NDT Plus Advance Access originally published online on June 23, 2008
NDT Plus 2008 1(5):322-325; doi:10.1093/ndtplus/sfn075
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Permanent renal failure induced by pentastarch
1 Department of Medicine, Maisonneuve-Rosemont Hospital, University of Montreal
2 Division of Nephrology, Verdun Hospital
3 Department of Pathology
4 Divisions of Nephrology and Critical Care, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC, Canada
Correspondence: Correspondence and offprint requests to: Martine Leblanc, Department of Nephrology and Critical Care, Maisonneuve-Rosemont Hospital, 5415 de l’Assomption, Montreal, QC H1T 2M4, Canada. Tel: +1-514-252-3489; Fax: +1-514-255-3026; E-mail: martine.leblanc{at}sympatico.ca
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Abstract |
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Background. Controversy exists with volume resuscitation using crystalloids or colloids. Renal dysfunction has been reported with some colloids and osmotic agents, but remains poorly defined.
Patient. We report the case of a 67-year-old male who had normal kidney function at baseline and who developed anuric ARF in relation to the administration of >10 litres of 10% pentastarch. A renal biopsy confirmed hydropic changes in tubular cells compatible with colloid-induced damage.
Conclusion. This case demonstrates that hydroxyethyl starch preparations may be associated with acute kidney injury, and one should carefully consider their use, especially in patients with pre-existing renal dysfunction. Osmotic tubular cell lesions may be long lasting and irreversible.
Key Words: acute renal failure • colloid • hydroxyethyl starch • pentastarch
Received for publication March 16, 2008. Accepted for publication May 29, 2008.