Fluid Overload May Increase Mortality in Patients with Acute Kidney Injury

2016 ◽  
pp. 157-162
Author(s):  
Ken Parhar ◽  
Vasileos Zochios
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Overload ◽  
Kidney Injury

138 Fluid overload in newborns undergoing abdominal surgery

2021 ◽  
Vol 26 (Supplement_1) ◽  
pp. e96-e97
Author(s):  
Nikoo Niknafs
Keyword(s):  
Acute Kidney Injury ◽  
Body Weight ◽  
Weight Gain ◽  
Abdominal Surgery ◽  
Serum Creatinine ◽  
Fluid Intake ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Ventilator Support ◽  
Post Operation

Abstract Primary Subject area Neonatal-Perinatal Medicine Background Infants undergoing abdominal surgery, particularly those born preterm, are at risk of postoperative fluid overload and acute kidney injury due to immature cardiac and renal functions, which could contribute to increased morbidity and mortality. Objectives The purpose of this study was to evaluate the burden of fluid overload and acute kidney injury among newborns undergoing abdominal surgery and the association with adverse neonatal outcomes. Design/Methods Newborns who had undergone laparotomy from January 2017 to June 2019 admitted to a tertiary level Neonatal Intensive Care Unit were included in this retrospective cohort study. Fluid overload was assessed by the maximum percentage change in body weight and the difference between actual and prescribed fluid intake post-operatively. Acute kidney injury was defined as an increase in serum creatinine >1.5 times of baseline or >26 mmol/L, or oliguria (< 0 .5mL/kg/hr over 24-hour). Results There were 60 eligible infants with medians [IQR] gestational age (GA) and birth weight being 29 weeks [25–36] and 1240 grams [721–2871], respectively. Indications for laparotomy included small bowel obstruction (45%), necrotizing enterocolitis (23%), and large bowel obstruction (11.7%). In the first three post-operative days, 24/60 (40%) required inotropes, 5/59 (8.5%) had hyponatremia (<130 mmol/L), and 15/31(48.4%) developed hypoalbuminemia (<20 g/L). 52/60 (86.7%) infants had serum creatinine measured and 4 (6.7%) fulfilled our AKI criteria. The median of actual fluid intake was significantly higher than the prescribed fluid intake in the first 7 post-operative days (p<0.01) [Figure 1]. Medians [IQR] of maximum % change of body weight within the first 3- and 7-days post operation were 6 [3–13] and 11 [5 –17], respectively. While we did not identify any associations between post-operative fluid overload and mortality/bronchopulmonary dysplasia in this cohort, we found that every 1% increase in weight gain within the first 3 days post-operation were associated with an increase in 0.6 day of invasive ventilator support (p=0.012) [Figure 2]. Such correlation still exists after adjusting for GA (p=0.033). Conclusion In our cohort of newborns undergoing abdominal surgery, weight gain within the first three post-operative days was associated with an increase in duration of invasive ventilator support. Fluid overload does not seem to be associated with acute kidney injury. Careful attention to intra and early postoperative fluid balance may play an important role in optimizing outcomes of newborns undergoing abdominal surgery.

Acute Kidney Injury and Fluid Overload in Pediatric Extracorporeal Cardio-Pulmonary Resuscitation

ASAIO Journal ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Katja M. Gist ◽  
Andrew Misfeldt ◽  
Rashmi D. Sahay ◽  
Stephen M. Gorga ◽  
David J. Askenazi ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Cardio Pulmonary Resuscitation

Pathophysiology of Acute Kidney Injury

2017 ◽  
Author(s):  
Shalini Bumb ◽  
Andrew Malone ◽  
Matthew A. Sparks
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Tissue Perfusion ◽  
Urinary Flow ◽  
Cellular Injury ◽  
Waste Products ◽  
Excretory Function ◽  
Tubular Necrosis ◽  
Vascular Compromise

Acute kidney injury (AKI) is defined as the abrupt loss of kidney excretory function with the accumulation of nitrogenous waste products and fluid overload. The etiologies of AKI are numerous and can largely be classified as prerenal, intrinsic, or postrenal. Complex pathways involving inflammatory mediators, vascular compromise, and direct cellular injury are triggered, and equally as complex pathways, including autophagy and fibrosis, are involved in the recovery. Prerenal azotemia is caused by a reduction in tissue perfusion with resulting AKI. Although acute tubular necrosis is the most common intrinsic etiology, other nephrotoxins and exposures can result in intrinsic injury as well. Postrenal AKI is due to obstruction of urinary flow. Herein, in further detail, the mechanisms, pathophysiology, and manifestations of these causes of AKI are discussed. Research into the mechanisms and development of markers and techniques to advance clinical practice is ongoing.

Early fluid overload is associated with acute kidney injury and PICU mortality in critically ill children

2015 ◽  
Vol 175 (1) ◽  
pp. 39-48 ◽  
Author(s):  
Yanhong Li ◽  
Jian Wang ◽  
Zhenjiang Bai ◽  
Jiao Chen ◽  
Xueqin Wang ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Critically Ill Children ◽  
Early Fluid

Fluid overload in acute kidney injury

2015 ◽  
Author(s):  
Achim Jörres ◽  
Dietrich Hasper ◽  
Michael Oppert
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Intake ◽  
Fluid Overload ◽  
Clinical Signs ◽  
Kidney Injury ◽  
Renal Perfusion ◽  
Daily Basis ◽  
Vasoactive Drugs ◽  
Haemodynamic Parameters ◽  
Poor Outcomes

A central objective in the management of acute kidney injury is the restoration and maintenance of adequate systemic and renal perfusion, often requiring the parallel administration of fluids and vasoactive drugs. However, hypovolaemia and fluid overload may both predispose the patient to complications and poor outcomes. Therefore, body weight and daily fluid intake/output should be recorded, patients should continuously be assessed for clinical signs of under- or over-hydration, and adequate monitoring of haemodynamic parameters should be performed. Together these parameters constitute the basis for individualized fluid therapy that needs to be initiated promptly and should be re-evaluated at least on a daily basis.

Renal

2013 ◽  
Author(s):  
Martin Beed ◽  
Richard Sherman ◽  
Ravi Mahajan
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Resuscitation ◽  
Fluid Balance ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Crush Syndrome ◽  
Careful Attention ◽  
Icu Patients ◽  
Balance Disorders ◽  
Maintenance Fluids

Fluid balance disordersAcute kidney injuryRhabdomyolysis/crush syndromeFluid balance disorders include hypovolaemia (oligaemia), dehydration/acute fluid depletion, and hypervolaemia/fluid overload. Careful attention to fluid balance is essential in ICU. Patients are likely to require ‘maintenance’ fluids in addition to any fluid resuscitation.Hypovolaemia (see also Shock, ...

scholarly journals Acute Kidney Injury, Fluid Overload, and Outcomes in Children Supported With Extracorporeal Membrane Oxygenation for a Respiratory Indication

ASAIO Journal ◽  
2020 ◽  
Vol 66 (3) ◽  
pp. 319-326 ◽  
Author(s):  
Palen P. Mallory ◽  
David T. Selewski ◽  
David J. Askenazi ◽  
David S. Cooper ◽  
Geoffrey M. Fleming ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Extracorporeal Membrane Oxygenation ◽  
Fluid Overload ◽  
Kidney Injury ◽  
Membrane Oxygenation

Fluid overload and acute kidney injury

2010 ◽  
Vol 14 (4) ◽  
pp. 348-354 ◽  
Author(s):  
Preethi YERRAM ◽  
Poorna R. KARUPARTHI ◽  
Madhukar MISRA
Keyword(s):  
Acute Kidney Injury ◽  
Fluid Overload ◽  
Kidney Injury
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