Estimated glomerular filtration rate decreased by Hydroxyethyl Starch in isolated coronary artery bypass graft surgery: A retrospective cohort study

Abstract

Background/Aim: Hydroxyethyl starches have been widely used to replace the intravascular volume. They increase the risk of renal injury in critically ill patients. In cardiac surgery, patients are at risk for cardiac surgery-associated acute kidney injury. This study aims to analyze the renal functions in coronary surgery with hydroxyethyl starches and crystalloids. Methods: Patients who underwent isolated on-pump coronary artery bypass graft surgery between January 2017 and June 2019 were included in the study. They were categorized into two groups according to intraoperative volume replacement therapy. The non-HES group consisted of patients who had been given a balanced electrolyte solution; the HES group consisted of patients who were administered a balanced electrolyte solution and 500 ml of hydroxyethyl starch solution. A two-sided P-value of <0.05 was considered significant. Results: There were no significant differences between the two groups in terms of demographic values and preoperative serum urea, creatinine, blood urea nitrogen, and estimated glomerular filtration rate levels (P>0.05). In the HES group, the postoperative value of creatinine was significantly higher and estimated glomerular filtration rate level was significantly lower compared to the preoperative values (P<0.001). Conclusion: The intraoperative administration of 500 mL hydroxyethyl starch affected renal function in isolated on-pump coronary artery bypass graft surgery patients.