact of intraoperative 6% hydroxyethyl starch on postoperative renal dysfunction. The primary outcome of this study was postoperative acute kidney injury as per KDIGO definition within 72 hours of surgery. Results: This study analysed data from 461 patients with a median (interquartile range) age of 45 (33–58) years, and 48.2% of all patients were female. The proportion (95% confidence interval) of patients who developed acute kidney injury was 0.18 (0.14−0.21); 62.9% of patients had acute kidney injury stage I, 32% had acute kidney injury stage II, and the rest were acute kidney injury stage III. 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subjects Abdominal surgery
Acute Kidney Injury - etiology
Adult
Carbohydrates
Digestive System Surgical Procedures - adverse effects
Female
Fluid Therapy - methods
Humans
Hydroxyethyl Starch Derivatives - administration & dosage
Hydroxyethyl Starch Derivatives - adverse effects
Intraoperative Care - methods
Intravenous therapy
Kidney diseases
Kidneys
Male
Middle Aged
Molecular weight
Perioperative care
Postoperative Complications - epidemiology
Postoperative period
Propensity Score
Retrospective Studies
Surgical outcomes
title Association between intraoperative starch use and postoperative kidney dysfunction in patients undergoing major gastro-intestinal surgery: A propensity score–matched analysis
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