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 |
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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. |
doi_str_mv | 10.1177/17504589231174967 |
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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.</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 & 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.
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><subject>Abdominal surgery</subject><subject>Acute Kidney Injury - etiology</subject><subject>Adult</subject><subject>Carbohydrates</subject><subject>Digestive System Surgical Procedures - adverse effects</subject><subject>Female</subject><subject>Fluid Therapy - methods</subject><subject>Humans</subject><subject>Hydroxyethyl Starch Derivatives - administration & dosage</subject><subject>Hydroxyethyl Starch Derivatives - adverse effects</subject><subject>Intraoperative Care - methods</subject><subject>Intravenous therapy</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Molecular weight</subject><subject>Perioperative care</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative period</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Surgical outcomes</subject><issn>1750-4589</issn><issn>2515-7949</issn><issn>2515-7949</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1UUuO1DAUtBCIaRoOwAZZYjObDHHsxAm71oifNBIbWEf-vM64Sezg54Cy4w5zEc7ESXDTAyOB8Mbyq3pVJRchT1l5wZiUL5isS1G3XcXzU3SNvEc2Vc3qQnaiu082R7w4Es7II8RDWdYVF91DcsZlIxoh2IZ83yEG41RywVMN6SuAp86nqMIMMY-_AMWkormmCwJV3tI5YLoDPznrYaV2xf3izS8Z5-mcQfAJ6eItxCE4P9BJHUKkg8IUQ5EtAJPzaqS4xAHi-pLu6ByzsEeXVoomRPjx7WZSyVyDzc5qXNHhY_Jgr0aEJ7f3lnx8_erD5dvi6v2bd5e7q8JUkrGC7W1rW6ZN1xrNuLW8Yk0jLBhtheYt51LXreJlWbWS17VphdRC2cZq3XEwfEvOT7o50-clZ-0nhwbGUXkIC_ZVm_-148ezJc__oh7CEnNe7DmrWcW7JhtuCTuxTAyIEfb9HN2k4tqzsj_W2f9TZ955dqu86Ansn43f_WXCxYmAaoA72_8r_gTUza4p</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Iyer, Karthik V</creator><creator>Giri, Sanjeeb</creator><creator>Ray, Bikash R</creator><creator>Muthiah, Thilaka</creator><creator>Anand, Rahul K</creator><creator>Kaur, Manpreet</creator><creator>Kumar, Rakesh</creator><creator>Punj, Jyotsna</creator><creator>Rewari, Vimi</creator><creator>Sahni, Peush</creator><creator>Maitra, Souvik</creator><general>SAGE Publications</general><general>Association for Perioperative Practice</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>4T-</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2328-9201</orcidid><orcidid>https://orcid.org/0000-0001-9800-1367</orcidid><orcidid>https://orcid.org/0000-0002-0832-7433</orcidid></search><sort><creationdate>20250101</creationdate><title>Association between intraoperative starch use and postoperative kidney dysfunction in patients undergoing major gastro-intestinal surgery: A propensity score–matched analysis</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2711-1fd8d81bc98cb13dd321664decbd4b38337b58a300287355c847b4ad6dbb93ec3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Abdominal surgery</topic><topic>Acute Kidney Injury - etiology</topic><topic>Adult</topic><topic>Carbohydrates</topic><topic>Digestive System Surgical Procedures - adverse effects</topic><topic>Female</topic><topic>Fluid Therapy - methods</topic><topic>Humans</topic><topic>Hydroxyethyl Starch Derivatives - administration & dosage</topic><topic>Hydroxyethyl Starch Derivatives - adverse effects</topic><topic>Intraoperative Care - methods</topic><topic>Intravenous therapy</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Molecular weight</topic><topic>Perioperative care</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative period</topic><topic>Propensity Score</topic><topic>Retrospective Studies</topic><topic>Surgical outcomes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><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><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Docstoc</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of perioperative practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iyer, Karthik V</au><au>Giri, Sanjeeb</au><au>Ray, Bikash R</au><au>Muthiah, Thilaka</au><au>Anand, Rahul K</au><au>Kaur, Manpreet</au><au>Kumar, Rakesh</au><au>Punj, Jyotsna</au><au>Rewari, Vimi</au><au>Sahni, Peush</au><au>Maitra, Souvik</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association between intraoperative starch use and postoperative kidney dysfunction in patients undergoing major gastro-intestinal surgery: A propensity score–matched analysis</atitle><jtitle>Journal of perioperative practice</jtitle><addtitle>J Perioper Pract</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>35</volume><issue>1-2</issue><spage>14</spage><epage>21</epage><pages>14-21</pages><issn>1750-4589</issn><issn>2515-7949</issn><eissn>2515-7949</eissn><abstract>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.</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>37646441</pmid><doi>10.1177/17504589231174967</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2328-9201</orcidid><orcidid>https://orcid.org/0000-0001-9800-1367</orcidid><orcidid>https://orcid.org/0000-0002-0832-7433</orcidid><oa>free_for_read</oa></addata></record> |
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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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