Associations of fluid overload with mortality and kidney recovery in patients with acute kidney injury: A systematic review and meta-analysis

Zhang, Ling; Chen, Zhiwen; Diao, Yongshu; Yang, Ying‐Ying; Fu, Ping

doi:10.1016/j.jcrc.2015.03.025

Cited by 100 publications

(69 citation statements)

References 36 publications

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“…The mortality of patients with CSA-AKI was associated with many factors [9,10], such as cardiopulmonary bypass duration, cardiac function, the severity of AKI, and fluid overload [11,12]. Continuous RRT (CRRT) or prolonged intermittent RRT (PIRRT) are often utilized to prevent or reduce fluid overload in these severe patients, for their better fluid control and better hemodynamic stability compared to conventional hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Relationship among Mortality of Patients with Acute Kidney Injury after Cardiac Surgery, Fluid Balance and Ultrafiltration of Renal Replacement Therapy: An Observational Study

Sun²,

Liu³

et al. 2017

Blood Purif

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Background/Aims: The study aimed to investigate the relationship among mortality of patients with cardiac surgery-associated acute kidney injury (CSA-AKI), fluid balance, and ultrafiltration of renal replacement therapy (RRT). Methods: From January 2009 to October 2015, hospitalized patients with CSA-AKI receiving continuous or prolonged intermittent RRT were screened. The effects of fluid balance and ultrafiltration of RRT on clinical outcome were analyzed. Results: The 30-day mortality of all the 63 patients in the study was 58.6%. Compared with the death group, the survival group had a significantly lower fluid balance, larger ultrafiltration volume, and similar ultrafiltration rate during the first 3 days of RRT. Multivariate Cox regression analysis revealed that positive fluid balance during the first day of RRT, cardiac function of grade IV, and higher Sequential Organ Failure Assessment score were independent risk factors of 30-day mortality. Conclusion: Fluid balance was more relevant to short-term prognosis of CSA-AKI-RRT patients than ultrafiltration volume or ultrafiltration rate.

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Section: Introductionmentioning

confidence: 99%

Relationship among Mortality of Patients with Acute Kidney Injury after Cardiac Surgery, Fluid Balance and Ultrafiltration of Renal Replacement Therapy: An Observational Study

Sun²,

Liu³

et al. 2017

Blood Purif

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“…Some studies failed to establish a positive fluid balance in the first hours of care at the ICU as an independent predictor of kidney failure. 20 Such discrepancy may be the result of the heterogeneity of the studied group and the low rate of kidney failure detected in the group who had fluid overload in these studies.…”

Section: M I N I S T R a T I O N O F F L U I D S F O R A S P E C I mentioning

confidence: 83%

Fluid overload and kidney failure in children with severe sepsis and septic shock: A cohort study

Romero¹,

Meléndez

2017

Arch Argent Pediat

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Introduction. In children with sepsis, fluid overload as a result of an aggressive fluid replacement or excessive fluid administration may result in kidney impairment and increased mortality. Objective. To determine the association between fluid overload and the rate of kidney failure in a group of children with severe sepsis and septic shock. Population and methods. This was a prospective cohort study conducted in the intensive care unit of Hospital Universitario de Pediatría Dr. Agustín Zubillaga (Barquisimeto, Lara State, Venezuela), between March 2013 and May 2016, in children with severe sepsis or septic shock. Results. One hundred and forty-nine patients were included in the analysis. Sepsis predominated in 59.7% of cases; patients' average age was 6.4 ± 3.3 years old, their average weight was 17.8 ± 3.6 kg, 30.2% had fluid overload, and overall mortality was 25.5%. Kidney failure occurred in 16.1% of cases. A binary logistic regression model was used to identify fluid overload (odds ratio [OR]: 1.5; 95% confidence interval [CI]: 1.2-4.9, p = 0.028) and shock for more than 2 days (OR: 1.7; 95% CI: 1.3-6.3, p = 0.039) as independent predictors of kidney failure. In addition, a significant increase in the risk of mortality among children with kidney failure and fluid overload was observed as per the Kaplan-Meier method (p= 0.019). Conclusion. Fluid overload and shock for more than 2 days increase the risk for kidney failure in critically ill children with severe sepsis and septic shock.

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“…Volume overload (defined as a positive weight gain or a positive value of the total input -total output/initial body weight) is commonly encountered in critically ill patients and is associated with poor outcomes including mortality, length of mechanical ventilation and hospital stay [17,18] . The Vasopressin and Septic Shock Trial noted that fluid accumulation values were staggering and ranged from 8 to 30 liters over the first 12 h of ICU care [1] .…”

Section: Fluid Balance and Regulationmentioning

confidence: 99%

Precision Fluid Management in Continuous Renal Replacement Therapy

Murugan

Hoste²,

Mehta³

et al. 2016

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Fluid management during continuous renal replacement therapy (CRRT) in critically ill patients is a dynamic process that encompasses 3 inter-related goals: maintenance of the patency of the CRRT circuit, maintenance of plasma electrolyte and acid-base homeostasis and regulation of patient fluid balance. In this article, we report the consensus recommendations of the 2016 Acute Disease Quality Initiative XVII conference on ‘Precision Fluid Management in CRRT'. We discuss the principles of fluid management, describe various prescription methods to achieve circuit integrity and introduce the concept of integrated fluid balance for tailoring fluid balance to the needs of the individual patient. We suggest that these recommendations could serve to develop the best clinical practice and standards of care for fluid management in patients undergoing CRRT. Finally, we identify and highlight areas of uncertainty in fluid management and set an agenda for future research.

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Associations of fluid overload with mortality and kidney recovery in patients with acute kidney injury: A systematic review and meta-analysis

Cited by 100 publications

References 36 publications

Relationship among Mortality of Patients with Acute Kidney Injury after Cardiac Surgery, Fluid Balance and Ultrafiltration of Renal Replacement Therapy: An Observational Study

Relationship among Mortality of Patients with Acute Kidney Injury after Cardiac Surgery, Fluid Balance and Ultrafiltration of Renal Replacement Therapy: An Observational Study

Fluid overload and kidney failure in children with severe sepsis and septic shock: A cohort study

Precision Fluid Management in Continuous Renal Replacement Therapy

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