How a positive fluid balance develops in acute kidney injury: A binational, observational study
Authors' conclusion
Among ICU patients with AKI, cumulative FB increased after diagnosis and was associated with an increased risk of mortality. Continued crystalloid administration, increased nutritional intake, limited UO, and minimal use of diuretics all contributed to positive FB.
Study context
- Population
- Critically ill intensive care unit (ICU) patients with acute kidney injury (AKI) not requiring RRTwith AKI (17.3%)
- Participants
- 7,894 patients
- Outcome
- Development of positive FB after AKI
- Follow-up
- First three days
Methodological detailsmultinational
- Multinational
Main finding
As reported in the abstract
- AKI onset after admission, median (days)
- two
- Fluid resuscitation in ICU
- 848 (10.7%)
- Persistent crystalloid use, median (IQR)
- 60.0 mL/h (28.9-89.2)
- Nutritional intake, median (IQR)
- 18.2 mL/h (0.0-45.9)
- Urine output, median (IQR)
- 70.8 mL/h (49.0-96.7)
- Diuretics in ICU
- 797 (10.1%)
Observational data: associations, not effects.
Further findings
Hospital mortality with positive fluid balance (FB) 4 days after AKI diagnosis · four days after AKI diagnosis
| OR (95% CI) | P value | ||
|---|---|---|---|
| Positive FBAdjusted · After adjustment | 1.12 (1.05–1.19) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Original publication
How a positive fluid balance develops in acute kidney injury: A binational, observational study. J Crit Care. Published 11 April 2024. doi:10.
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