Perioperative medicine & outcomes
Hydroxyethyl Starch and Perioperative Complications: A Systematic Review and Meta-analysis
Authors' conclusion
Current hydroxyethyl starch solutions do not provoke renal injury in surgical patients.
Study context
- Population
- Surgical patients (major cardiac 30%, major abdominal 46%, other 24%)
- Participants
- 13,951 patients · 114 trials
- Comparison
- HES 130/0.4 or HES 130/0.42 vs comparator fluids
- Outcome
- AKI and preoperative-to-postoperative change in creatinine concentration
Methodological detailsrandom-effect models, trial sequential analysis
- Random-effect models
- Trial sequential analysis
Pooled result
As reported in the abstract
HESRelative risk (95% CI)
AKI
1.02(0.91–1.16)
- Preoperative-to-postoperative
- Change in creatinine concentration −0.62 µmol/l (95% CI −3.82 to 2.57)
Safety
Overall or severe adverse events, mortality
- HES did not meaningfully worsen any other outcome evaluated
Original publication
Hydroxyethyl Starch and Perioperative Complications: A Systematic Review and Meta-analysis. Anesthesiology. Published 20 May 2026. doi:10.
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