Is Albumin Administration in Hypoalbuminemic Elderly Cardiac Surgery Patients of Benefit with Regard to Inflammation, Endothelial Activation, and Long-Term Kidney Function?: Retracted

Abstract

Use of HA in hypoalbuminemic cardiac surgery patients aged >80 yr was without benefit with regard to inflammatory response, endothelial activation, and renal function compared to 6% HES 130/0.4.

Prevention and Treatment of Acute Kidney Injury in Patients Undergoing Cardiac Surgery: A Systematic Review

“…1). A total of 70 studies (5,554 patients) met eligibility criteria [17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86] (table 1). …”

Fluid therapy with hydroxyethyl starch for massive blood loss during surgery

“…However, these studies differ from the present study in terms of the pathological condition of the patients (i.e., severe sepsis vs. acute intraoperative massive bleeding), the property and concentration of HES used (i.e., 10% HES200/0.5/6 and 6% HES200/0.62/9 vs. 6% HES70/0.55/4), and the mode of infusion (i.e., chronic infusion vs. intraoperative infusion). Boldt et al [16] reported that HES130/0.4/9 maintained proximal tube function (as albumin did) and had more beneficial effects regarding renal impairment than albumin. The most recent review of HES stated: ''… there are differences between the older and newer generations of HES and the reports of adverse effects on renal function should not be extrapolated to newer HES products'' [11].…”

Are renal adverse effects of hydroxyethyl starches merely a consequence of their incorrect use?

“…An international survey of 1013 ICU patients needing fl uid resuscitation for shock states found that the incidence of ARF was comparable in patients receiving HES 130/0.4 and in those receiving older HES solutions (20/119, 16 A recent review cited 9 studies in adult patients as proof for the claims of improved renal safety of HES 130/0.4 [19], but these studies were inadequately designed for such a purpose, being: -a non-randomized observational study which did not specify the type of used HES solutions [50], -a non-controlled small observational study in volunteers [51], -a study which compared cumulative doses of 19 L HES 130/0.4 against 22 L HES 200/0.5 in 31 patients with brain injury and found no diff erence in renal function [52], -a comparison of HES 130/0.4 in two diff erent solvents [53], -two perioperative studies [54,55] comparing HES 130/0.4 with the synthetic colloid gelatin which can also impair renal function [8,56,57]. Th e remaining three studies from the surgical setting [58][59][60] compared HES 130/0.4 with normal saline or human albumin but were underpowered (mean sample size 37 patients), used small cumulative doses (mean 45.5 mL/kg, 50 mL/kg being the recommended maximal daily dose) and short observation periods (mean 34.7 hours). Only one of these studies followed up renal function after 60 days [58].…”

“…Th e remaining three studies from the surgical setting [58][59][60] compared HES 130/0.4 with normal saline or human albumin but were underpowered (mean sample size 37 patients), used small cumulative doses (mean 45.5 mL/kg, 50 mL/kg being the recommended maximal daily dose) and short observation periods (mean 34.7 hours). Only one of these studies followed up renal function after 60 days [58]. Further study details are given in Tables 2a and b. HES 130/0.4 was approved in the US in 2008 on the basis of a study roster which is open to the public [61].…”