Associations of fluid amount, type, and balance and acute kidney injury in patients undergoing major surgery

Fluid administration has been reported to be associated with an increased risk of acute kidney injury (AKI). We assessed whether, after correction for fluid balance, amount and chloride content of fluids administered have an independent association with AKI. We performed an observational study in pa...

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Bibliographic Details
Published in:Anaesthesia and intensive care 2018-01, Vol.46 (1), p.79-87
Main Authors: Weinberg, L., Li, M. H. G., Churilov, L., Armellini, A., Gibney, M., Hewitt, T., Tan, C. O., Robbins, R., Tremewen, D., Christophi, C., Bellomo, R.
Format: Article
Language:English
Subjects:
Acute Kidney Injury - epidemiology
Adult
Age
Age Factors
Aged
Biochemistry
Care
Chloride
Complications
Female
Flow velocity
Fluid Therapy - methods
Fluid Therapy - statistics & numerical data
Fluids
Health risk assessment
Humans
Infections
Kidney diseases
Kidneys
Male
Middle Aged
Morbidity
Mortality
Patients
Physiology
Risk Factors
Surgery
Surgical Procedures, Operative
Teaching hospitals
Time Factors
Victoria - epidemiology
Water-Electrolyte Balance
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Summary:Fluid administration has been reported to be associated with an increased risk of acute kidney injury (AKI). We assessed whether, after correction for fluid balance, amount and chloride content of fluids administered have an independent association with AKI. We performed an observational study in patients after major surgery assessing the independent association of AKI with volume, chloride content and fluid balance, after adjustment for Physiological and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) score, age, elective versus emergency surgery, and duration of surgery. We studied 542 consecutive patients undergoing major surgery. Of these, 476 patients had renal function tested as part of routine clinical care and 53 patients (11.1%) developed postoperative AKI. After adjustments, a 100 ml greater mean daily fluid balance was artificially associated with a 5% decrease in the instantaneous hazard of AKI: adjusted Hazard Ratio (aHR) 0.951, 95% confidence intervals (CI) 0.935 to 0.967, P
ISSN:0310-057X
1448-0271
DOI:10.1177/0310057X1804600112