Document Detail

Pentastarch 10% (250 kDa/0.45) is an independent risk factor of acute kidney injury following cardiac surgery.
MedLine Citation:
PMID:  19242349     Owner:  NLM     Status:  MEDLINE    
MEASURES: We assessed previously identified preoperative, perioperative, and postoperative risk factors, and the volume of pentastarch given until the end of the first postoperative day. We defined AKI by a 50% rise in serum creatinine within 4 days after surgery. Different propensity adjustment methods were used to further assess the selection bias.
RESULTS: Fifty-four (10%) patients developed AKI. Risk factors of AKI were age, female gender, preoperative creatinine clearance, hypertension, diuretic use, left ventricular ejection fraction, valvular surgery, duration of extracorporeal circulation, duration and dose of postoperative vasopressor support, and the number of red blood cells and fresh frozen plasma transfusions. Patients with AKI received 16 +/- 9 mL/kg of pentastarch as opposed to 10 +/- 7 mL/kg in controls (p < 0.001). Pentastarch remained independently predictive of AKI, with an adjusted odds ratio per mL/kg of 1.08 (95% confidence interval 1.04-1.12, p = 0.001). This risk was dose-dependent, and the optimal cutoff volume predicting AKI was 14 mL/kg. Different propensity adjustment methods were tested, and pentastarch as a risk factor of AKI was identified.
CONCLUSIONS: This study identified a dose-dependent risk of AKI with pentastarch following cardiac surgery, given until the end of the first postoperative day.
Jean-Philippe Rioux; Myriam Lessard; Bruno De Bortoli; Patrick Roy; Martin Albert; Colin Verdant; François Madore; Stéphan Troyanov
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  37     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-25     Completed Date:  2009-05-05     Revised Date:  2011-01-11    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1293-8     Citation Subset:  AIM; IM    
Division of Nephrology, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada.
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MeSH Terms
Acute Kidney Injury / chemically induced*
Cardiac Surgical Procedures*
Hetastarch / adverse effects*
Plasma Substitutes / adverse effects*
Postoperative Complications / chemically induced*
Retrospective Studies
Risk Factors
Reg. No./Substance:
0/Plasma Substitutes; 9005-27-0/Hetastarch
Comment In:
Crit Care Med. 2009 Apr;37(4):1499-501   [PMID:  19318837 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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