Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Nov;44(5):431-7.
doi: 10.1097/SHK.0000000000000453.

Increased Fluid Administration After Early Acute Kidney Injury is Associated with Less Renal Recovery

Mario Raimundo  1 , Siobhan Crichton, John R Martin, Yadullah Syed, Matt Varrier, Duncan Wyncoll, Marlies Ostermann
Affiliations

Increased Fluid Administration After Early Acute Kidney Injury is Associated with Less Renal Recovery

Mario Raimundo et al. Shock. 2015 Nov.

Abstract

Introduction: In acute kidney injury (AKI), fluid accumulation is associated with poor outcome. We aimed to determine whether fluid intake or output had the major role.

Methods: Retrospective analysis of patients admitted to the Intensive Care Unit between July 2007 and June 2009 who had AKI stage I. We collected fluid input, output, and haemodynamic data on day of AKI I and on day of AKI III (if AKI III developed) or 72 h after AKI I (if patients did not progress to AKI III). Univariable and multivariable logistic regression analyses were performed.

Results: Among 210 patients with AKI I (median age 70 y; 138 males), 85 had a subsequent mean fluid gain >1 L/day. Their risk of AKI III or death in intensive care unit was significantly higher compared with patients who gained ≤1 L/day (63.5% vs. 23.3%, P = 0.001, and 43.5% vs. 24.8%, P = 0.004, respectively). AKI I patients who gained >1 L/day had a significantly lower urine output (50 vs. 66 mL/h, P = 0.02), lower mean arterial pressure (71 vs. 74 mmHg, P = 0.01), higher arterial lactate level (2.7 vs. 2.0 mmol/L, P < 0.001), and higher Sequential Organ Failure Assessment score (9.4 vs. 8.2, P = 0.002) on day of AKI I compared with those who gained ≤ 1 L/day. Multivariable analysis showed that only fluid intake was independently associated with progression to AKI III (OR 1.8 per 1 L; 95% CI 1.1 - 8.8; P = 0.02), but reduced urine output was not an independent risk factor (OR 0.8; 95% CI 0.3 - 2.2; P = 0.6).

Conclusion: Increased fluid intake in early AKI was an independent risk factor for AKI III.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

LinkOut - more resources