To the Editor: With some degree of amazement, we read the article by Kashy et al.1 on the influence of 6% hydroxyethyl starch (HES) 670/0.75 (Hextend; Hospira Inc., USA) on perioperative acute kidney injury in patients undergoing noncardiac surgery. The data are derived from a database of more than 120,000 patients treated in Cleveland hospitals, in which 6% HES 670/0.75 was the most commonly u...