Fluid management and risk factors for renal dysfunction in patients with severe sepsis and/or septic shock.

This French multicentric study evaluated the possible side effect on renal failure (need for renal replacement therapy) of the administration of HES 130/0.4 during the first 24 hours after admission in patients with severe sepsis and septic shock. This study included 388 patients surviving after 24 hours of evolution. Ninety (23%) patients required renal replacement. The majority of these patients received both HES and crystalloids (72.8%) and only 10.3 % HES alone. Not surprisingly, due to the short study period (the first day), the limited number of patients (388 patients in total), and especially exclusive treatment with HES (39 patients), no side effects of HES on renal failure were reported. Only large randomized, blinded, multicentric clinical trials will be able to answer this important question!

– Michael Piagnerelli