目的 探讨羟乙基淀粉注射液致急性肾损伤（AKI）的危险因素，为临床安全用药提供参考。方法 回顾性分析2015年1月—2019年3月衡水市人民医院86例羟乙基淀粉注射液致AKI和同期使用羟乙基淀粉注射液但未发生AKI的767例患者的临床资料，采用单因素（χ²检验）及多因素（Logistic回归）对肾毒性危险因素进行分析。结果 AKI是羟乙基淀粉注射液严重不良反应之一，发生率为10.08%。单因素分析显示，体重指数、低蛋白血症、肌酐清除率、合并肾毒性药物、术中出血量、日剂量和用药时间与羟乙基淀粉肾毒性相关；多因素分析显示，日剂量（≥14 mL/kg）、肌酐清除率（<30mL/min）、用药时间（≥5 d）、术中出血量（>3 000 mL）、合并肾毒性药物和低蛋白血症（ALB<30 mL/L）是羟乙基淀粉130/0.4氯化钠注射液致AKI的独立危险因素。所有患者停药或经相关治疗后肾功能均逐渐恢复。结论 日剂量偏大、肾功能不全、长时间用药、术中出血量偏大、合并肾毒性药物和低蛋白血症是羟乙基淀粉致AKI的独立危险因素，临床中重点关注有独立危险因素的患者，以保证临床安全用药。

Objective To investigate the risk factors of acute kidney injury (AKI) which induced by Hydroxyethyl Starch Injection (HES), to provide a reference for clinical safety medication. Methods The 86 non-severe patients with AKI which induced by hydroxyethyl starch injection and 767 patients who were given hydroxyethyl starch injection but not demonstrated AKI from Jan. 2015 to Mar. 2019 in our hospital were respectively analyzed. Single factor (χ² test) and multiple factors (Logistic regression) were used to select risk factors that related to AKI. Results AKI was one of the serious ADR of hydroxyethyl starch injection, it's incidence was 10.08% in this investigation. According to single factor analysis, factors associated with nephrotoxicity were body mass index, hypoproteinemia, creatinine clearance, combined with nephrotoxic drugs, intraoperative blood loss, daily doseand medication timefor HES;And multivariate analysis identified independent factors with daily dose (≥ 14 mL/kg), creatinine clearance (<30 mL/min), medication time (≥ 5 days), intraoperative blood loss (>3 000 mL), combined with nephrotoxic drugs and hypoproteinemia (ALB<30 mL/L) for hydroxyethyl starch injection. Renal function of all patients was gradually restored after discontinuation of the drug or related treatment. Conclusion Large daily dose, renal insufficiency, long-term medication, intraoperative blood loss, combined with nephrotoxic drugs and hypoproteinemia are independent risk factors for AKI caused by HES. Clinical practice should focus on patients with independent risk factors to ensure clinical safe use of HES.