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Perioperative fluid balance and acute kidney injury

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Abstract

Background

Positive fluid balance (FB) has been linked to adverse clinical outcomes. We performed this study to explore the relationship between perioperative fluid balance and acute kidney injury (AKI).

Methods

The relationships between FB and AKI were explored using a prospective, observational design. Patients were divided into quartiles based on FB status in the first 24 h from initiation of surgery in order to further explore this relationship.

Results

One hundred adult patients undergoing cardiovascular surgery were included in the analysis. The major finding of the study was that positive FB occurred early in the intraoperative period and progressed into the postoperative period and that fluid administration was not clearly associated with any identifiable volume-sensitive event. The evolution of positive FB preceded the rise in serum creatinine. Progressive severity of positive FB was associated with increased incidence of AKI. The highest quartile FB group had a five-fold increased risk for AKI (adjusted odds ratio 4.98, 95 % confidence interval 1.38–24.10, p = 0.046) compared to the lowest quartile group, higher postoperative peak serum creatinine values (p < 0.001), surgery-related complications (p < 0.001) and intensive care unit (p < 0.001) and hospital length of stay (p = 0.048).

Conclusions

Positive FB was associated with increased incidence of AKI.

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Conflict of interest

The authors do not have any conflicts of interest to declare.

Author information

Authors and Affiliations

  1. Division of Nephrology, Hypertension and Transplantation, University of Florida, P.O. Box 100224, Gainesville, FL, 32610-0224, USA

    Ganesh Kambhampati, Edward A. Ross, Mourad M. Alsabbagh, Uma Pakkivenkata, Amir A. Arif & A. Ahsan Ejaz

  2. Department of Clinical Sciences, University of Central Florida, Orlando, FL, USA

    Abdo Asmar

  3. The College at the University of Chicago, Chicago, IL, USA

    Noel I. Ejaz

Authors
  1. Ganesh Kambhampati
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  2. Edward A. Ross
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  3. Mourad M. Alsabbagh
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  4. Abdo Asmar
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  5. Uma Pakkivenkata
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  6. Noel I. Ejaz
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  7. Amir A. Arif
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  8. A. Ahsan Ejaz
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Corresponding author

Correspondence to A. Ahsan Ejaz.

Additional information

Clinical trials registration information. http://www.clinicaltrial.gov. Unique identifier NCT01168583.

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Kambhampati, G., Ross, E.A., Alsabbagh, M.M. et al. Perioperative fluid balance and acute kidney injury. Clin Exp Nephrol 16, 730–738 (2012). https://doi.org/10.1007/s10157-012-0623-5

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  • DOI: https://doi.org/10.1007/s10157-012-0623-5

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