Association of plasma chloride values with acute kidney injury in the critically ill : a prospective observational study

Show full item record



Permalink

http://urn.fi/URN:NBN:fi:hulib-201606092289
Title: Association of plasma chloride values with acute kidney injury in the critically ill : a prospective observational study
Author: Marttinen, Maiju
Other contributor: Helsingin yliopisto, Lääketieteellinen tiedekunta
University of Helsinki, Faculty of Medicine
Helsingfors universitet, Medicinska fakulteten
Publisher: Helsingfors universitet
Date: 2016
Language: eng
URI: http://urn.fi/URN:NBN:fi:hulib-201606092289
http://hdl.handle.net/10138/163644
Thesis level: master's thesis
Discipline: Anaesthesiology and Intensive Care Medicine
Anestesiologia ja tehohoito
Anestesiologi och intensivvård
Abstract: BACKGROUND: Chloride-rich fluids have been found to associate with an increased risk for acute kidney injury (AKI) among intensive care unit (ICU) patients. Studies evaluating the association of plasma chloride (Cl) with the development of AKI are few. We hypothesized that higher plasma Cl is associated with an increased risk for the development of AKI. METHODS: In this sub-study of the prospective FINNAKI study, we analyzed Cl values measured during ICU stay in two ICUs at a tertiary center including 445 patients. We calculated time-weighted mean values within the first 24h in ICU for plasma Cl (ClTWM 24). We analyzed the association of ClTWM 24 primarily with the development of AKI, and secondarily with 90-day mortality. RESULTS: Based on the first measured Cl value, 350 of 445 patients [78.7 (95 CI, 74.8-82.5)] had hyperchloremia (PCl >106 mmol/L) and 48 [10.8 (95 CI, 7.9-13.7)] severe hyperchloremia (P-Cl > 114 mmol/L). Altogether 217 of 445 [48.8% (95% CI 44.2-53.4%)] patients developed AKI. Of these 217, AKI was diagnosed in 62 (28.6%) after 24h from ICU admission and were included in the analysis regarding development of AKI. ClTWM 24 was associated with an increased risk for the development of AKI (OR1.099; 1.003-1.205) after multivariable adjustments. According to ClTWM 24, no difference in 90-day mortality between severely hyperchloremic patients and others existed. CONCLUSIONS: More than three of four critically ill patients had hyperchloremia and one of ten had its severe form. Higher time-weighted mean chloride was independently associated with an increased risk for AKI.
Subject: hyperchloremia
acute kidney injury
intensive care unit


Files in this item

Files Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Show full item record