[Nephrotoxicity of plasma volume expanders]

Abstract

Expansion of extracellular volume is a treatment traditionally proposed to correct abnormalities of renal perfusion and prevent ischemic injury. However, vascular filling is not at risk for tissue oxygenation and renal function. The use of synthetic colloids exposes the patient to the risk of developing lesions such as osmotic nephrosis. Hyperoncotic colloids reduce glomerular filtration pressure. The nephrotoxicity of hydroxyethyl starches is now clearly established regardless of their characteristics. Colloids have never demonstrated their superiority as plasma volume expanders, they should be abandoned in favour of crystalloid solutions.

Keywords: Acute renal failure; Colloids; Colloïdes; Hydroxyethylstarch; Hydroxyéthylamidons; Insuffisance rénale aiguë; Néphrose osmotique; Oncotic pressure; Osmotic nephrosis; Pression oncotique; Remplissage.