ReviewNature reviews. Nephrology2010
Fluid balance and acute kidney injury.
Review in Nature reviews. Nephrology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 195 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Evaluation of Multimodal Monitoring Technologies in the Peri-operative Care of Cardiac Surgical Patients
Assessment of Portal Flow Using Bedside Doppler Ultrasonography for the Detection of Portal Pulsatility as a Risk Factor for Acute Kidney Injury in Cardiac Surgery Patients
Effectiveness of Fluid Deresuscitation With Central Venous Pressure Target 0-4 mmHg on Capillary Perfusion Density, Acute Kidney Injury Stage, Cardiac Index, and the Intensive Care Unit Length of Stay in Septic Shock Patients After Resuscitation
Who cites it
195 citing papers in PubMed, 4 syntheses or guidelines pooled it, 502 citations in OpenAlex.
- Conservative fluid management or deresuscitation for patients with sepsis or acute respiratory distress syndrome following the resuscitation phase of critical illness: a systematic review and meta-analysis.Intensive care medicine · 2017Pooled it
- Fluid type and the use of renal replacement therapy in sepsis: a systematic review and network meta-analysis.Intensive care medicine · 2015Pooled it
- Pooled it
- Clinical review: Volume of fluid resuscitation and the incidence of acute kidney injury - a systematic review.Critical care (London, England) · 2012Pooled it
- A Pilot Randomized Controlled Trial of Ultrasound Evaluation of Fluid Tolerance for Acute Kidney Injury: USE-the-FORCE-for-AKI Trial.Clinical journal of the American Society of Nephrology : CJASN · 2026Trial
- The Effects of Conservative Fluid Management and Active Deresuscitation on Markers of Tissue Perfusion, Kidney Injury, and Vascular Injury in Critically Ill Adults: A Secondary Analysis of the Role of Active Deresuscitation After Resuscitation-2 (RADAR-2) Trial.Critical care explorations · 2026Trial
- Evaluation of the effects of Plasma-Lyte 148 or 0.9% saline on acid-base balance in patients undergoing neurosurgery: a randomized clinical trial.Einstein (Sao Paulo, Brazil) · 2026Trial
- Fluid balance neutralization secured by hemodynamic monitoring versus protocolized standard of care in patients with acute circulatory failure requiring continuous renal replacement therapy: results of the GO NEUTRAL randomized controlled trial.Intensive care medicine · 2024Trial
- Crystalloid Liberal or Vasopressors Early Resuscitation in Sepsis-Study of Treatment's Echocardiographic Mechanisms (CLOVERS-STEM).Critical care explorations · 2024Trial
- Volume control strategy and patient survival in sepsis-associated acute kidney injury receiving continuous renal replacement therapy: a randomized controlled trial with secondary analysis.Scientific reports · 2024Trial
- Optimizing Fluid Management Guided by Volumetric Parameters in Patients with Sepsis and ARDS.International journal of molecular sciences · 2023Trial
- Fluid balance control in critically ill patients: results from POINCARE-2 stepped wedge cluster-randomized trial.Critical care (London, England) · 2023Trial
- Fluid balance and renal replacement therapy initiation strategy: a secondary analysis of the STARRT-AKI trial.Critical care (London, England) · 2022Trial
- Trial
- Trial
- The Effects of Alternative Resuscitation Strategies on Acute Kidney Injury in Patients with Septic Shock.American journal of respiratory and critical care medicine · 2016Trial
- A pilot study on reparixin, a CXCR1/2 antagonist, to assess safety and efficacy in attenuating ischaemia-reperfusion injury and inflammation after on-pump coronary artery bypass graft surgery.Clinical and experimental immunology · 2015Trial
- Diuretic response to colloid and crystalloid fluid loading in critically ill patients.Journal of nephrology · 2015Trial
- Combining creatinine and volume kinetics identifies missed cases of acute kidney injury following cardiac arrest.Critical care (London, England) · 2013Trial
- Dual Impact of Tolvaptan on Intracellular and Extracellular Water in Chronic Kidney Disease Patients with Fluid Retention.Internal medicine (Tokyo, Japan)Trial
135 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Intravenous fluids are widely administered to patients who have, or are at risk of, acute kidney injury (AKI). However, deleterious consequences of overzealous fluid therapy are increasingly being recognized. Salt and water overload can predispose to organ dysfunction, impaired wound healing and nosocomial infection, particularly in patients with AKI, in whom fluid challenges are frequent and excretion is impaired. In this Review article, we discuss how interstitial edema can further delay renal recovery and why conservative fluid strategies are now being advocated. Applying these strategies in critical illness is challenging. Although volume resuscitation is needed to restore cardiac output, it often leads to tissue edema, thereby contributing to ongoing organ dysfunction. Conservative strategies of fluid management mandate a switch towards neutral balance and then negative balance once hemodynamic stabilization is achieved. In patients with AKI, this strategy might require renal replacement therapy to be given earlier than when more-liberal fluid management is used. However, hypovolemia and renal hypoperfusion can occur in patients with AKI if excessive fluid removal is pursued with diuretics or extracorporeal therapy. Thus, accurate assessment of fluid status and careful definition of targets are needed at all stages to improve clinical outcomes. A conservative strategy of fluid management was recently tested and found to be effective in a large, randomized, controlled trial in patients with acute lung injury. Similar randomized, controlled studies in patients with AKI now seem justified.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.