Fluid management for sepsis-induced hypotension in patients with advanced chronic kidney disease: a secondary analysis of the crystalloid liberal or vasopressor early resuscitation in sepsis (CLOVERS) trial
Primary result · Death from any cause before discharge home by day 90Result — go to the resultHazard ratio 0.5 95% CI 0.29–0.85Authors' conclusion
In patients with advanced CKD and sepsis-induced hypotension, an early restrictive fluid strategy, prioritizing vasopressor use, was associated with a lower risk of death from any cause before discharge home by day 90 as compared with an early liberal fluid strategy.
Study context
- Population
- Patients with sepsis-induced hypotension and advanced chronic kidney disease (CKD) (eGFR <30 mL/min/1.73 m² or end-stage renal disease on chronic dialysis)45% on chronic dialysis
- Participants
- 196 patients
- Comparison
- Early restrictive vs liberal fluid management
- Restrictiven = 92
- Liberaln = 104reference
- Primary endpoint
- Death from any cause before discharge home
- Follow-up
- Day 90
Methodological detailspost-hoc analysis
- Post-hoc analysis
Primary result
As reported in the abstract
Death from any cause before discharge home by day 90
Hazard ratio
0.5
95% CI 0.29–0.85
Events by treatment group
Restrictive vs Liberal
HR 0.5 (95% CI 0.29–0.85)
Further findings
| Outcome | Restrictive | Liberal | Mean difference (days) (95% CI) | |
|---|---|---|---|---|
| Vasopressor-free days | 19.7 ± 10.4 days | 15.4 ± 12.6 days | 4.3 (1.0–7.5) | |
| Ventilator-free days · day 28 | 21.0 ± 11.8 days | 16.5 ± 13.6 days | 4.5 (0.9–8.1) | |
| −50510Difference, days (linear scale) |
Original publication
Fluid management for sepsis-induced hypotension in patients with advanced chronic kidney disease: a secondary analysis of the CLOVERS trial. Crit Care. Published 11 July 2024. doi:10.
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