Critical Care

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Commentary

Colloid-induced kidney injury: experimental evidence may help to understand mechanisms

Frédérique Schortgen1* and Laurent Brochard3,1,2

Author Affiliations

1 AP-HP, Groupe Hospitalier Albert Chenevier – Henri Mondor, Réanimation Médicale, F-94000 Créteil, France

2 Université Paris 12, Faculté de Médecine, F-94000 Créteil, France

3 INSERM, U955, Faculté de Médecine, F-94000 Créteil, France

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Critical Care 2009, 13:130 doi:10.1186/cc7745

Published: 3 April 2009

Abstract

Fluid resuscitation is widely used, and many patients are therefore exposed to plasma volume expanders. Among these, colloids, particularly hydroxyethyl starches, have been shown in recent experiments and clinical studies to induce acute kidney injury. The mechanisms of colloid-induced acute kidney injury remain incompletely elucidated. The risks associated with colloid osmotic pressure elevation in vivo and the high incidence of osmotic nephrosis lesions in experimental models and clinical studies indicate that hydroxyethyl starches can no longer be considered safe.