1. Effects of hydroxyethyl starch and gelatin on the risk of acute kidney injury following orthotopic liver transplantation: A multicenter retrospective comparative clinical study
- Author
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Xu Niu, Yun Yue, Yanxing Zhao, Lingdi Hou, Anshi Wu, Wenfei Lv, Shu-Jun Han, Fu-Shan Xue, Chen Yao, Sainan Zhu, Ping Chi, Meixia Shang, Xin-Yu Ning, Jia Jiang, Shengnan Li, Shanshan Mu, Jing Wang, Hai-Yang Lu, and Ying-Qi Chen
- Subjects
medicine.medical_specialty ,Orthotopic liver transplantation ,medicine.medical_treatment ,030232 urology & nephrology ,Hydroxyethyl starch ,Liver transplantation ,urologic and male genital diseases ,Gastroenterology ,gelatin ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Internal medicine ,Medicine ,risk factors ,reproductive and urinary physiology ,liver transplantation ,business.industry ,Incidence (epidemiology) ,Acute kidney injury ,Retrospective cohort study ,General Medicine ,Odds ratio ,medicine.disease ,Confidence interval ,humanities ,hydroxyethyl starch ,surgical procedures, operative ,acute kidney injury ,biological phenomena, cell phenomena, and immunity ,business ,medicine.drug ,Research Article - Abstract
Objectives This multicenter retrospective study aimed to compare the effects of HES and gelatin (GEL) on the risk of post-OLT AKI. Method A total of 1,672 patients undergoing OLT were enrolled from major transplant centers in China between 2005 and 2013. These patients were divided into three groups: GEL, hydroxyethyl starch (HES), and GEL + HES group. Results There was no significant difference in the incidence of post-OLT AKI among the GEL, HES, and GEL + HES groups. The GEL + HES group had a lower incidence of stage II post-OLT AKI than the other two groups. Compared with patients receiving GEL, patients receiving HES did not harbor an increased risk of AKI. Our results showed that MELD score (adjusted odds ratio [OR], 1.579; 95% confidence interval [CI], 1.123–2.219; P = 0.009) and preoperative anemia (adjusted OR, 1.533; 95% CI, 1.212–1.939; P < 0.001) were independent risk factors for post-OLT AKI, and normal preoperative Scr level (vs abnormal; adjusted OR, 0.402; 95% CI, 0.222–0.729; P = 0.003) was independent protective factors for post-OLT AKI. Conclusion This large-scale multicenter retrospective study found that the intraoperative use of HES did not increase the overall incidence of post-OLT AKI in patients when compared with GEL, and whether to increase the risk of post-OLT AKI needs to be further explored.
- Published
- 2021