Fluid overload is an independent risk factor for acute kidney injury in critically Ill patients: results of a cohort study

BMC Nephrology

Research Article

Ranim Dahli¹  Ammar Hamdan¹  Rawan Alquaiz¹  Khalid Maghrabi¹  Mustafa Sammani¹  Nawal Salahuddin¹  Mini Joseph²  Yasir Al-Nemary³ 

[1] Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Center Riyadh, Riyadh, Saudi Arabia;Critical Care, Department of Nursing, King Faisal Specialist Hospital & Research Centre Riyadh, Riyadh, Saudi Arabia;Department of Surgery, King Faisal Specialist Hospital & Research Centre Riyadh, Riyadh, Saudi Arabia;

关键词: Acute kidney injury;    Fluid overload;    Renal congestion;    Chloride-liberal fluids;    Critical illness;   

DOI  :  10.1186/s12882-017-0460-6

 received in 2015-08-28, accepted in 2017-01-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAcute Kidney injury (AKI) is common and increases mortality in the intensive care unit (ICU). We carried out this study to explore whether fluid overload is an independent risk factor for AKI.MethodsSingle-center prospective, observational study. Consecutively admitted, ICU patients were followed for development of AKI. Intravenous fluid volumes, daily fluid balances were measured, hourly urine volumes, daily creatinine levels were recorded.ResultsThree hundred thirty nine patients were included; AKI developed in 141 (41.6%) patients; RISK in 27 (8%) patients; INJURY in 25 (7%); FAILURE in 89 (26%) by the RIFLE criteria. Fluid balance was significantly higher in patients with AKI; 1755 ± 2189 v/s 924 ± 1846 ml, p < 0.001 on ICU day 1. On multivariate regression analysis, a net fluid balance in first 24 h of ICU admission, OR 1.02 (95% CI 1.01,1.03 p = 0.003), percentage of fluid accumulation adjusted for body weight OR1.009 (95% CI 1.001,1.017, p = 0.02), fluid balance in first 24 h of ICU admission with serum creatinine adjusted for fluid balance, OR 1.024 (95% CI 1.012,1,035, p = 0.005), Age, OR 1.02 95% CI 1.01,1.03, p < 0.001, CHF, OR 3.1 (95% CI 1.16,8.32, p = 0.023), vasopressor requirement on ICU day one, OR 1.9 (95% CI 1.13,3.19, p = 0.014) and Colistin OR 2.3 (95% CI 1.3, 4.02, p < 0.001) were significant predictors of AKI. There was no significant association between fluid type; Chloride-liberal, Chloride-restrictive, and AKI.ConclusionsFluid overload is an independent risk factor for AKI.

【 授权许可】

CC BY   
© The Author(s). 2017