Hydroxyethyl Starch and Perioperative Complications: A Systematic Review and Meta-analysis.
AnesthesiologyMay 20, 2026 (epub)
Daniel I Sessler, Lorenzo Pradelli, Massimiliano Povero et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the impact of hydroxyethyl starch (HES 130/0.4) on renal injury in surgical patients, incorporating data from 114 trials with 13,951 patients. The analysis found no significant increase in acute kidney injury risk (relative risk, 1.02; 95% CI, 0.91 to 1.16) or worsening of creatinine levels postoperatively.
Key findings
- HES 130/0.4 did not significantly increase the risk of acute kidney injury (relative risk, 1.02; 95% CI, 0.91 to 1.16).
- The change in creatinine concentration was not significantly worsened by HES administration (-0.62 µmol/l; 95% CI, -3.82 to 2.57 µmol/l).
- HES did not meaningfully worsen overall or severe adverse events or mortality.
Why it matters
Understanding the safety profile of hydroxyethyl starch in surgical settings is crucial for clinicians, especially given previous concerns regarding renal injury. This evidence supports its continued use without significant risk of acute kidney injury.