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Increased risk of kidney injury related to the use of hydroxyethyl starch (HES) in resuscitation fluids reflects the mass of HES molecules, according to a new study. 

The "total mass of HES molecule" explains the harmful effect of HES on cultured human renal proximal tubule cells. 

Hydroxyethyl starch is basically a starch derivative that has been widely used for fluid resuscitation with volume expansion for critically ill or injured patients in shock. Previously studies suggested that HES solutions may have harmful effects including an increased risk kidney injury and death. 

The new study suggests that the molecular mass of HES is the major factor responsible for damage to kidney cells. Other factors have no significant influence-even with new low-molecular weight HES solutions, cellular-level toxic effects appear just as likely, once the total mass of HES molecules is taken into account, the press release added.

 "Our data show that HES itself has a negative impact on renal PTC, which should be considered when used clinically," concluded lead researcher Dr Christian Wunder of University Hospital Würzburg, Austria. 

The study has been published in journal Anesthesia & Analgesia.