Intraoperative Colloid Use on Post-operative Renal Function

This review summarizes the most recent literature on the association between intraoperative colloid administration and its effect on post-operative renal function.

It appears albumin decreases the incidence of acute kidney injury (AKI); however, meta-analysis studies show an increased need for post-operative renal replacement therapy. There was moderate certainty that early starches increased the need for renal replacement therapy; however, it appears newer starches have a better safety profile. Gelatins do not appear to contribute to renal dysfunction, despite a study showing a statistically insignificant higher incidence of moderate AKI. Studies involving dextran suggest better renal outcomes when used as a priming solution for cardiopulmonary bypass.

Albumin administration remains controversial with conflicting studies. While earlier starch products have been associated with renal dysfunction, further studies should be done on newer starches. There are limited studies for gelatins and dextran, suggesting possible renal-sparing effects.