{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T23:13:04Z","timestamp":1792192384335,"version":"4.4.0"},"reference-count":27,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,12,18]],"date-time":"2014-12-18T00:00:00Z","timestamp":1418860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Danish Strategic Research Council"},{"name":"ACTA foundation"},{"DOI":"10.13039\/501100005111","name":"Rigshospitalet","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005111","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2015,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>We aimed to detail the effects of hydroxyethyl starch (<jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content>) vs. <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>inger's on kidney function including the interaction with mortality in post\u2010hoc analyses as resuscitation with <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> 130\/0.42 increased mortality in the <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>candinavian <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>tarch for <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>evere <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>epsis\/<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>eptic <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>hock (6<jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>) trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In all 798 randomised patients, we assessed the incidence and effect on mortality of acute kidney injury (<jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content>) in the <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> vs. <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>inger's acetate groups using the <jats:styled-content style=\"fixed-case\">K<\/jats:styled-content>idney <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>isease: <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>mproving <jats:styled-content style=\"fixed-case\">G<\/jats:styled-content>lobal <jats:styled-content style=\"fixed-case\">O<\/jats:styled-content>utcome criteria. We also assessed the intervention effect on time to and duration of renal replacement therapy (<jats:styled-content style=\"fixed-case\">RRT<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At baseline, the intervention groups were similar. The maximal <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> stage was higher in the <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> vs. <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>inger's group within the first 5 days after randomisation (<jats:italic>P<\/jats:italic>\u2009=\u20090.03), the average difference being 0.2 points (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). An increase in <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> stage was associated with mortality (hazard ratio (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>) 1.35; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.22 to 1.49; <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). Significantly, more patients in the <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> group received <jats:styled-content style=\"fixed-case\">RRT<\/jats:styled-content> within the first 5 days (<jats:italic>P<\/jats:italic>\u2009=\u20090.01), and the time to initiation of <jats:styled-content style=\"fixed-case\">RRT<\/jats:styled-content> was also shorter compared with the <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>inger's group (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content> 1.40; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.01\u20131.93; <jats:italic>P<\/jats:italic>\u2009=\u20090.04). The intervention effect of <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> on mortality was reduced when adjusting for AKI stage as a time\u2010dependent covariate (<jats:italic>P<\/jats:italic>\u2009=\u20090.15).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In patients with severe sepsis, <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> appeared to increase the rate of severe <jats:styled-content style=\"fixed-case\">AKI<\/jats:styled-content> and use of <jats:styled-content style=\"fixed-case\">RRT<\/jats:styled-content> within the first 5 days. The increased mortality observed with <jats:styled-content style=\"fixed-case\">HES<\/jats:styled-content> may have been partly mediated through acute kidney impairment.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.12453","type":"journal-article","created":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T08:52:27Z","timestamp":1418979147000},"page":"329-336","source":"Crossref","is-referenced-by-count":32,"title":["Acute kidney injury with hydroxyethyl starch 130\/0.42 in severe sepsis"],"prefix":"10.1111","volume":"59","author":[{"given":"R. B.","family":"M\u00dcLLER","sequence":"first","affiliation":[{"name":"Department of Intensive Care Rigshospitalet University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"HAASE","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Rigshospitalet University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"LANGE","sequence":"additional","affiliation":[{"name":"Department of Public Health Section of Biostatistics University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"WETTERSLEV","sequence":"additional","affiliation":[{"name":"Copenhagen Trial Unit Centre for Clinical Intervention Research University of Copenhagen  Copenhagen 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