netherlands journal of critical care Conclusion Fluids are commonly given to prevent deterioration of renal function in hypovolaemia, sepsis, contrast nephropathy and administration of nephrotoxins. Summarising the current evidence, no clear highgrade recommendation can be given regarding the type of hydration regimen. Crystalloids appear to be safe in many settings, but exert less volume effect and may aggravate extravascular oedema. On the other hand, HES exerts larger volume effect, but caution is warranted when using high molecular weight HES with a higher degree of substitution as they may impair renal function. Albumin appears to be safe with regard to renal function. References 1. Groeneveld AB, Tran,DD, van der,MJ, Nauta,JJ, Thijs,LG. Acute renal failure in the medical intensive care unit: predisposing, complicating factors and outcome. Nephron 1991;59:602-610. 2. Schaefer JH, Jochimsen,F, Keller,F, Wegscheider,K, Distler,A. 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