Chloride-liberal vs. chloride-restrictive intravenous fluid administration and acute kidney injury: an extended analysis

Purpose In a previous study, restricting intravenous chloride administration in ICU patients decreased the incidence of acute kidney injury (AKI). To test the robustness of this finding, we extended our observation period to 12 months. Methods The study extension included a 1-year control period (18...

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Bibliographic Details
Published in:Intensive care medicine 2015-02, Vol.41 (2), p.257-264
Main Authors: Yunos, Nor’azim Mohd, Bellomo, Rinaldo, Glassford, Neil, Sutcliffe, Harvey, Lam, Que, Bailey, Michael
Format: Article
Language:English
Subjects:
Acute Kidney Injury - chemically induced
Acute Kidney Injury - epidemiology
Acute Kidney Injury - mortality
Analysis
Anesthesiology
Chloride
Chlorides - administration & dosage
Chlorides - adverse effects
Creatinine
Critical Care Medicine
Emergency Medicine
Female
Fluid Therapy - adverse effects
Hospital patients
Humans
Incidence
Infusions, Intravenous
Intensive
Intensive care
Intensive Care Units
Kidney diseases
Length of Stay
Male
Medical research
Medicine
Medicine & Public Health
Medicine, Experimental
Middle Aged
Original
Pain Medicine
Patients
Pediatrics
Physiology
Pneumology/Respiratory System
Prospective Studies
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Summary:Purpose In a previous study, restricting intravenous chloride administration in ICU patients decreased the incidence of acute kidney injury (AKI). To test the robustness of this finding, we extended our observation period to 12 months. Methods The study extension included a 1-year control period (18 August 2007 to 17 August 2008) and a 1-year intervention period (18 February 2009 to 17 February 2010). During the extended control period, patients received standard intravenous fluids. During the extended intervention period, we continued to restrict all chloride-rich fluids. We used the Kidney Disease: Improving Global Outcomes (KDIGO) staging to define AKI. Results We studied 1,476 control and 1,518 intervention patients. Stages 2 and 3 of KDIGO defined AKI decreased from 302 (20.5 %; 95 % CI, 18.5–22.6 %) to 238 (15.7 %; 95 % CI, 13.9–17.6 %) ( P  
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-014-3593-0