Fluid management in patients with acute kidney injury-A post-hoc analysis of the FINNAKI study

Show full item record



Permalink

http://hdl.handle.net/10138/332337

Citation

Inkinen , N , Jukarainen , S , Wiersema , R E , Poukkanen , M , Pettilä , V & Vaara , S T 2021 , ' Fluid management in patients with acute kidney injury-A post-hoc analysis of the FINNAKI study ' , Journal of Critical Care , vol. 64 , pp. 205-210 . https://doi.org/10.1016/j.jcrc.2021.05.002

Title: Fluid management in patients with acute kidney injury-A post-hoc analysis of the FINNAKI study
Author: Inkinen, Nina; Jukarainen, Sakari; Wiersema, Renske E.; Poukkanen, Meri; Pettilä, Ville; Vaara, Suvi T.
Contributor organization: HUS Perioperative, Intensive Care and Pain Medicine
University of Helsinki
Helsinki University Hospital Area
Institute for Molecular Medicine Finland
Anestesiologian yksikkö
Helsinki Institute of Life Science HiLIFE
Department of Diagnostics and Therapeutics
Date: 2021-08
Language: eng
Number of pages: 6
Belongs to series: Journal of Critical Care
ISSN: 0883-9441
DOI: https://doi.org/10.1016/j.jcrc.2021.05.002
URI: http://hdl.handle.net/10138/332337
Abstract: Purpose: Whether positive fluid balance among patients with acute kidney injury (AKI) stems from decreased urine output, overzealous fluid administration, or both is poorly characterized. Materials and methods: This was a post hoc analysis of the prospective multicenter observational Finnish Acute Kidney Injury study including 824 AKI and 1162 non-AKI critically ill patients. Results: We matched 616 AKI (diagnosed during the three first intensive care unit (ICU) days) and non-AKI patients using propensity score. During the three first ICU days, AKI patients received median [IQR] of 11.4 L [8.0-15.2]L fluids and non-AKI patients 10.2 L [7.5-13.7]L, p < 0.001 while the fluid output among AKI patients was 4.7 L [3.0-7.2]L and among non-AKI patients 5.8 L [4.1-8.0]L, p < 0.001. In AKI patients, the median [IQR] cumulative fluid balance was 2.5 L [-0.2-6.0]L compared to 0.9 L [-1.4-3.6]L among non-AKI patients, p < 0.001. Among the 824 AKI patients, smaller volumes of fluid input with a multivariable OR of 0.90 (0.88-0.93) and better fluid output (multivariable OR 1.12 (1.07-1.18)) associated with enhanced change of resolution of AKI. Conclusions: AKI patients received more fluids albeit having lower fluid output compared to matched critically ill non-AKI patients. Smaller volumes of fluid input and higher fluid output were associated with better AKI recovery. (c) 2021 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
Acute kidney injury
Fluid input
Fluid output
Fluid balance
Acute kidney injury recovery
Acute kidney injury
Fluid input
Fluid output
Fluid balance
Acute kidney injury recovery
CRITICALLY-ILL PATIENTS
RENAL REPLACEMENT THERAPY
INTENSIVE-CARE
90-DAY MORTALITY
CARDIAC-SURGERY
RISK-FACTOR
BALANCE
ACCUMULATION
OVERLOAD
RECOVERY
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


Files in this item

Total number of downloads: Loading...

Files Size Format View
1_s2.0_S0883944121000812_main.pdf 464.7Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record