Effect of waxy maize-derived hydroxyethyl starch 130/0.4 on renal function in surgical patients.

BACKGROUND The aim of this meta-analysis was to evaluate renal safety with the active substance of the latest generation of waxy maize-derived hydroxyethyl starch in surgical patients. The authors focused on prospective, randomized, controlled studies that documented clinically relevant variables with regard to renal effects of waxy maize-derived hydroxyethyl starch 130/0.40. MATERIALS AND METHODS The authors carefully searched for all available prospective, randomized studies and evaluated the greatest delta from baseline values in renal safety variables (serum creatinine values, calculated creatinine clearance, incidence of renal replacement therapy, and acute renal failure). The authors included 17 studies that analyzed patients (n = 1,230) undergoing a variety of surgical procedures. RESULTS For maximum serum creatinine values, the effect size estimate was 0.068 (95% CI = -0.227 to 0.362), P = 0.65. For calculated creatinine clearance values, pooled risk difference was 0.302 (95% CI = -0.098 to 0.703), P = 0.14. For incidence of acute renal failure, pooled risk difference was 0.0003 (95% CI = -0.018 to 0.019), P = 0.98. For incidence of renal replacement therapy, pooled risk difference was -0.003 (95% CI = -0.028 to 0.022), P = 0.85. CONCLUSIONS The authors found no evidence for renal dysfunction caused by modern waxy maize-derived hydroxyethyl starch 130/0.40 in surgical patients.