Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 24 , ISSUE S3 ( April, 2020 ) > List of Articles

INVITED ARTICLE

Fluid Overload and Acute Kidney Injury

Bindiya G Salunke

Keywords : Acute kidney injury, Fluid movement, Fluid overload, Renal blood flow

Citation Information : Salunke BG. Fluid Overload and Acute Kidney Injury. Indian J Crit Care Med 2020; 24 (S3):94-97.

DOI: 10.5005/jp-journals-10071-23401

License: CC BY-NC 4.0

Published Online: 01-04-2020

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Commonest intervention in hospitalized patient is fluid therapy, and practically every critically ill patient receives fluid resuscitation. Commonest indication for fluid administration is to achieve hemodynamic stability and prevent or manage acute kidney injury (AKI). However, fluid administration is a two-edged sword, i.e., inadequate fluids give rise to hypoperfusion and organ injury and overzealous fluid therapy can give rise to fluid overload and related consequences. Though fluids are commonly given to prevent development of AKI, hypervolemia itself has the potential to cause AKI.


PDF Share
  1. Uchino S, Kellum JA, Bellomo R, Doig GS, Morimatsu H, Morgera S, et al. Beginning and ending supportive therapy for the kidney (BEST kidney) investigators: acute renal failure in critically ill patients: a multinational, multicenter study. JAMA 2005;294(7):813–818. DOI: 10.1001/jama.294.7.813.
  2. Kaufman J, Dhakal M, Patel B, Hamburger R. Community-acquired acute renal failure. Am J Kidney Dis 1991;17(2):191–198. DOI: 10.1016/s0272-6386(12)81128-0.
  3. Ostermann M, Straaten HMO, Forni LG. Fluid overload and acute kidney injury: causes and consequence? Crit Care 2015;19(1):443. DOI: 10.1186/s13054-015-1163-7.
  4. Wang N, Jiang L, Zhu B, Wen Y, Xi XM, The Beijing acute kidney injury trial (BAKIT) workgroup. Fluid balance and mortality in critically ill patients with acute kidney injury: a multicenter prospective epidemiological study. Crit Care 2015;19(1):371. DOI: 10.1186/s13054-015-1085-4.
  5. Alobaidi R, Morgan C, Basu RK, Stenson E, Featherstone R, Majumdar SR, et al. Association between fluid balance and outcomes in critically ill ChildrenA systematic review and Meta-analysis. JAMA Pediatr 2018;172(3):257–268. DOI: 10.1001/jamapediatrics.2017.4540.
  6. Payen D, de Pont AC, Sakr Y, Spies C, Reinhart K, Vincent JL, et al. A positive fluid balance is associated with a worse outcome in patients with acute renal failure. Crit Care 2008;12(3):R74. DOI: 10.1186/cc6916.
  7. Prowle JR, Chua HR, Bagshaw SM, Bellomo R. Clinical review: volume of fluid resuscitation and the incidence of acute kidney injury - a systematic review. Crit Care 2012;16(4):230. DOI: 10.1186/cc11345.
  8. Chappell D, Bruegger D, Potzel J, Jacob M, Brettner F, Vogeser M, et al. Hypervolemia increases release of atrial natriuretic peptide and shedding of the endothelial glycocalyx. Crit Care 2014;18(5):538. DOI: 10.1186/s13054-014-0538-5.
  9. Berg S, Golster M, Lisander B. Albumin extravasation and tissue washout of hyaluronan after plasma volume expansion with crystalloid or hypooncotic colloid solutions. Acta Anaesthesiol Scand 2002;46(2):166–172. DOI: 10.1034/j.1399-6576.2002.460207.x.
  10. Krogh A, Landis EM, Turner AH. The movement of fluid through the human capillary wall in relation to venous pressure and to the colloid osmotic pressure of the blood. J Clin Invest 1932;11(1):63–95. DOI: 10.1172/JCI100408.
  11. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Crit Care Med 2017;45(3):486–552. DOI: 10.1097/CCM.0000000000002255.
  12. Langenberg C, Wan L, Egi M, May CN, Bellomo R. Renal blood flow in experimental septic acute renal failure. Kidney Int 2006;69(11):1996–2002. DOI: 10.1038/sj.ki.5000440.
  13. Langenberg C, Wan L, Egi M, May CN, Bellomo R. Urinary biochemistry in experimental septic acute renal failure. Nephrol Dial Transplant 2006;21(12):3389–3397. DOI: 10.1093/ndt/gfl541.
  14. Salahuddin N, Sammani M, Hamdan A, Joseph M, Al-Nemary Y, Alquaiz R, et al. Fluid overload is an independent risk factor for acute kidney injury in critically ill patients: results of a cohort study. BMC Nephrol 2017;18(1):45. DOI: 10.1186/s12882-017-0460-6.
  15. Malbrain ML, Cheatham ML, Kirkpatrick A, Sugrue M, Parr M, De Waele J, et al. Results from the international conference of experts on intra-abdominal hypertension and abdominal compartment syndrome. I. definitions. Intensive Care Med 2006;32(11):1722–1732. DOI: 10.1007/s00134-006-0349-5.
  16. Sugrue M, Jones F, Deane SA, Bishop G, Bauman A, Hillman K. Intra-abdominal hypertension is an independent cause of postoperative renal impairment. Arch Surg 1999;134(10):1082–1085. DOI: 10.1001/archsurg.134.10.1082.
  17. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P, Acute Dialysis Quality Initiative workgroup. Acute dialysis quality initiative workgroup: acute renal failure - definition, outcome measures, animal models, fluid therapy and information technology needs: the second international consensus conference of the acute dialysis quality initiative (ADQI) group. Crit Care 2004;8(4):R204–R212. DOI: 10.1186/cc2872.
  18. Bradley SE, Bradley GP. The effect of increased intra-abdominal pressure on renal function in man. J Clin Invest 1947;26(5):1010–1022. DOI: 10.1172/JCI101867.
  19. Doty JM, Saggi BH, Sugerman HJ, Blocher CR, Pin R, Fakhry I, et al. Effect of increased renal venous pressure on renal function. J Trauma 1999;47(6):1000–1003. DOI: 10.1097/00005373-199912000-00002.
  20. Winton FR. The influence of venous pressure on the isolated mammalian kidney. J Physiol 1931;72(1):49–61. DOI: 10.1113/jphysiol.1931.sp002761.
  21. Firth JD, Raine AE, Ledingham JG. Raised venous pressure: a direct cause of renal sodium retention in oedema? Lancet 1988;1(8593):1033–1035. DOI: 10.1016/s0140-6736(88)91851-x.
  22. Butcher BW, Kathleen DL. Fluid overload in AKI: epiphenomenon or putative effect on mortality?. current opinion. Crit Care 2012;18:593–598.
  23. Himmelfarb J, McMonagle E, Freedman S, Klenzak J, McMenamin E, Le P, et al. The PICARD group. oxidative stress is increased in critically ill patients with acute renal failure. J Am Soc Nephrol 2004;15(9):2449–2456. DOI: 10.1097/01.ASN.0000138232.68452.3B.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.