Positive fluid balance as an early biomarker for acute kidney injury: a prospective study in critically ill adult patients
Clinics
;
76: e1924, 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1153960
ABSTRACT
OBJECTIVES:
Positive fluid balance is frequent in critically ill patients and has been considered a potential biomarker for acute kidney injury (AKI). This study aimed to evaluate positive fluid balance as a biomarker for the early detection of AKI in critically ill patients.METHODS:
This was a prospective cohort study. The sample was composed of patients ≥18 years old who stayed ≥3 days in an intensive care unit. Fluid balance, urinary output and serum creatinine were assessed daily. AKI was diagnosed by the Kidney Disease Improving Global Outcome criteria.RESULTS:
The final cohort was composed of 233 patients. AKI occurred in 92 patients (40%) after a median of 3 (2-6) days following ICU admission. When fluid balance was assessed as a continuous variable, a 100-ml increase in fluid balance was independently associated with a 4% increase in the odds of AKI (OR 1.04; 95% CI 1.01-1.08). Positive fluid balance categorized using different thresholds was always significantly associated with subsequent detection of AKI. The mixed effects model showed that increased fluid balance preceded AKI by 4 to 6 days.CONCLUSION:
These results suggest that a positive fluid balance might be an early biomarker for AKI development in critically ill patients.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Critical Illness
/
Acute Kidney Injury
Type of study:
Observational study
/
Prognostic study
/
Risk factors
/
Screening study
Limits:
Adult
/
Humans
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2021
Type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Departamento de Epidemiologia, Faculdade de Saude Publica, Universidade de Sao Paulo/BR
/
Escola Bahiana de Medicina e Saude Publica/BR
/
LIM 12, Disciplina de Nefrologia, Faculdade de Medicina FMUSP, Universidade de Sao Paulo/BR
/
Medicina Interna e Apoio Diagnostico, Universidade Federal da Bahia/BR
/
Monte Tabor Hospital Sao Rafael/BR
/
Universidade do Estado da Bahia/BR
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