ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2012
Fluid overload at initiation of renal replacement therapy is associated with lack of renal recovery in patients with acute kidney injury.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 70 papers, 2 of them syntheses that pooled it.
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Who cites it
70 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Kidney Recovery after Acute Kidney Injury: A Comprehensive Review.Cardiorenal medicine · 2025Pooled it
- Interventions to prevent hemodynamic instability during renal replacement therapy in critically ill patients: a systematic review.Critical care (London, England) · 2018Pooled it
- Impact on fluid balance of an optimized restrictive strategy targeting non-resuscitative fluids in intensive care patients with septic shock: a single-blind, multicenter, randomized, controlled, pilot study.Critical care (London, England) · 2024Trial
- Ultrafiltration in the critically ill patient: a framework for personalized care.Critical care (London, England) · 2026Review
- Analysis of factors associated with the initiation of renal replacement therapy in patients on veno-arterial extracorporeal membrane oxygenation: a case-control study.BMC nephrology · 2025Observational
- Proactive Prescription-Based Fluid Management Versus Usual Care in Critically Ill Patients on Kidney Replacement Therapy (Probe-Fluid): A Pilot Clinical Trial Protocol.Canadian journal of kidney health and disease · 2025Article
- Influence of fluid accumulation on major adverse kidney events in critically ill patients - an observational cohort study.Annals of intensive care · 2024Article
- Prospective Study of Ultrasound Markers of Organ Congestion in Critically Ill Patients With Acute Kidney Injury.Kidney international reports · 2024Article
- Current Fluid Management Practice in Critically Ill Adults on Continuous Renal Replacement Therapy: A Binational, Observational Study.Blood purification · 2024Observational
- Capillary leak and endothelial permeability in critically ill patients: a current overview.Intensive care medicine experimental · 2023Review
- Prognostic Value of Natriuretic Peptide Levels for Adverse Renal Outcomes in Patients With Moderate to Severe Acute Kidney Injury With or Without Heart Failure.Journal of the American Heart Association · 2023Review
- Current management of fluid balance in critically ill patients with acute kidney injury: A scoping review.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Risk factors for severe acute kidney injury after pediatric hematopoietic cell transplantation.Pediatric nephrology (Berlin, Germany) · 2023Article
- Measurement of renal congestion and compliance following intravenous fluid administration using shear wave elastography.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2023Article
- Evaluation of Platelet Distribution Width as an Early Predictor of Acute Kidney Injury in Extensive Burn Patients.Emergency medicine international · 2023Article
- Fluid Overload and Precision Net Ultrafiltration in Critically Ill Patients.Cardiorenal medicine · 2023Review
- Assessment of prescribed vs. achieved fluid balance during continuous renal replacement therapy and mortality outcome.PloS one · 2022Article
- Association between Latent Trajectories of Fluid Balance and Clinical Outcomes in Critically Ill Patients with Acute Kidney Injury: A Prospective Multicenter Observational Study.Kidney diseases (Basel, Switzerland) · 2022Article
- Intravenous albumin for the prevention of hemodynamic instability during sustained low-efficiency dialysis: a randomized controlled feasibility trial (The SAFER-SLED Study).Annals of intensive care · 2021Article
- Hemodynamic disturbances and oliguria during continuous kidney replacement therapy in critically ill children.Pediatric nephrology (Berlin, Germany) · 2021Observational
10 more citing papers are in PubMed but not listed here.
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Authors and funding
6 authors.
Funding
Abstract
backgroundPatients with acute kidney injury (AKI) requiring initiation of renal replacement therapy (RRT) have poor short- and long-term outcomes, including the development of dialysis dependence. Currently, little is known about what factors may predict renal recovery in this population.
methodsWe conducted a single-center, retrospective analysis of 170 hospitalized adult patients with AKI attributed to acute tubular necrosis who required inpatient initiation of RRT. Data collection included patient characteristics, laboratory data, details of hospital course and degree of fluid overload at RRT initiation. The primary outcome was recovery of renal function to dialysis independence.
resultsWithin 1 year of RRT initiation, 35.9% (61/170) of patients reached the primary end point of renal recovery. The median (interquartile range) duration of RRT was 11 (3-33) days and 83.6% (51/61) recovered prior to hospital discharge. Recovering patients had significantly less fluid overload at the time of RRT initiation compared to non-recovering patients (3.5 versus 9.3%, P = 0.004). In multivariate Cox proportional hazard regression analysis, a rise in percent fluid overload at dialysis initiation remained a significant negative predictor of renal recovery (hazard ratio 0.97, 95% confidence interval 0.95-1.00, P = 0.024).
conclusionsIn patients with AKI, a higher degree of fluid overload at RRT initiation predicts worse renal recovery at 1 year. Clinical trials are needed to determine whether interventions targeting fluid overload may improve patient and renal outcomes.
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