Kidney function after the intraoperative use of 6% tetrastarches (HES 130/0.4 and 0.42)

Concerns about the nephrotoxicity of tetrastarches have recently increased with the accumulation of new evidence, particularly in relationship to septic patients. Two meta-analyses in 2011 and early 2012 also raised concerns about nephrotoxicity in surgical patients and prompted the present review of the nephrotoxicity of tetrastarches solely in the surgical setting. Seven reports consisting of two review articles and five single-trial papers published between 2012 and August 2013 were examined. Six of the seven studies did not show any adverse renal outcomes following the intraoperative use of tetrastarch, although their data are not robust enough to confirm definitive safety. Moreover, balanced electrolyte solutions are strongly recommended as a carrier solution for tetrastarches to reduce adverse outcomes.